Zestril Tabs ICI ( Lisinopril )

Description

Zestril contains Lisinopril, a long-acting ACE (Angiotensin-Converting Enzyme) inhibitor manufactured by ICI Pakistan Ltd., that works by competitively inhibiting the ACE enzyme responsible for converting angiotensin I to the potent vasoconstrictor angiotensin II, thereby reducing vasoconstriction, decreasing aldosterone secretion, lowering sodium and water retention, and ultimately reducing both preload and afterload on the heart, resulting in significant and sustained reduction of blood pressure with a convenient once-daily dosing regimen due to its long half-life of approximately 12 hours. Unlike most other ACE inhibitors that are prodrugs requiring hepatic conversion, Lisinopril is a lysine analog of enalaprilat that is pharmacologically active in its absorbed form, does not undergo hepatic metabolism, and is excreted unchanged by the kidneys, making its pharmacokinetics more predictable and consistent across patient populations including those with hepatic impairment. It is indicated for the management of hypertension, congestive heart failure (as adjunctive therapy), acute myocardial infarction (to improve survival when initiated within 24 hours), and diabetic nephropathy where it reduces proteinuria and slows the progression of renal disease through its hemodynamic and non-hemodynamic renoprotective effects, available in strengths of 5mg and 10mg tablets administered once daily with doses titrated up to a maximum of 40mg. A persistent dry cough (due to bradykinin accumulation) is the most characteristic and commonly reported side effect, while angioedema, hyperkalemia, first-dose hypotension, and acute renal failure in patients with bilateral renal artery stenosis represent the most serious adverse effects, and Zestril is strictly contraindicated in pregnancy due to fetotoxicity and in patients with a history of ACE inhibitor-associated angioedema.