page139
tolic blood pressure 100–120 mmHg,
initially 2.5 mg
once daily,
increased to maintenance dose of 5 mg
once daily
Note
Should not
be started after
myocardial
infarction if
systolic blood pressure less than 100 mmHg; temporarily
reduce maintenance dose to 5 mg and if necessary 2.5 mg
daily if systolic blood pressure 100 mmHg or less during
treatment;
withdraw if prolonged hypotension occurs (sys-
tolic blood pressure less than 90 mmHg for more than 1
hour)
. Renal complications of diabetes mellitus, initially 2.5–
5 mg once daily adjusted according to response; usual
dose range 10–20 mg once daily
Lisinopril
(Non-proprietary) A
Tablets,
lisinopril (as dihydrate) 2.5 mg, net price 28-
tab pack = 87p;
5 mg,
28-tab pack = 93p;
10 mg,
28-
tab pack = £1.01;
20 mg,
28-tab pack = £1.19
Zestril
c
(AstraZeneca) A
Tablets
,
lisinopril (as dihydrate) 2.5 mg,
net price 28-
tab pack = £1.78;
5 mg (pink), 28-tab pack = £1.31;
10 mg (pink), 28-tab pack = £2.05;
20 mg (pink),
28-
tab pack = £2.17
With diuretic
Note
For mild to moderate hypertension in patients stabilised
on the individual components in the same proportions.
For
prescribing information on thiazides, see section 2.2.1
Carace Plus
c
(MSD) A
Carace 10 Plus tablets
,
blue,
lisinopril 10 mg,
hydrochlorothiazide 12.5 mg,
net price 28-tab pack =
£10.10
Carace 20 Plus tablets
,
yellow,
scored,
lisinopril
20 mg,
hydrochlorothiazide 12.5 mg,
net price 28-tab
pack = £11.43
Lisicostad
c
(Genus) A
Lisicostad 10/12.5 mg tablets
,
scored,
lisinopril (as
dihydrate) 10 mg,
hydrochlorothiazide 12.5 mg,
net
price 28-tab pack = £10.99
Lisicostad 20/12.5 mg tablets
,
scored,
lisinopril (as
dihydrate) 20 mg,
hydrochlorothiazide 12.5 mg,
net
price 28-tab pack = £11.99
Zestoretic
c
(AstraZeneca) A
Zestoretic 10 tablets
, peach, lisinopril (as dihydrate)
10 mg,
hydrochlorothiazide 12.5 mg,
net price 28-tab
pack = £2.27
Zestoretic 20 tablets
, lisinopril (as dihydrate) 20 mg,
hydrochlorothiazide 12.5 mg,
net price 28-tab pack =
£3.84
MOEXIPRIL HYDROCHLORIDE
Indications
essential hypertension
Cautions
see notes above
Contra-indications
see notes above
Hepatic impairment
see notes above;
initial dose
3.75 mg once daily in hepatic cirrhosis
Renal impairment
see notes above; if eGFR less than
40 mL/minute/1.73 m
2
,
initial dose 3.75 mg once
daily titrated to max.
15 mg once daily
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above;
arrhythmias,
angina,
chest pain,
syncope,
cerebrovascular accident,
myo-
cardial infarction;
appetite and weight changes;
dry
mouth,
photosensitivity,
flushing,
nervousness,
mood
changes,
anxiety,
drowsiness,
sleep disturbance,
tin-
nitus,
influenza-like syndrome,
sweating and dys-
pnoea
Dose
. Monotherapy,
initially 7.5 mg once daily;
if used in
addition to diuretic (see notes above), with nifedipine,
or in elderly,
initially 3.75 mg once daily;
usual range
7.5–30 mg once daily;
doses above 30 mg daily not
shown to increase efficacy
Perdix
c
(UCB Pharma) A
Tablets
,
f/c,
pink, scored,
moexipril hydrochloride
7.5 mg,
net price 28-tab pack = £6.04;
15 mg,
28-tab
pack = £6.96
PERINDOPRIL ERBUMINE
Indications
hypertension (but see notes above);
symptomatic heart failure (adjunct—see section
2.5.5);
prophylaxis of cardiac events following myo-
cardial infarction or revascularisation in stable cor-
onary artery disease
Cautions
see notes above
Contra-indications
see notes above
Hepatic impairment
see notes above
Renal impairment
see notes above;
max.
initial dose
2 mg once daily if eGFR 30–60 mL/minute/1.73 m
2
;
2 mg once daily on alternate days if eGFR 15–30 mL/
minute/1.73 m
2
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above; also asthenia, mood and
sleep disturbances
Dose
. Hypertension, initially 4 mg once daily in the morning
for 1 month,
subsequently adjusted according to
response;
if used in addition to diuretic (see notes
above), in elderly,
in renal impairment,
in cardiac
decompensation, or in volume depletion, initially 2 mg
once daily;
max. 8 mg daily
. Heart failure (adjunct), initially 2 mg once daily in the
morning under close medical supervision (see notes
above), increased after at least 2 weeks to max. 4 mg
once daily if tolerated
. Following myocardial infarction or revascularisation,
initially 4 mg once daily in the morning increased after
2 weeks to 8 mg once daily if tolerated;
ELDERLY
2 mg
once daily for 1 week, then 4 mg once daily for 1 week,
thereafter increased to 8 mg once daily if tolerated
Perindopril
(Non-proprietary) A
Tablets
,
perindopril erbumine (=
tert
-butylamine)
2 mg, net price 30-tab pack = £1.72; 4 mg, 30-tab pack
= £1.81;
8 mg,
30-tab pack = £1.94.
Label:
22
PERINDOPRIL ARGININE
Indications
see under Perindopril Erbumine and notes
above
Cautions
see notes above
Contra-indications
see notes above
Hepatic impairment
see notes above
Renal impairment
see notes above;
max.
initial dose
2.5 mg once daily if eGFR 30–60 mL/minute/1.73 m
2
;
2.5 mg once daily on alternate days if eGFR 15–
30 mL/minute/1.73 m
2
Pregnancy
see notes above
Breast-feeding
see notes above
BNF 61
2.5.5 Drugs affecting the renin-angiotensin system
119
2
Cardiovascular system