Zestril is indicated:

Hypertension:

• For the treatment of hypertension in adult patients and pediatric patients 6 years of age and older to lower blood pressure. Zestril may be administered alone or with other antihypertensive agents.

Heart Failure:

• To reduce signs and symptoms of systolic heart failure.

Reduction of Mortality in Acute Myocardial Infarction:

• For the reduction of mortality in treatment of hemodynamically stable patients within 24 hours of acute myocardial infarction. Patients should receive, as appropriate, the standard recommended treatments such as thrombolytics, aspirin and beta-blockers.

Zestril is not recommended in pediatric patients < 6 years or in pediatric patients with glomerular filtration rate < 30 mL/min/1.73m².

Do not co-administer aliskiren with Zestril in patients with diabetes.

Avoid use of aliskiren with Zestril in patients with renal impairment (GFR <60 ml/min).

Zestril is contraindicated in patients with hereditary or idiopathic angioedema.

Avoid use of Zestril in patients who are hemodynamically unstable after acute MI.

ACE inhibitors have been associated with a higher rate of angioedema in black than in non-black patients.

Angioedema of the face, extremities, lips, tongue, glottis and/or larynx, including some fatal reactions, have occurred in patients treated with angiotensin converting enzyme inhibitors, including Zestril, at any time during treatment. Intestinal angioedema has occurred in patients treated with ACE inhibitors.

Sudden and potentially life threatening anaphylactoid reactions have occurred in some patients dialyzed with high-flux membranes and treated concomitantly with an ACE inhibitor.

Zestril can cause symptomatic hypotension, sometimes complicated by oliguria, progressive azotemia, acute renal failure or death.

ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice or hepatitis and progresses to fulminant hepatic necrosis and sometimes death.

In patients undergoing major surgery or during anesthesia with agents that produce hypotension, Zestril may block angiotensin II formation secondary to compensatory renin release. If hypotension occurs and is considered to be due to this mechanism, it can be corrected by volume expansion.

Zestril is contraindicated in combination with a neprilysin inhibitor (e.g., sacubitril). Do not administer Zestril within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor.

Patients receiving co-administration of ACE inhibitor and mTOR (mammalian target of rapamycin) inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema.

Zestril attenuates potassium loss caused by thiazide-type diuretics. Potassium-sparing diuretics (spironolactone, amiloride,triamterene, and others) can increase the risk of hyperkalemia.

Concomitant administration of Zestril and antidiabetic medicines (insulins, oral hypoglycemic agents) may cause an increased blood-glucose-lowering effect with risk of hypoglycemia.

The antihypertensive effect of ACE inhibitors, including lisinopril, may be attenuated by NSAIDs.

In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including lisinopril, may result in deterioration of renal function, including possible acute renal failure.

Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. In general, avoid combined use of RAS inhibitors.

Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs, which cause elimination of sodium, including ACE inhibitors.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including Zestril.

When pregnancy is detected, discontinue Zestril as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Because of the potential for severe adverse reactions in the breastfed infant, advise women not to breastfeed during treatment with Zestril.

GoToSource

• Use in patients under the age of 6. GoToSource

• Prevention of migraines. GoToSource

• Prevention of onset of type 2 diabetes. GoToSource

• Retinopathy. GoToSource

• Reduction of proteinuria in renal disease. GoToSource

• Prevention of diabetic peripheral neuropathy. GoToSource 

• Mitigation of radiation-induced lung injury. GoToSource

• Cognitive function in hypertensive patients with executive dysfunction. GoToSource

• Idiopathic oligospermia. GoToSource

• Reducing the risk of developing colorectal cancer. GoToSource

Lip angioedema. GoToSource

Intestinal angioedema. GoToSource

Lip cancer. GoToSource

Genital swelling. GoToSource

Pancreatitis (inflammation of the pancreas). GoToSource

Liver damage. GoToSource

Fetal injury and death. GoToSource

Drug-induced lupus. GoToSource

Fatal angioedema. GoToSource

Inappropriate antidiuretic hormone secretion (body makes too much antidiuretic hormone, the hormone that helps kidneys control the amount of water body loses through the urine). GoToSource

Hyperkalemia (high potassium level in blood). GoToSource

Visual hallucinations. GoToSource

Bradycardia (slow heart rate) and hypotension (low blood pressure) when used with tizanidine. GoToSource

Increased serum creatinine and kidney failure. GoToSource

Rash and taste disturbances. GoToSource

Lawsuits filed for liver damage and failure and birth defects.