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In patients with severe congestive heart failure whose renal function may depend on the activity of the renin-angiotensin-aldosterone system, treatment with angiotensin converting enzyme inhibitors, including lisinopril, may be associated with oliguria and/or progressive azotemia and rarely with acute renal failure and/or death. Whether increased levels of bradykinin, a potent vasodepressor peptide, play a role in the therapeutic effects of Zestril remains to be elucidated. Do not coadminister aliskiren with vasotec in patients with diabetes. Ndice, farmacologa editar, el usa lisinopril es el anlogo de lisina del enalapril. Very rarely, fatalities have been reported due to angioedema associated with laryngeal edema or tongue edema. Because lisinopril reduces the production of aldosterone, concomitant therapy with lisinopril attenuates the diuretic-induced potassium loss (see precautions, Drug Interactions, Agents Increasing Serum Potassium ). Coli, sister chromatid exchange with cultured mammalian cells, and the micronucleus test with mice, as well as in an in vivo cytogenic study using mouse bone marrow. Symptomatic Hypotension: Patients should be cautioned to report lightheadedness especially during the first few days of therapy. Enalaprilat is dialyzable at the rate of 62 mL/min. However, the lowest doses studied,.625 mg and.25 mg, corresponding to an average.02 mg/kg once daily, did not appear to offer consistent antihypertensive lisinopril efficacy. Non-Steroidal Anti-Inflammatory Agents In a study in 36 patients with mild to moderate hypertension where the antihypertensive effects of Zestril alone were compared to Zestril given concomitantly with indomethacin, the use of indomethacin was associated with a reduced effect, although. In such patients renal function should be monitored during the first few weeks of therapy. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias. 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