Pharmacy No. 84. Delivery of medicines to your home and office.

The pharmacy is closed on Sundays and holidays.

Medicines

my basket

Apteka84.kz is an online pharmacy that offers its customers medicines, medicinal and decorative cosmetics, dietary supplements, vitamins, baby food, intimate products for adults, medical equipment and thousands of other medical and cosmetic products at low prices. All data presented on the Apteka84.kz website is for informational purposes only and is not a substitute for professional medical care. Apteka84.kz strongly recommends that you carefully read the instructions for use contained in each package of medicines and other products. If you currently have any symptoms of the disease, you should seek help from a doctor. You should always tell your doctor or pharmacist about all the medicines you take. If you feel you need further help, please consult your local pharmacist or contact our GP online or by telephone.

Lisinopril-Teva instructions for use

special instructions

Symptomatic hypotension Most often, a pronounced decrease in blood pressure occurs with a decrease in circulating blood volume (CBV) caused by diuretic therapy, a decrease in sodium chloride in food, dialysis, diarrhea or vomiting.
In patients with chronic heart failure with or without simultaneous renal failure, a pronounced decrease in blood pressure is possible. Under strict medical supervision, Lisinopril should be used in patients with coronary heart disease, cerebrovascular insufficiency, in whom a sharp decrease in blood pressure can lead to myocardial infarction or stroke. Transient arterial hypotension is not a contraindication for taking the next dose of the drug. When using the drug Lisinopril, some patients with chronic heart failure, but with normal or low blood pressure, may experience a decrease in blood pressure, which is usually not a reason to discontinue treatment. Before starting treatment with the drug, if possible, the sodium content should be normalized and/or the blood volume should be replenished, and the effect of the initial dose of Lisinopril on the patient should be carefully monitored. In case of renal artery stenosis (especially with bilateral stenosis or in the presence of stenosis of the artery of a single kidney), as well as with circulatory failure due to a lack of sodium ions and/or fluid, the use of the drug Lisinopril can lead to impaired renal function, acute renal failure, which usually turns out to be irreversible even after discontinuation of the drug. In case of acute myocardial infarction, the use of standard therapy (thrombolytics, acetylsalicylic acid, beta-blockers) is indicated. Lisinopril can be used in conjunction with intravenous administration or with the use of therapeutic transdermal nitroglycerin systems. Surgery/general anesthesia During major surgical procedures, as well as when using other drugs that cause a decrease in blood pressure, Lisinopril, by blocking the formation of angiotensin II, can cause a pronounced, unpredictable decrease in blood pressure. In elderly patients, the same dose leads to a higher concentration of the drug in the blood, so special care is required when determining the dose. Since the potential risk of agranulocytosis cannot be excluded, periodic monitoring of the blood picture is required. When using the drug under dialysis conditions with polyacrylic-nitrile membranes, anaphylactic shock may occur, so either a different type of dialysis membrane or the prescription of other antihypertensive drugs is recommended.

Effect on the ability to drive vehicles and machines There is no data on the effect of the drug Lisinopril on the ability to drive vehicles and machines, used in therapeutic doses, however, it must be taken into account that at the beginning of treatment, arterial hypotension may develop, which can affect the ability to drive vehicles and working with potentially dangerous machinery, and may cause dizziness and drowsiness, so caution should be exercised.

Lisinopril-Teva 10 mg tbl N20

Lisinopril -Teva - instructions for use
Trade name of the drug: Lisinopril -Teva
International nonproprietary name: lisinopril

Dosage form: tablets

Composition: 1 tablet contains: active substance: lisinopril dihydrate (lisinopril) - 2.73 mg (2.50 mg); 5.46 mg (5.00 mg); 10.92 mg (10.00 mg); 21.84 mg (20.00 mg); excipients: pregelatinized starch (12.00/12.00/12.00/12.00 mg), corn starch (40.00/40.00/40.00/40.00 mg), calcium hydrogen phosphate (anhydrous) (93.07/90.34/84.88/73.96 mg), mannitol (70.00/70.00/70.00/70.00 mg), magnesium stearate (2.20/2.20/ 2.20/2.20 mg).

DescriptionTablets 2.5 mg: Biconvex, oval, white tablets.

On one side there is an engraving LSN 2.5.
5 mg tablets: White, oval, biconvex tablets. On one side there is an engraving LSN 5, on the other there is a dividing line. Tablets 10 mg: Biconvex, oval, white tablets. On one side there is an engraving LSN 10, on the other there is a dividing line. Tablets 20 mg: Biconvex, oval, white tablets. On one side there is an engraving LSN 20, on the other there is a dividing line. Pharmacotherapeutic group: angiotensin-converting enzyme inhibitor ATX code: C09AA03
Pharmacological properties Pharmacodynamics.

An angiotensin-converting enzyme (ACE) inhibitor, reduces the formation of angiotensin II from angiotensin I. A decrease in angiotensin II leads to a direct decrease in the release of aldosterone.
Reduces the degradation of bradykinin and increases the synthesis of prostaglandins. Reduces total peripheral vascular resistance (TPVR), blood pressure (BP), preload, pressure in the pulmonary capillaries, causes an increase in minute blood volume and an increase in myocardial load tolerance in patients with chronic heart failure. Dilates arteries more than veins. Some effects have been attributed to effects on the renin-angiotensin-aldosterone system (RAAS). With long-term use, hypertrophy of the myocardium and the walls of resistive arteries decreases. Improves blood supply to ischemic myocardium. ACE inhibitors extend life expectancy in patients with chronic heart failure (CHF) and slow the progression of left ventricular dysfunction in patients who have suffered acute myocardial infarction without clinical manifestations of heart failure. The onset of action of the drug is after 1 hour, the maximum antihypertensive effect is achieved after 6-7 hours and lasts for 24 hours. The duration of the effect also depends on the size of the dose taken. In case of arterial hypertension, the effect is observed in the first days after the start of treatment, a stable effect develops after 1-2 months. therapy. When lisinopril was abruptly discontinued, no significant increase in blood pressure was observed. Lisinopril reduces albuminuria. Does not affect the concentration of glucose in the blood in patients with diabetes and does not lead to an increase in cases of hypoglycemia. Pharmacokinetics Absorption.
After oral administration, lisinopril is absorbed from the gastrointestinal tract (GIT) by an average of 25%, but absorption can vary from 6 to 60%.
Bioavailability is 29%. The maximum concentration in blood plasma (Cmax) is reached after 7 hours. Food intake does not affect the absorption of lisinopril. Distribution. Lisinopril is slightly bound to plasma proteins. Permeability through the blood-brain and placental barrier is low. Metabolism. Lisinopril is not biotransformed in the body. Excretion. It is excreted unchanged by the kidneys. The half-life (T1/2) is 12.6 hours. The clearance of lisinopril is 50 ml/min. The decrease in serum concentration of lisinopril occurs in two phases. The bulk of lisinopril is eliminated during the initial alpha phase (effective T1/2 12 hours), followed by a terminal late beta phase (about 30 hours). Pharmacokinetics in certain groups of patients: In patients with CHF, absorption and clearance of lisinopril are reduced, bioavailability is 16%. In patients with renal failure (creatinine clearance (CC) less than 30 ml/min), the concentration of lisinopril is several times higher than the concentration in the blood plasma of healthy volunteers, and there is an increase in the time to reach Cmax in the plasma blood and an increase in T1/2. In elderly patients, the concentration of the drug in the blood plasma and the area of the concentration-time curve are 2 times greater than in young patients. In patients with liver cirrhosis, the bioavailability of lisinopril is reduced by 30% and clearance by 50% compared to patients with normal liver function. In elderly patients, the concentration of lisinopril in the blood is increased by an average of 60%. Indications for use
Arterial hypertension (in monotherapy or in combination with other antihypertensive drugs).
Chronic heart failure (as part of combination therapy). Early treatment of acute myocardial infarction (in the first 24 hours with stable hemodynamic parameters to maintain these parameters and prevent left ventricular dysfunction and heart failure). Diabetic nephropathy (decreased albuminuria in patients with type 1 diabetes mellitus with normal blood pressure, and in patients with type 2 diabetes mellitus with arterial hypertension). Contraindications Hypersensitivity to lisinopril, other components of the drug or other ACE inhibitors;
history of angioedema (including from the use of other ACE inhibitors);
hereditary angioedema and/or idiopathic angioedema; age under 18 years (efficacy and safety have not been established); pregnancy and breastfeeding period. With caution: Bilateral renal artery stenosis or stenosis of the artery of a single kidney with progressive azotemia;
condition after kidney transplantation; renal failure; hemodialysis using high-flow dialysis membranes (AN69); azotemia; hyperkalemia; aortic stenosis; hypertrophic obstructive cardiomyopathy; primary hyperaldosteronism; arterial hypotension; cerebrovascular diseases (including cerebrovascular insufficiency);
coronary heart disease (CHD); coronary insufficiency; autoimmune connective tissue diseases (including scleroderma, systemic lupus erythematosus); inhibition of bone marrow hematopoiesis; conditions accompanied by a decrease in circulating blood volume (CBV) (including as a result of diarrhea, vomiting); use in patients on a salt-restricted diet; in elderly patients; simultaneous use with potassium preparations, diuretics, other antihypertensive drugs, non-steroidal anti-inflammatory drugs (NSAIDs), lithium preparations, antacids, cholestyramine, ethanol, insulin, other hypoglycemic drugs, allopurinol, procainamide, gold preparations, neuroleptics, tricyclic antidepressants, barbiturates, beta adrenergic blockers, slow calcium channel blockers. Use during pregnancy and breastfeeding The use of Lisinopril-Teva during pregnancy is contraindicated.
If pregnancy is diagnosed, the drug should be stopped as soon as possible.
Taking ACE inhibitors in the second and third trimesters of pregnancy has an adverse effect on the fetus (a marked decrease in blood pressure, renal failure, hyperkalemia, hypoplasia of the skull bones, and intrauterine death are possible). There is no data on the negative effect of the drug on the fetus when used in the first trimester. For newborns and infants who have been exposed in utero to ACE inhibitors, it is recommended to conduct careful monitoring for timely detection of a pronounced decrease in blood pressure, oliguria, and hyperkalemia. There is no data on the penetration of lisinopril into breast milk. If it is necessary to use the drug Lisinopril-Teva during lactation, breastfeeding should be discontinued. Method of administration and dosage The drug Lisinopril-Teva is taken orally 1 time per day, regardless of the time of meal, preferably at the same time of day.
The dose is selected individually.
For arterial hypertension, patients not receiving other antihypertensive drugs are prescribed 5 mg per day. In the absence of a therapeutic effect, the dose is increased every 2-3 days by 5 mg to a dose of 20-40 mg/day (increasing the dose above 40 mg/day usually does not lead to a further decrease in blood pressure). The average daily maintenance dose is 20 mg. The maximum daily dose is 40 mg. The therapeutic effect usually develops within 2-4 weeks from the start of treatment, which should be taken into account when increasing the dose. If the effect is insufficient, simultaneous use of the drug with other antihypertensive drugs is possible. If the patient has received prior treatment with diuretics, then these drugs must be stopped 2-3 days before starting the use of Lisinopril-Teva. If this is not possible, then the initial dose of Lisinopril-Teva should not exceed 5 mg per day. In this case, after taking the first dose, medical supervision is recommended for several hours (the maximum effect is achieved after approximately 6 hours), since a pronounced decrease in blood pressure may occur. In case of renovascular hypertension associated with increased activity of the RAAS, it is also advisable to use a low initial dose of 2.5 mg per day over time, under enhanced medical supervision (monitoring blood pressure, renal function, potassium levels in the blood serum). The maintenance dose, while continuing strict medical supervision, should be determined depending on the dynamics of blood pressure. For chronic heart failure, the initial dose is 2.5 mg per day, the dose is gradually increased (by no more than 10 mg, with an interval of at least 2 weeks) depending on blood pressure. The maximum daily dose is 20 mg. In the early treatment of acute myocardial infarction, the dose is 5 mg on the first day, then 5 mg every other day, 10 mg after two days and then 10 mg per day as maintenance therapy. In patients with acute myocardial infarction, the drug should be used for at least 6 weeks. At the beginning of treatment or during the first 3 days after myocardial infarction in patients with low systolic blood pressure (120 mm Hg or lower), a lower dose of Lisinopril-Teva is used - 2.5 mg. If systolic blood pressure is less than or equal to 100 mm Hg. The use of Lisinopril-Teva is not recommended. With concomitant renal failure (creatinine clearance less than 80 ml/min.), an appropriate dose adjustment of the drug should be made. For diabetic nephropathy in patients with type 1 diabetes mellitus, the drug Lisinopril-Teva is used at a dose of 10 mg per day. If necessary, the dose can be increased to 20 mg per day in order to achieve diastolic blood pressure below 75 mm Hg. Art. in a sitting position. For patients with type 2 diabetes mellitus, Lisinopril-Teva is used at the same dose in order to achieve diastolic blood pressure below 90 mm Hg. in a sitting position. CC (ml/min.) Initial dose (mg/day) 30-80 5-10 10-29 2.5-5 less than 10 (including patients on hemodialysis) 2.5 For renal failure and in patients on hemodialysis, the initial dose is set depending on QC. The maintenance dose is determined depending on blood pressure (under the control of renal function, potassium and sodium levels in the blood) Side effects The most common side effects: dizziness, headache, fatigue, diarrhea, dry cough, nausea.
The incidence of side effects is classified according to the recommendations of the World Health Organization: very often - at least 10%;
often - at least 1%, but less than 10%; infrequently - not less than 0.1%, but less than 1%; rarely - not less than 0.01%, but less than 0.1%; very rarely - less than 0.01%. From the cardiovascular system: often - marked decrease in blood pressure, orthostatic hypotension; uncommon - acute myocardial infarction, tachycardia, palpitations; Raynaud's syndrome; rarely - bradycardia, tachycardia, worsening of symptoms of CHF, impaired atrioventricular conduction, chest pain. From the central nervous system: often - dizziness, headache; uncommon - mood lability, paresthesia, sleep disturbances, stroke; rarely - confusion, asthenic syndrome, convulsive twitching of the muscles of the limbs and lips, drowsiness. From the hematopoietic and lymphatic systems: rarely - decrease in hemoglobin, hematocrit; very rarely - leukopenia, neutropenia, agranulocytosis, thrombocytopenia, eosinophilia, erythropenia, hemolytic anemia, lymphadenopathy, autoimmune diseases, suppression of bone marrow function. From the respiratory system: often - cough, infrequently - rhinitis, very rarely - sinusitis, bronchospasm, allergic alveolitis/eosinophilic pneumonia, shortness of breath. From the digestive system: often - diarrhea, vomiting; uncommon - dyspepsia, taste changes, abdominal pain; rarely - dryness of the oral mucosa; very rarely - pancreatitis, jaundice (hepatocellular or cholestatic), hepatitis, liver failure, intestinal edema, anorexia. From the skin: infrequently - itching, rash; rarely - angioedema of the face, limbs, lips, tongue, larynx, urticaria, alopecia, psoriasis; very rarely - increased sweating, vasculitis, pemphigus, photosensitivity, toxic epidermal necrolysis (Lyell's syndrome), erythema multiforme, Stevens-Johnson syndrome. From the urinary system: often - impaired renal function; uncommon - uremia, acute renal failure; very rarely - anuria, oliguria, proteinuria. From the reproductive system: infrequently - impotence, rarely - gynecomastia. Metabolic disorders: very rarely - hypoglycemia. From laboratory parameters: infrequently - increased concentration of urea in the blood, hypercreatininemia, hyperkalemia, increased activity of liver transaminases, rarely - hyperbilirubinemia, hyponatremia, increased erythrocyte sedimentation rate, false positive test results for antinuclear antibodies. From the musculoskeletal system: rarely - arthralgia/arthritis, myalgia. Other: rarely - when used simultaneously with gold preparations intravenously, a symptom complex has been described, including facial flushing, nausea, vomiting and decreased blood pressure (see section Interactions with other drugs). Overdose Symptoms: marked decrease in blood pressure, dryness of the oral mucosa, water-electrolyte imbalance, renal failure, increased breathing, tachycardia, palpitations, bradycardia, dizziness, anxiety, increased irritability, cough, drowsiness, urinary retention, constipation, collapse, hyperventilation of the lungs.
Treatment: there is no specific antidote.
Gastric lavage, use of enterosorbents and laxatives. Intravenous administration of 0.9% sodium chloride solution is indicated. In case of treatment-resistant bradycardia, the use of an artificial pacemaker is necessary. Monitoring of blood pressure and water and electrolyte balance is necessary. Hemodialysis is effective. Interaction with other drugs. Lisinopril should be used with caution simultaneously with potassium-sparing diuretics (spironolactone, triamterene, amiloride, eplerenone), potassium supplements, salt substitutes containing potassium, cyclosporine - the risk of hyperkalemia increases, especially with impaired renal function. Therefore, these combinations should be used only on the basis of an individual physician’s decision with regular monitoring of serum potassium levels and renal function. When used simultaneously with diuretics and other antihypertensive drugs, the antihypertensive effect of lisinopril is enhanced. When used simultaneously with NSAIDs (including selective cyclooxygenase-2 (COX-2) inhibitors), acetylsalicylic acid at a dose of more than 3 g/day, estrogens, and sympathomimetics, the antihypertensive effect of lisinopril is reduced. NSAIDs, including COX-2, and ACE inhibitors increase serum potassium and may impair renal function. This effect is usually reversible. Lisinopril slows down the elimination of lithium preparations, therefore, with simultaneous use, there is a reversible increase in its concentration in the blood plasma, which may increase the likelihood of adverse events, so the concentration of lithium in the blood serum should be regularly monitored. When used simultaneously with antacids and cholestyramine, the absorption of lisinopril from the gastrointestinal tract is reduced. Ethanol enhances the effect of lisinopril. When used simultaneously with insulin and oral hypoglycemic agents, the risk of developing hypoglycemia increases. With simultaneous use of lisinopril with vasodilators, barbiturates, antipsychotics (neuroleptics), tricyclic antidepressants, slow calcium channel blockers, beta blockers, the antihypertensive effect may be enhanced. With the simultaneous use of ACE inhibitors and intravenous gold preparations (sodium aurothiamalate), a symptom complex has been described, including facial flushing, nausea, vomiting and decreased blood pressure. Combined use with allopurinol, procainamide, and cytostatics can lead to leukopenia. Special instructions Most often, a pronounced decrease in blood pressure occurs with a decrease in blood volume caused by diuretic therapy, a decrease in the content of sodium chloride in food, dialysis, diarrhea or vomiting.
Under the supervision of a physician, it is recommended to use the drug Lisinopril-Teva in patients with coronary artery disease, cerebrovascular insufficiency, in whom a sharp decrease in blood pressure can lead to myocardial infarction or stroke.
The use of the drug Lisinopril-Teva can lead to impaired renal function, acute renal failure, which is usually irreversible even after discontinuation of the drug. Transient arterial hypotension is not a contraindication for further use of the drug. In case of renal artery stenosis (especially with bilateral stenosis or in the presence of stenosis of the artery of a single kidney), as well as with peripheral circulatory failure resulting from hyponatremia and hypovolemia, the use of the drug Lisinopril-Teva can lead to impaired renal function, acute renal failure, which usually turns out to be irreversible after discontinuation of the drug. The drug Lisinopril-Teva can be used simultaneously with standard therapy for acute myocardial infarction (thrombolytics, acetylsalicylic acid as an antiplatelet agent, beta-blockers). The drug Lisinopril-Teva can be used simultaneously with intravenous administration of nitroglycerin or with the use of therapeutic transdermal nitroglycerin systems. The use of Lisinopril-Teva is not recommended in patients who have suffered acute myocardial infarction if systolic blood pressure does not exceed 100 mmHg. Art. During surgical interventions, as well as when using other drugs that cause a decrease in blood pressure, lisinopril, by blocking the formation of angiotensin II, can cause a pronounced, unpredictable decrease in blood pressure. Before surgery (including dental surgery), the surgeon/anesthetist should be informed about the use of an ACE inhibitor. In elderly patients, the use of standard doses leads to higher concentrations of the drug in the blood, so special care is required when determining the dose, despite the fact that no differences in the antihypertensive effect of Lisinopril-Teva were identified in elderly and young patients. Since the potential risk of agranulocytosis cannot be excluded, periodic monitoring of peripheral blood is required. Angioedema of the face, extremities, lips, tongue, epiglottis and/or larynx, which may occur during any period of treatment, has rarely been reported in patients taking an ACE inhibitor, including lisinopril. In this case, treatment with the drug should be stopped as soon as possible, and the patient should be monitored until symptoms completely regress. Angioedema with laryngeal edema can be fatal. Swelling of the tongue, epiglottis or larynx can cause airway obstruction, so appropriate therapy (0.3-0.5 ml of 1:1000 epinephrine (adrenaline) solution subcutaneously) and/or measures to ensure airway patency should be immediately carried out. In cases where the swelling is localized only on the face and lips, the condition most often goes away without treatment, but the use of antihistamines is possible. ACE inhibitors are more likely to cause the development of angioedema in patients of the Black race than in representatives of other races. The risk of developing angioedema is increased in patients who have a history of angioedema not associated with previous treatment with ACE inhibitors. In extremely rare cases, patients taking ACE inhibitors during desensitization to hymenoptera venom may develop life-threatening anaphylactoid reactions. This can be avoided if you temporarily stop treatment with the ACE inhibitor before each desensitization procedure on the hymenopter. Anaphylactoid reactions are also noted in patients on hemodialysis using high -flow dialysis membranes (AN69), who simultaneously take ACE inhibitors. In such cases, the use of a different type of dialysis membrane or another antihypertensive agent should be considered. In patients receiving hypoglycemic drugs for oral administration and insulin, during the first month of therapy, ACE inhibitors should regularly monitor blood glucose. Very rarely, when using ACE inhibitors, a syndrome was observed, which began with cholestatic jaundice and progressed to the fulminant necrosis of the liver, sometimes with death. The mechanism of development of this syndrome is unknown. When jaundice appears against the background of the use of the drug Lizinopril -Tev or a pronounced increase in the activity of liver transaminases, the drug can be canceled and observations of the patient's condition are observed. When using ACE inhibitors, a cough was noted. The cough is dry and prolonged, which disappears after stopping treatment with an ACE inhibitor. In the differential diagnosis of cough, cough caused by the use of an ACE inhibitor must also be taken into account. The impact on the ability to drive vehicles and mechanisms should be careful when taking Lizinopril -Teva due to the fact that it is possible to develop arterial hypotension, dizziness and drowsiness, which can affect the ability to drive vehicles and work with potentially dangerous mechanisms. Output form 2.5 mg;
5 mg; 10 mg; 20 mg. Dosage tablets 2.5 mg: 10 tablets to a blister from al./ PVC.
3 blisters, along with instructions for use in a pack of cardboard. Tablets with a dosage of 5 mg: 10 tablets to a blister from al./ PVC. 1 or 3 blisters, along with instructions for the use of cardboard in a pack. Tablets with a dosage of 10 mg: 10 tablets to a blister from al./ PVC. 1, 2 or 3 blisters along with instructions for use in a pack of cardboard. Tablets with a dosage of 20 mg: 10 tablets to a blister from al./ PVC. 1, 2 or 3 blisters along with instructions for use in a pack of cardboard. Storage conditions at a temperature of not higher than 25 C.
Store inaccessible places for children!
Shelf life2 of the year.
Do not use after expiration date.
Conditions for the vacation from the pharmacy recipe.
The appearance of the product may differ from the photographs on the website.

Information about medications posted on the site is intended for specialists and includes materials from publications from different years. The information provided on the site is general and is presented for informational purposes only, does not replace consultation with a doctor and cannot serve as a guarantee of the positive effect of the drug. Tvoyaapteka.rf warns you about possible negative consequences that may arise as a result of incorrect use of the information presented on the site and strongly recommends that you consult with a specialist before choosing a drug.

You can find detailed and up-to-date instructions for the drug on the website of the State Register of Medicines www.grls.rosminzdrav.ru.

Lisinopril-teva

Most often, a pronounced decrease in blood pressure occurs when there is a decrease in blood volume caused by diuretic therapy, a decrease in the content of sodium chloride in food, dialysis, diarrhea or vomiting. Under the supervision of a physician, it is recommended to use the drug Lisinopril-Teva in patients with coronary artery disease, cerebrovascular insufficiency, in whom a sharp decrease in blood pressure can lead to myocardial infarction or stroke. The use of the drug Lisinopril-Teva can lead to impaired renal function, acute renal failure, which is usually irreversible even after discontinuation of the drug. Transient arterial hypotension is not a contraindication for further use of the drug.

In case of renal artery stenosis (especially with bilateral stenosis or in the presence of stenosis of the artery of a single kidney), as well as with peripheral circulatory failure resulting from hyponatremia and hypovolemia, the use of the drug Lisinopril-Teva can lead to impaired renal function, acute renal failure, which usually turns out to be irreversible after discontinuation of the drug.

The drug Lisinopril-Teva can be used simultaneously with standard therapy for acute myocardial infarction (thrombolytics, acetylsalicylic acid as an antiplatelet agent, beta-blockers).

The drug Lisinopril-Teva can be used simultaneously with intravenous administration of nitroglycerin or with the use of therapeutic transdermal nitroglycerin systems.

The use of Lisinopril-Teva is not recommended in patients who have suffered acute myocardial infarction if systolic blood pressure does not exceed 100 mm Hg. During surgical interventions, as well as when using other drugs that cause a decrease in blood pressure, lisinopril, by blocking the formation of angiotensin II, can cause a pronounced, unpredictable decrease in blood pressure. Before surgery (including dental surgery), the surgeon/anesthetist should be informed about the use of an ACE inhibitor.

In elderly patients, the use of standard doses leads to higher concentrations of the drug in the blood, so special care is required when determining the dose, despite the fact that no differences in the antihypertensive effect of Lisinopril-Teva were identified in elderly and young patients.

Since the potential risk of agranulocytosis cannot be excluded, periodic monitoring of peripheral blood is required.

Angioedema of the face, extremities, lips, tongue, epiglottis and/or larynx, which may occur during any period of treatment, has rarely been reported in patients taking an ACE inhibitor, including lisinopril. In this case, treatment with the drug should be stopped as soon as possible, and the patient should be monitored until symptoms completely regress. Angioedema with laryngeal edema can be fatal. Swelling of the tongue, epiglottis or larynx can cause airway obstruction, so appropriate therapy (0.3-0.5 ml of 1:1000 epinephrine (adrenaline) solution subcutaneously) and/or measures to ensure airway patency should be immediately carried out. In cases where the swelling is localized only on the face and lips, the condition most often goes away without treatment, but the use of antihistamines is possible. ACE inhibitors are more likely to cause the development of angioedema in patients of the Black race than in representatives of other races. The risk of developing angioedema increases in patients who have a history of angioedema not associated with previous treatment with ACE inhibitors. In extremely rare cases, patients taking ACE inhibitors during desensitization to hymenoptera venom may develop life-threatening anaphylactoid reactions. This can be avoided by temporarily stopping ACE inhibitor treatment before each Hymenoptera desensitization procedure. Anaphylactoid reactions have also been observed in patients on hemodialysis using high-flow dialysis membranes (AN69®) who are also taking ACE inhibitors. In such cases, the use of a different type of dialysis membrane or another antihypertensive agent should be considered. In patients receiving oral hypoglycemic agents and insulin, blood glucose should be regularly monitored during the first month of ACE inhibitor therapy.

Very rarely, when using ACE inhibitors, a syndrome was observed that began with cholestatic jaundice and progressed to fulminant liver necrosis, sometimes with death. The mechanism of development of this syndrome is unknown. If jaundice appears during the use of the drug Lisinopril-Teva or a marked increase in the activity of “liver” transaminases, the drug is discontinued and the patient’s condition is monitored.

Cough has been reported when using ACE inhibitors. The cough is dry and prolonged, which disappears after stopping treatment with an ACE inhibitor. In the differential diagnosis of cough, cough caused by the use of an ACE inhibitor must also be taken into account.

Impact on the ability to drive vehicles and operate machinery

Caution should be exercised when taking the drug Lisinopril-Teva due to the fact that arterial hypotension, dizziness and drowsiness may develop, which can affect the ability to drive vehicles and work with potentially dangerous mechanisms.