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If the diuretic cannot be discontinuedan initial dose of 5 mg should be used under medical supervision for at least 2 hours and until blood pressure has stabilized for at least an additional hoursee WarningsHypotension and PrecautionsDrug Interactions
Congestive Heart FailureLisinopril is to be used in conjunction with a diuretic and where appropriate digitalisTherapy must be initiated under close medical supervisionusually in a hospitalBlood pressure and renal function should be monitoredboth before and during treatment with lisinoprilbecause severe hypotension andmore rarelyconsequent renal failure have been reportedsee WarningsHypotension and PrecautionsRenal Impairment
PharmacokineticsFollowing oral administration sale prinivil lisinoprilpeak serum concentrations of lisinopril occur within about 7 hoursDeclining serum concentrations exhibit a prolonged terminal phase which does not contribute to drug accumulationThis terminal phase probably represents saturable binding to ACE and is not proportional to doseLisinopril does not bind serum proteins other than ACE.
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