Read all of this leaflet carefully before you start taking this medicine. Keep this leaflet. You may want to read it again. If you have further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you personally and you should not pass it on to others. It may harm them, even if their symptoms are the same as yours.
Composition
Each tablet contains:
5 mg or 10 mg or 20 mg Lisinopril.
Properties
Lisinopril is an ACE inhibitor. It works by widening blood vessels, which helps reduce your blood pressure and makes it easier for your heart to pump blood to all parts of your body. This helps reduce raised blood pressure. It can also help the heart to work better if the heart does not pump as well as is needed.
Indications
“Zestril” is indicated for you if:
- Your blood pressure is too high (hypertension).
- You have a heart condition known as symptomatic heart failure, where the heart does not pump your blood around your body as well as it should.
- You have had a heart attack (myocardial infarction) that may lead to a weakening of your heart. Zestril slows the weakening down.
- You have kidney problems related to your diabetes and high blood pressure.
Contraindications
Do not take Zestril:
- If you have previously been treated with a medicine in the same group of drugs as Zestril (ACE inhibitors) and have had an allergic reaction which caused swelling of the hands, feet or ankles, face , lips, tongue and/or throat with difficulty in swallowing or breathing or if you or a member of your family have had a similar reaction.
- If you have ever had allergic reaction to Zestril.
If you are not sure whether to start taking Zestril, talk to your doctor.
TAKE SPECIAL CARE WITH ZESTRIL
Tell your doctor if you have or have had any medical condition, especially the following:
* A narrowing of the aorta (aortic stenosis) ,the kidney artery (renal artery stenosis) or the heart
valves (mitral valve stenosis), or an increase in the thickness of the heart muscle (hypertrophic
cardiomyopathy, 'HOCM').
* Other health problems such as:
- Low blood pressure (you may notice this as dizziness or light-headedness especially when standing).
- Kidney disease or you are undergoing dialysis.
- Liver disease
- Blood vessel disease (collagen vascular disease).
- Diarrhea or vomiting.
- A salt-restricted diet or you are taking potassium supplements.
Tell your doctor if you are undergoing /or will undergo desensitization treatment for an allergy, for example, to insect stings. The desensitization treatment reduces the effects of the allergy (e.g. bee or wasps stings) but sometimes it can cause a more severe allergic reaction if you are taking ACE inhibitors during desensitization treatment.
Tell your doctor if you are going into hospital for an operation. Tell your doctor or dentist that you are taking Zestril before your are given a local or general anaesthetic. Zestril ,combined with some anaesthetics, may cause a short-term drop in blood pressure soon after taking the tablets.
Do not give Zestril to children under 18 years. There is limited information on the safety and effectiveness of Zestril in children.
Stop taking Zestril and seek medical attention immediately if any of the following situations occur:
* If you develop difficulty in breathing with or without swelling of the face, lips, tongue and/or throat.
* If you develop swelling of the face, lips, tongue and/or throat which may cause difficulty in swallowing.
* If you develop severe itching of the skin (with raised lumps).
Pregnancy and breast-feeding
Tell your doctor if you are pregnant or intend to become pregnant. Zestril must not be taken during pregnancy. Tell your doctor if you are breast-feeding or intend to breast-feed. Zestril should not be used whilst breast-feeding.
Drug Interactions
Tell your doctor if you are taking or have recently taken any other medicines, including herbal remedies, health foods or supplements that you have bought yourself. This also applies to medicines used some time ago. Some medicines may affect the actions of the other medicines.
Talk to your doctor if you are taking any of the following medicines:
- Diuretics (water tablets including those which conserve potassium)
- Other medicines for your high blood pressure (antihypertensives)
- Non-steroidal anti-inflammatory medicines (NSAIDs) such as indomethacin and high doses of aspirin (more
than 3 grams perday), which are used to treat arthritis or muscle pain
- Medicines for mental disorders such as lithium, antipsychotics or tricyclic antidepressants
- Potassium tablets or potassium-containing salt substitutes
- Medicines for the treatment of diabetes, such as insulin or those taken orally, to lower blood sugar
- Medicines that stimulate the central nervous system (sympathomimetics). These include ephedrine,
pseudoephedrine and salbutamol and may be found in some decongestants, cough/cold remedies and asthmamedication
- Medicines that suppress the body's immune response (immunosuppressants), treatment with allopurinol (for
gout) or procainimide (for abnormal heart beats)
Driving and using machines
Your tablets are unlikely to affect your ability to drive or operate machinery. However, you should not perform tasks which require special attention until you know how your medicine will affect you.
Administration and Dosage
Your doctor will tell you how many tablets to take each day. The dosage is individual and it is important that you take it as prescribed by your doctor. You must keep taking ”Zestril” even if you are feeling well, because regular treatment is most effective. Your starting dose and long-term dose will depend on your medical condition and whether you are taking any other medicines.Check with your doctor or pharmacist if you are not sure.
- For raised blood pressure: The usual recommended starting dose is 10 mg taken once a day.
The usual longterm dose is 20 mg taken once a day .
- For symptomatic heart failure: The usual recommended starting dose is 2.5 mg taken once a day. The usual long – term dose is 5 to 35 mg taken once a day.
- After a heart attack: The usual recommended starting dose is 5 mg on day 1 and day 2, then 10 mg once a day.
- For problems related to diabetes: The usual dose is either 10 mg or 20 mg taken once a day.
- Swallow the tablets with a drink of water.
- Try to take your tablets at the same time each day. It does not matter if you take Zestril before or after food
- Do not stop taking your tablets if you are feeling well, unless your doctor tells you
- Remember, the first dose of Zestril may cause a greater fall in blood pressure than will occur following continued treatment. You may notice this as dizziness or light-headedness and it may help to lie down. If concerned, please consult your doctor as soon as possible
- If you have the impression that the effect of Zestril is too strong or too weak, talk to your doctor or pharmacist as soon as possible.
- If you miss a dose, just carry on with the next dose when it is due. Do not take an extra tablet to make up.
- contact your doctor or nearest hospital immediately, if you have taken more than you should (overdose).
Side Effects
Like all medicines, Zestril can cause side effects. Do not be alarmed by this list of possible side effects, you may not have any of them. Most patients do not notice any side effects. However if you do and they bother you, talk to your doctor.
Common side effects that may occur :Headache, dizziness or light-headedness especially when standing up quickly, diarrhea, cough, vomiting.
Zestril may affect the kidneys, causing low or no urine to be passed.
Uncommon side effects that may occur: Mood changes, change of colour (pale blue followed by redness) and/or numbness or tingling in the fingers or toes, changes in the way things taste, feeling sleepy or difficulty in going to sleep, strange dreams, rapid heart beat, running nose, nausea, stomach pain or indigestion, skin rash, itching, impotence, tiredness, weakness (loss of strength).
An excessive drop in blood pressure may be experienced in patients with coronary heart disease, or those with a narrowing of the aorta (aortic stenosis), the kidney artery (renal artery stenosis) or the heart valves (mitral valve stenosis), or those patients with an increase in the thickness of the heart muscle (hypertrophic cardiomyopathy).
Rare side effects that may occur: Allergic reactions.
Rarely, there may be changes to some of the cells or other parts of your blood. It is possible that your doctor may occasionally take blood samples to check whether Zestril has had any effect on your blood.
Sometimes these changes may show themselves as tiredness or a sore throat, or they may be accompanied by a fever, joint and muscle pains, swelling of the joints or glands, or sensitivity to sunlight.
Other rare side effects are: Confusion, dry mouth, hair loss, psoriasis, development of breast in men.
Very rare side effects that may occur : Sinus pain, wheezing, inflammation of the lungs, yellow skin and/or eyes (Jaundice), inflammation of the liver or pancreas, severe skin disorders (symptoms of which include redness, blistering and peeling), sweating.
Tell your doctor if you have any side effects that are not mentioned in this leaflet.
Storing Zestril
Store your tablets in a cool and dry place , at a temperature below 25oC .
Keep your tablets in the container they came in.
Keep your tablets in a safe place where children cannot see or reach them. Your tablets may harm them.
Do not take your tablets after the expiry date found on the container.
Packing
Zestril 5 20 - 28 tablets
Zestril 10 20 - 28 tablets
Zestril 20 10 - 20 tablets