Zestril

High Blood Pressure (Hypertension)

Zestril is primarily prescribed to treat high blood pressure in adults and children who are at least 6 years old. It can be used alone or in combination with other blood pressure medications. Managing hypertension helps reduce the risk of serious complications, such as strokes and heart attacks.

Heart Failure

This medication is used as an adjunctive therapy for heart failure. When used with other treatments like diuretics and digitalis, it helps the heart pump blood more effectively and can improve the symptoms of the condition.

Heart Attack Recovery

Zestril is used in the early treatment of patients who have recently suffered a heart attack (acute myocardial infarction). When started within 24 hours of the event, it can help improve survival rates and reduce the risk of further heart complications.

How Zestril Works

Zestril belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by interfering with the body's production of a chemical that causes blood vessels to tighten.

By blocking this chemical, Zestril helps the body achieve the following:

• Relaxes blood vessels: The medication allows blood vessels to widen, which reduces the resistance the heart faces when pumping blood.
• Lowers blood pressure: Wider blood vessels lead to a decrease in blood pressure levels.
• Improves blood flow: With less resistance, blood and oxygen can reach the heart and other organs more easily.

For individuals with heart failure, this process reduces the overall workload on the heart muscle. When used after a heart attack, Zestril helps improve survival by reducing the strain on the heart as it recovers.

Common Side Effects

Some people taking Zestril may experience mild side effects. These often improve as the body adjusts to the medication. Common symptoms include:

• A dry, persistent cough
• Dizziness or lightheadedness, especially when standing up quickly
• Headache
• Fatigue or unusual tiredness
• Nausea or diarrhea
• Sneezing or runny nose
• Decreased sexual ability

Serious Side Effects

Contact a healthcare provider immediately or seek emergency care if you experience any of the following serious symptoms:

• Angioedema: Swelling of the face, throat, tongue, lips, eyes, or extremities
• Difficulty breathing or swallowing
• Hoarseness
• Fainting
• High potassium levels: Symptoms may include muscle weakness or a slow, irregular heartbeat
• Liver problems: Yellowing of the skin or eyes (jaundice), dark urine, or pain in the upper right stomach area
• Kidney issues: A significant change in the amount or frequency of urination
• Infection: Fever, chills, or a persistent sore throat

Fetal Toxicity

Zestril can cause serious injury or death to a developing fetus. Use of this medication during the second and third trimesters of pregnancy is particularly dangerous. If pregnancy is detected, the medication should be stopped as soon as possible.

Angioedema and Severe Allergic Reactions

Zestril may cause angioedema, which is a rapid swelling of the face, lips, tongue, throat, or extremities. This condition can be life-threatening if it obstructs the airway. These reactions can occur at any time during treatment. Research indicates that Black patients may have a higher risk of experiencing angioedema while taking ACE inhibitors.

Hypotension (Low Blood Pressure)

Excessive low blood pressure can occur, especially after the first dose or when the dosage is increased. This risk is higher for individuals who are volume-depleted, such as those taking high-dose diuretics, those on a salt-restricted diet, or those undergoing dialysis.

Kidney and Liver Function

Changes in kidney function may occur during treatment, particularly in patients with pre-existing renal disease or severe heart failure. Additionally, rare but serious liver problems have been reported. Treatment should be discontinued if jaundice (yellowing of the skin or eyes) or significant elevations in liver enzymes develop.

Hyperkalemia

Increased levels of potassium in the blood (hyperkalemia) may occur. This is more likely in patients with kidney impairment, diabetes, or those using potassium supplements or potassium-sparing diuretics.

Contraindications

Zestril should not be used in patients with:

• A history of angioedema related to previous treatment with an ACE inhibitor.
• Hereditary or idiopathic angioedema.
• Co-administration with neprilysin inhibitors (such as sacubitril).
• Diabetes, if also taking medications containing aliskiren.

Pregnancy

Zestril carries a boxed warning because it can cause severe injury or death to a developing fetus. This risk is highest when the medication is taken during the second and third trimesters of pregnancy. Potential complications for the baby include:

• Kidney failure
• Low blood pressure
• Underdevelopment of the skull
• Death

If you are planning to become pregnant or discover you are pregnant while taking Zestril, you should stop the medication and contact your doctor as soon as possible to discuss alternative treatments for high blood pressure.

Breastfeeding

It is currently unknown whether Zestril passes into human breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the medication to the mother. Consult with a healthcare professional to evaluate the risks and benefits of breastfeeding while using this medication.

Dosage Forms

Zestril is provided as a tablet for oral administration. It is typically taken by mouth once a day.

While the active ingredient, lisinopril, is available in other formulations such as an oral solution, the Zestril brand specifically refers to the tablet form. The tablets are produced in various shapes and colors to help identify different versions of the medication.

FDA Approval and Indications

Zestril (lisinopril) was first approved by the U.S. Food and Drug Administration (FDA) in 1987. It is currently approved for the following indications:

• Treatment of hypertension (high blood pressure) in adults and pediatric patients 6 years of age and older.
• Adjunctive therapy in the management of heart failure in patients not responding adequately to diuretics and digitalis.
• Reduction of mortality in hemodynamically stable patients within 24 hours of an acute myocardial infarction (heart attack).

Boxed Warning

The FDA requires a boxed warning for Zestril regarding fetal toxicity. Drugs that act directly on the renin-angiotensin system can cause injury and death to a developing fetus. When pregnancy is detected, Zestril should be discontinued as soon as possible.

Safety Communications

The FDA has issued safety communications regarding the use of ACE inhibitors like Zestril in combination with aliskiren-containing medications. This combination is contraindicated in patients with diabetes and should generally be avoided in patients with moderate to severe kidney impairment due to increased risks of kidney failure, hypotension (low blood pressure), and hyperkalemia (high potassium levels).

Generic vs. Brand Name Cost

Zestril is the brand name for the medication lisinopril. Generic versions of drugs are required to have the same active ingredients and effectiveness as the brand-name version but are usually available at a significantly lower price. Most insurance plans and Medicare Part D programs prioritize coverage for generic lisinopril over brand-name Zestril.

Factors Affecting Price

The actual amount you pay for Zestril or lisinopril can depend on several factors, including:

• Insurance Coverage: Your specific health insurance plan, including your deductible and copayment requirements, will determine your out-of-pocket costs.
• Pharmacy Selection: Prices may differ between local retail pharmacies, mail-order pharmacies, and large chain stores.
• Dosage and Quantity: The strength of the prescription (such as 5 mg, 10 mg, or 20 mg) and the number of tablets dispensed per fill will impact the total cost.

Financial Assistance

For individuals without insurance or those with high out-of-pocket costs, there may be options to reduce the price of the medication. Many pharmacies offer discount programs or savings cards that can be used in place of insurance. Additionally, because lisinopril is a common medication, it is often included in low-cost generic drug programs at various retail pharmacies.