Zestril 20mg Tablets
1. What Zestril is and what it is used for
2. What you need to know before you take Zestril
3. How to take Zestril
Package leaflet: Information for the patient Zestril® 20mg Tablets
(lisinopril)
Your medicine is known as the above but will be referred to as Zestril throughout the remainder of this leaflet.
This product is available in multiple strengths and all strengths will be referred to throughout this leaflet.
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist.
This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Zestril is and what it is used for
2. What you need to know before you take Zestril
3. How to take Zestril
4. Possible side effects
5. How to store Zestril
6. Contents of the pack and other information
Zestril contains a medicine called lisinopril. This belongs to a group of medicines called ACE inhibitors.
Zestril can be used for the following conditions:
• To treat high blood pressure (hypertension).
• To treat heart failure.
• If you have recently had a heart attack (myocardial infarction).
• To treat kidney problems caused by Type II diabetes in people with high blood pressure.
Zestril works by making your blood vessels widen. This helps to lower your blood pressure.
It also makes it easier for your heart to pump blood to all parts of your body.
Do not take Zestril:
• if you are allergic to lisinopril or any of the other ingredients of this medicine (listed in section 6).
• if you have ever had an allergic reaction to another ACE inhibitor medicine. The allergic reaction may have caused swelling of the hands, feet, ankles, face, lips, tongue or throat. It may also have made it difficult to swallow or breathe (angioedema).
• if a member of your family has had severe allergic reactions (angioedema) to an ACE inhibitor or you have had severe allergic reactions (angioedema) without a known cause.
• if you are more than 3 months pregnant. (It is also better to avoid Zestril in early pregnancy - see Pregnancy section).
• if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.
If you are not sure if any of these apply to you, talk to your doctor or
pharmacist before taking Zestril.
If you develop a dry cough which is persistent for a long time after starting treatment with Zestril, talk to your doctor.
Warnings and precautions
Talk to your doctor or pharmacist before taking Zestril:
• if you have a narrowing (stenosis) of the aorta (an artery in your heart) or a narrowing of the heart valves (mitral valves).
• if you have a narrowing (stenosis) of the kidney artery.
• if you have an increase in the thickness of the heart muscle (known as hypertrophic cardiomyopathy).
• if you have problems with your blood vessels (collagen vascular disease).
• if you have low blood pressure. You may notice this as feeling dizzy or light-headed, especially when standing up.
• if you have kidney problems or you are having kidney dialysis.
• if you have liver problems.
• if you have diabetes.
• if you are taking any of the following medicines used to treat high blood pressure:
- an angiotensin II receptor blocker (ARBs) (also known as sartans - for example valsartan, telmisartan, irbesartan), in particular if you have diabetes-related kidney problems
- aliskiren.
Your doctor may check your kidney function, blood pressure and the amount of electrolytes (e.g. potassium) in your blood at regular intervals. See also information under the heading “Do not take Zestril”.
• if you have recently had diarrhoea or vomiting (being sick).
• if your doctor has told you to control the amount of salt in your diet.
• if you have high levels of cholesterol and you are having a treatment called 'LDL apheresis'.
• you must tell your doctor if you think you are (or might become) pregnant. Zestril is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see Pregnancy section).
• if you are of black origin as Zestril may be less effective. You may also more readily get the side effect 'angioedema' (a severe allergic reaction).
If you are not sure if any of these apply to you, talk to your doctor or
pharmacist before taking Zestril.
Treatment for allergies such as insect stings
Tell your doctor if you are having or are going to have treatment to lower the effects of an allergy such as insect stings (desensitisation treatment). If you take Zestril while you are having this treatment, it may cause a severe allergic reaction.
Operations
If you are going to have an operation (including dental surgery) tell your doctor or dentist that you are taking Zestril. This is because you can get low blood pressure (hypotension) if you are given certain local or general anaesthetics while you are taking Zestril.
Children and adolescents
Zestril has been studied in children. For more information, talk to your doctor. Zestril is not recommended in children under 6 years of age or in any child with severe kidney problems.
Other medicines and Zestril
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. This is because Zestril can affect the way some medicines work and some medicines can have an effect on Zestril. Your doctor may need to change your dose and/or to take other precautions.
In particular, tell your doctor or pharmacist if you are taking any of the following medicines:
• Other medicines to help lower your blood pressure.
• An angiotensin II receptor blocker (ARB) or aliskiren, (see also information under the headings “Do not take Zestril” and “Warnings and precautions”).
• Water tablets (diuretic medicines).
• Medicines to break up blood clots (usually given in hospital).
• Beta-blocker medicines, such as atenolol and propranolol.
• Nitrate medicines (for heart problems).
• Non-steroidal anti-inflammatory drugs (NSAIDs) used to treat pain and arthritis.
• Aspirin (Acetylsalicylic acid), if you are taking more than 3 grams each day.
• Medicines for depression and for mental problems, including lithium.
• Potassium tablets or salt substitutes that have potassium in them.
• Insulin or medicines that you take by mouth for diabetes.
• Medicines used to treat asthma.
• Medicines to treat nose or sinus congestion or other cold remedies (including those you can buy in the pharmacy).
• Medicines to suppress the body's immune response (immunosuppressants).
• Allopurinol (for gout).
• Procainamide (for heart beat problems).
• Medicines that contain gold, such as sodium aurothiomalate, which may be given to you as an injection.
Pregnancy and breast-feeding Pregnancy:
You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Zestril before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Zestril. Zestril is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.
Breast-feeding:
Tell your doctor if you are breast-feeding or about to start breast-feeding. Zestril is not recommended for mothers who are breastfeeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.
Driving and using machines
• Some people feel dizzy or tired when taking this medicine. If this happens to you, do not drive or use any tools or machines.
• You must wait to see how your medicine affects you before trying these activities.
Always take this medicine exactly as your doctor has told you.
Check with your doctor or pharmacist if you are not sure.
Once you have started taking Zestril your doctor may take blood
tests. Your doctor may then adjust your dose so you take the right
amount of medicine for you.
Taking your medicine
• Swallow the tablet 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.
• Keep taking Zestril for as long as your doctor tells you to, it is a long term treatment. It is important to keep taking Zestril every day.
Taking your first dose
• Take special care when you have your first dose of Zestril or if your dose is increased. It may cause a greater fall in blood pressure than later doses.
• This may make you feel dizzy or lightheaded. If this happens, it may help to lie down. If you are concerned, please talk to your doctor as soon as possible.
