{"id":58400,"date":"2024-02-27T18:32:26","date_gmt":"2024-02-27T18:32:26","guid":{"rendered":"https:\/\/medsname.com\/angiotensin\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"angiotensin","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/angiotensin\/","title":{"rendered":"Angiotensin"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">&#9889; Quick Answer &mdash; What is Angiotensin?<\/h3>\n<p style=\"margin:0;\"><strong>Angiotensin<\/strong> je <strong>5 \/ 10 mg lisinopril tablet<\/strong> od v\u00fdrobce s certifikac\u00ed WHO-GMP \u2014 <strong>inhibitor angiotenzin konvertuj\u00edc\u00edho enzymu (ACE)<\/strong>. ACE inhibitory jsou <strong>l\u00e9\u010dba hypertenze prvn\u00ed volby<\/strong> ve v\u011bt\u0161in\u011b mezin\u00e1rodn\u00edch sm\u011brnic (NICE, AHA\/ACC, ESC\/ESH), zejm\u00e9na pro pacienty mlad\u0161\u00ed 55 let a pro diabetiky, pacienty se srde\u010dn\u00edm selh\u00e1n\u00edm, pacienty po infarktu myokardu a pacienty s proteinurickou ledvinnou chorobou. Lisinopril je <strong>aktivn\u00ed l\u00e9\u010div\u00e1 l\u00e1tka<\/strong> \u2014 na rozd\u00edl od jin\u00fdch ACE inhibitor\u016f lisinopril NEN\u00cd prol\u00e9\u010divo, nevy\u017eaduje jatern\u00ed p\u0159em\u011bnu a je vylu\u010dov\u00e1n ledvinami v nezm\u011bn\u011bn\u00e9 podob\u011b. To jej \u010din\u00ed u\u017eite\u010dn\u00fdm p\u0159i jatern\u00edm posti\u017een\u00ed, kde prol\u00e9\u010div\u00e9 ACE inhibitory (ramipril, enalapril, perindopril) maj\u00ed nep\u0159edv\u00eddatelnou aktivaci s polo\u010dasem 12 hodin; d\u00e1vkov\u00e1n\u00ed jednou denn\u011b. Typick\u00e1 d\u00e1vka pro hypertenzi: <strong>za\u010dn\u011bte s 10 mg jednou denn\u011b (5 mg u star\u0161\u00edch pacient\u016f, pacient\u016f s ren\u00e1ln\u00edm posti\u017een\u00edm nebo hypovol\u00e9mi\u00ed), upravte na 10-40 mg jednou denn\u011b<\/strong>. Hlavn\u00ed vedlej\u0161\u00ed \u00fa\u010dinek: <strong>such\u00fd p\u0159etrv\u00e1vaj\u00edc\u00ed ka\u0161el<\/strong> (a\u017e u 20 % u\u017eivatel\u016f, t\u0159\u00eddn\u00ed \u00fa\u010dinek; pokud je nesnesiteln\u00fd, p\u0159ej\u00edt na ARB jako je <a href=\"https:\/\/medsbase.com\/cs\/losar\/\">losartan<\/a> nebo <a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">telmisartan<\/a>). Dal\u0161\u00ed t\u0159\u00eddn\u00ed \u00fa\u010dinky: hyperkalemie, hypotenze po prvn\u00ed d\u00e1vce, reverzibiln\u00ed vzestup kreatininu na za\u010d\u00e1tku l\u00e9\u010dby. <strong>Absolutn\u011b kontraindikov\u00e1n v t\u011bhotenstv\u00ed<\/strong> (v\u0161echna trimestra \u2014 zp\u016fsobuje fet\u00e1ln\u00ed ren\u00e1ln\u00ed agenezi, oligohydramnion, plicn\u00ed hypopl\u00e1zii, defekty lebky), bilater\u00e1ln\u00ed sten\u00f3zu ren\u00e1ln\u00edch tepen a anamn\u00e9zu ACE-inhibitor-indukovan\u00e9ho angioed\u00e9mu.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">What Is Angiotensin?<\/h2>\n<p>Angiotensin is an oral 5 \/ 10 mg lisinopril tablet from a WHO-GMP certified manufacturer, supplied in 30-180 tablets. Introduced 1987 as <strong>Prinivil \/ Zestril<\/strong> (Merck \/ AstraZeneca). Odvozen od enalapril\u00e1tu; jedin\u00fd \u0161iroce pou\u017e\u00edvan\u00fd ACE inhibitor bez sulfhydrylov\u00e9 skupiny a neprol\u00e9\u010divo.<\/p>\n<p>Lisinopril je <strong>aktivn\u00ed l\u00e9\u010div\u00e1 l\u00e1tka<\/strong> \u2014 na rozd\u00edl od jin\u00fdch ACE inhibitor\u016f lisinopril NEN\u00cd prol\u00e9\u010divo, nevy\u017eaduje jatern\u00ed p\u0159em\u011bnu a je vylu\u010dov\u00e1n ledvinami v nezm\u011bn\u011bn\u00e9 podob\u011b. To jej \u010din\u00ed u\u017eite\u010dn\u00fdm p\u0159i jatern\u00edm posti\u017een\u00ed, kde prol\u00e9\u010div\u00e9 ACE inhibitory (ramipril, enalapril, perindopril) maj\u00ed nep\u0159edv\u00eddatelnou aktivaci, s polo\u010dasem 12 hodin; d\u00e1vkov\u00e1n\u00ed jednou denn\u011b.<\/p>\n<h2 class=\"wp-block-heading\">Jak lisinopril sni\u017euje krevn\u00ed tlak<\/h2>\n<p>ACE inhibitory blokuj\u00ed <strong>angiotensin konvertuj\u00edc\u00ed enzym<\/strong>, kter\u00fd katalyzuje p\u0159em\u011bnu neaktivn\u00edho angiotensinu I na aktivn\u00ed angiotensin II. Angiotensin II je siln\u00fd vazokonstriktor a hlavn\u00ed stimul pro uvol\u0148ov\u00e1n\u00ed aldosteronu z nadledvin. Blokov\u00e1n\u00ed jeho tvorby zp\u016fsobuje:<\/p>\n<ul>\n<li><strong>P\u0159\u00edmou vazodilataci tepen<\/strong> \u2014 sn\u00ed\u017een\u00fd syst\u00e9mov\u00fd c\u00e9vn\u00ed odpor = ni\u017e\u0161\u00ed krevn\u00ed tlak<\/li>\n<li><strong>Sn\u00ed\u017eenou sekreci aldosteronu<\/strong> \u2014 men\u0161\u00ed retenci sod\u00edku a vody v ledvin\u00e1ch<\/li>\n<li><strong>Sn\u00ed\u017een\u00e9 p\u0159edt\u00ed\u017een\u00ed<\/strong> (\u017eiln\u00ed + m\u00edrn\u00e9 odleh\u010den\u00ed komor) \u2014 zvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00e9 p\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed<\/li>\n<li><strong>Akumulaci bradykininu<\/strong> \u2014 ACE tak\u00e9 degraduje bradykinin; blokov\u00e1n\u00ed ACE zvy\u0161uje hladiny bradykininu, co\u017e zesiluje vazodilataci (a zp\u016fsobuje vedlej\u0161\u00ed \u00fa\u010dinek such\u00e9ho ka\u0161le u ~20 % u\u017eivatel\u016f)<\/li>\n<li><strong>Sn\u00ed\u017eenou aktivaci sympatick\u00e9ho nervov\u00e9ho syst\u00e9mu<\/strong><\/li>\n<li><strong>Zlep\u0161en\u00ed endoteli\u00e1ln\u00ed funkce<\/strong> a sn\u00ed\u017een\u00e9 ventrikul\u00e1rn\u00ed remodelaci \u2014 zodpov\u011bdn\u00e9 za vaskul\u00e1rn\u011b-protektivn\u00ed \u00fa\u010dinky pozorovan\u00e9 ve studi\u00edch (HOPE, EUROPA), kter\u00e9 p\u0159esahuj\u00ed pouh\u00e9 sn\u00ed\u017een\u00ed krevn\u00edho tlaku<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Hypertenze<\/strong> \u2014 prim\u00e1rn\u00ed indikace, prvn\u00ed volba dle doporu\u010den\u00ed NICE, ESC\/ESH a AHA\/ACC pro v\u011bt\u0161inu dosp\u011bl\u00fdch do 55 let a pro v\u0161echny v\u011bkov\u00e9 kategorie s diabetem, CKD nebo srde\u010dn\u00edm selh\u00e1n\u00edm<\/li>\n<li><strong>Srde\u010dn\u00ed selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed (HF-REF)<\/strong> \u2014 d\u016fkazy o mortalit\u011b p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch z studie ATLAS<\/li>\n<li><strong>Sekund\u00e1rn\u00ed prevence po IM<\/strong> \u2014 studie GISSI-3 a ISIS-4<\/li>\n<li><strong>Diabetick\u00e1 nefropatie<\/strong> (s hypertenz\u00ed i bez n\u00ed)<\/li>\n<li><strong>Preferov\u00e1no u pacient\u016f s jatern\u00edm posti\u017een\u00edm<\/strong> (nen\u00ed t\u0159eba aktivace v j\u00e1trech)<\/li>\n<\/ul>\n<p><strong>Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> Studie ATLAS (1999) \u2014 vysok\u00e1 d\u00e1vka lisinoprilu (35 mg\/den) vs. n\u00edzk\u00e1 d\u00e1vka (5 mg\/den) u HF-REF; vysok\u00e1 d\u00e1vka sn\u00ed\u017eila mortalitu a hospitalizaci, \u010d\u00edm\u017e stanovila princip c\u00edlov\u00e9 d\u00e1vky pro terapii ACE inhibitory u HF. GISSI-3 (1994) \u2014 sn\u00ed\u017een\u00ed mortality po IM p\u0159i zah\u00e1jen\u00ed do 24 hodin.<\/p>\n<h2 class=\"wp-block-heading\">Angiotensin Dosage<\/h2>\n<p><strong>Hypertenze:<\/strong><\/p>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> 10 mg jednou denn\u011b (5 mg u star\u0161\u00edch pacient\u016f, p\u0159i ren\u00e1ln\u00edm posti\u017een\u00ed nebo hypovol\u00e9mii)<\/li>\n<li><strong>C\u00edlov\u00e1 d\u00e1vka:<\/strong> 10-40 mg jednou denn\u011b<\/li>\n<li><strong>Maxim\u00e1ln\u00ed d\u00e1vka:<\/strong> 40 mg jednou denn\u011b<\/li>\n<li>Titrujte ka\u017ed\u00e9 2\u20134 t\u00fddny podle odpov\u011bdi krevn\u00edho tlaku a sn\u00e1\u0161enlivosti<\/li>\n<\/ul>\n<p><strong>Srde\u010dn\u00ed selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed (HF-REF):<\/strong> Za\u010dn\u011bte s 2,5-5 mg jednou denn\u011b; titrujte na 20-35 mg jednou denn\u011b (c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed dle studie ATLAS)<\/p>\n<p><strong>Po infarktu myokardu:<\/strong> 5 mg v 1. dni po IM, 10 mg 2. den, pot\u00e9 10 mg jednou denn\u011b po dobu 6 t\u00fddn\u016f<\/p>\n<p><strong>Precauce p\u0159i prvn\u00ed d\u00e1vce:<\/strong> hypotenze po prvn\u00ed d\u00e1vce je nejpravd\u011bpodobn\u011bj\u0161\u00ed u pacient\u016f na vysok\u00fdch d\u00e1vk\u00e1ch diuretik, u dehydratovan\u00fdch pacient\u016f, u srde\u010dn\u00edho selh\u00e1n\u00ed a u star\u0161\u00edch pacient\u016f. Prvn\u00ed d\u00e1vku u\u017eijte p\u0159ed span\u00edm; monitorujte TK; pokud mo\u017eno vynechejte diuretika 24\u201348 hodin p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby.<\/p>\n<p><strong>Monitorov\u00e1n\u00ed:<\/strong><\/p>\n<ul>\n<li>V\u00fdchoz\u00ed vy\u0161et\u0159en\u00ed: mo\u010dovina, elektrolyty (zejm\u00e9na drasl\u00edk), kreatinin, eGFR. Zaznamenejte v\u00fdchoz\u00ed hodnoty krevn\u00edho tlaku.<\/li>\n<li>Po 1\u20132 t\u00fddnech: opakujte U&amp;E. O\u010dek\u00e1van\u00e9 \u00fa\u010dinky: m\u00edrn\u00fd vzestup kreatininu (a\u017e 30 % je p\u0159ijateln\u00e9 a odr\u00e1\u017e\u00ed intraren\u00e1ln\u00ed hemodynamick\u00e9 zm\u011bny, nikoli nefrotoxicitu); m\u00edrn\u00fd vzestup drasl\u00edku.<\/li>\n<li>Po zv\u00fd\u0161en\u00ed d\u00e1vky: opakujte U&amp;E za 1\u20132 t\u00fddny.<\/li>\n<li>Pr\u016fb\u011b\u017en\u011b: ro\u010dn\u00ed kontrola U&amp;E po stabilizaci.<\/li>\n<li><strong>P\u0159eru\u0161te a vy\u0161et\u0159ete:<\/strong> zv\u00fd\u0161en\u00ed kreatininu &gt;30%, pokles eGFR &gt;25%, drasl\u00edk &gt;5,5 mmol\/l, nov\u011b vznikl\u00e1 hypotenze\/z\u00e1vrat\u011b.<\/li>\n<\/ul>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> Postupn\u00e9 vysazov\u00e1n\u00ed nen\u00ed u ACE inhibitor\u016f (na rozd\u00edl od betablok\u00e1tor\u016f) striktn\u011b vy\u017eadov\u00e1no, ale n\u00e1hl\u00e9 ukon\u010den\u00ed l\u00e9\u010dby m\u016f\u017ee zp\u016fsobit rebound hypertenzi b\u011bhem n\u011bkolika dn\u00ed. P\u0159i ukon\u010dov\u00e1n\u00ed l\u00e9\u010dby sni\u017eujte d\u00e1vky postupn\u011b po dobu 1-2 t\u00fddn\u016f a monitorujte krevn\u00ed tlak.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9 (&gt;5 %):<\/strong><\/p>\n<ul>\n<li><strong>Such\u00fd p\u0159etrv\u00e1vaj\u00edc\u00ed ka\u0161el<\/strong> (a\u017e u 20 % pacient\u016f \u2013 t\u0159\u00eddn\u00ed \u00fa\u010dinek zp\u016fsoben\u00fd akumulac\u00ed bradykininu). Obvykle za\u010d\u00edn\u00e1 b\u011bhem n\u011bkolika t\u00fddn\u016f od zah\u00e1jen\u00ed terapie; \u010dasem neust\u00e1v\u00e1. Pokud je obt\u011b\u017euj\u00edc\u00ed, p\u0159ejd\u011bte na ARB (losartan, telmisartan, olmesartan, valsartan, irbesartan) \u2013 ARB nezp\u016fsobuj\u00ed ka\u0161el, proto\u017ee p\u016fsob\u00ed mimo metabolismus bradykininu.<\/li>\n<li>Z\u00e1vrat\u011b, ortostatick\u00e1 hypotenze (zejm\u00e9na na za\u010d\u00e1tku l\u00e9\u010dby)<\/li>\n<li>M\u00edrn\u00e1 hyperkal\u00e9mie (kontrolujte hladinu drasl\u00edku)<\/li>\n<li>Reverzibiln\u00ed zv\u00fd\u0161en\u00ed s\u00e9rov\u00e9ho kreatininu (n\u00e1r\u016fst a\u017e ~30 % je o\u010dek\u00e1van\u00fd a p\u0159ijateln\u00fd)<\/li>\n<li>Bolest hlavy, \u00fanava<\/li>\n<li>Porucha chu\u0165ov\u00e9ho vn\u00edm\u00e1n\u00ed (dysgeuzie)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale d\u016fle\u017eit\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Angioed\u00e9m<\/strong> \u2013 \u017eivot ohro\u017euj\u00edc\u00ed otok rt\u016f, jazyka nebo d\u00fdchac\u00edch cest. V\u00fdskyt ~0,1-0,5 %; vy\u0161\u0161\u00ed u pacient\u016f africk\u00e9ho p\u016fvodu. M\u016f\u017ee se objevit i po letech bezprobl\u00e9mov\u00e9ho u\u017e\u00edv\u00e1n\u00ed. <strong>Okam\u017eit\u011b ukon\u010dete l\u00e9\u010dbu<\/strong>, vyhledejte neodkladnou p\u00e9\u010di a ji\u017e nikdy neobnovujte l\u00e9\u010dbu \u017e\u00e1dn\u00fdm ACE inhibitorem \u2013 ARB jsou tak\u00e9 kontraindikov\u00e1ny v prvn\u00edch 4 t\u00fddnech u pacient\u016f s anamn\u00e9zou angioed\u00e9mu vyvolan\u00e9ho ACE inhibitory.<\/li>\n<li><strong>Akutn\u00ed po\u0161kozen\u00ed ledvin p\u0159i oboustrann\u00e9 sten\u00f3ze ren\u00e1ln\u00ed arterie<\/strong> \u2013 ACE inhibitory odstra\u0148uj\u00ed angiotensin-II-dependentn\u00ed konstrikci eferentn\u00ed arterioly, kter\u00e1 udr\u017euje GFR p\u0159i v\u00fdrazn\u011b omezen\u00e9 ren\u00e1ln\u00ed perfuzi. Obvykle se projev\u00ed jako zv\u00fd\u0161en\u00ed kreatininu o &gt;30 % b\u011bhem n\u011bkolika dn\u00ed od zah\u00e1jen\u00ed l\u00e9\u010dby.<\/li>\n<li><strong>T\u011b\u017ek\u00e1 hyperkal\u00e9mie<\/strong> \u2014 zejm\u00e9na s dopl\u0148ky drasl\u00edku, \u0161et\u0159\u00edc\u00edmi diuretiky (spironolacton), NSAID nebo p\u0159i chronick\u00e9m onemocn\u011bn\u00ed ledvin (CKD)<\/li>\n<li><strong>Neutropenie a agranulocyt\u00f3za<\/strong> \u2014 velmi vz\u00e1cn\u00e9, v\u011bt\u0161inou historick\u00fd probl\u00e9m spojen\u00fd s kaptoprilem<\/li>\n<li><strong>Jatern\u00ed dysfunkce \/ cholestatick\u00e1 \u017eloutenka<\/strong> \u2014 velmi vz\u00e1cn\u00e9<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed \u2014 ABSOLUTN\u00cd kontraindikace ve v\u0161ech trimestrech.<\/strong> ACE inhibitory zp\u016fsobuj\u00ed fet\u00e1ln\u00ed ren\u00e1ln\u00ed agenezi, oligohydramnion, plicn\u00ed hypoplazii a hypoplazii lebky. Okam\u017eit\u011b p\u0159eru\u0161te l\u00e9\u010dbu v p\u0159\u00edpad\u011b t\u011bhotenstv\u00ed. \u017deny v reproduk\u010dn\u00edm v\u011bku by m\u011bly pou\u017e\u00edvat spolehlivou antikoncepci nebo p\u0159ej\u00edt na t\u011bhotenstv\u00edm bezpe\u010dn\u00fd antihypertenziv (<a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a>, methyldopa, nifedipin, hydralazin) p\u0159ed po\u010det\u00edm.<\/li>\n<li><strong>Historie angioed\u00e9mu vyvolan\u00e9ho ACE inhibitory<\/strong> \u2014 absolutn\u00ed; i jedin\u00e1 epizoda v minulosti \u010din\u00ed ACE inhibitory kontraindikovan\u00fdmi na cel\u00fd \u017eivot<\/li>\n<li><strong>Bilater\u00e1ln\u00ed sten\u00f3za ren\u00e1ln\u00edch tepen<\/strong> nebo sten\u00f3za u jedn\u00e9 funk\u010dn\u00ed ledviny \u2014 riziko AKI<\/li>\n<li><strong>Heredit\u00e1rn\u00ed nebo idiopatick\u00fd angioed\u00e9m<\/strong><\/li>\n<li><strong>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za<\/strong> \u2014 relativn\u00ed; m\u016f\u017ee vyvolat hypotenzi<\/li>\n<li><strong>Hyperkalemie &gt;5,5 mmol\/l<\/strong> p\u0159i vstupn\u00edm vy\u0161et\u0159en\u00ed (nejprve korigovat)<\/li>\n<li><strong>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed sacubitrilu\/valsartanu (Entresto)<\/strong> \u2014 nekombinovat; vy\u017eaduje 36hodinovou vy\u010dk\u00e1vac\u00ed dobu<\/li>\n<li><strong>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed aliskirenu u diabetu nebo CKD<\/strong> (inhibitor p\u0159\u00edm\u00e9ho reninu)<\/li>\n<li>P\u0159ecitliv\u011blost na lisinopril<\/li>\n<\/ul>\n<p><strong>Kojen\u00ed:<\/strong> enalapril a kaptopril jsou pova\u017eov\u00e1ny za kompatibiln\u00ed (mal\u00e1 mno\u017estv\u00ed p\u0159ech\u00e1zej\u00ed do mate\u0159sk\u00e9ho ml\u00e9ka); \u00fadaje pro lisinopril jsou omezen\u00e9 \u2014 vyvarujte se u\u017e\u00edv\u00e1n\u00ed v prvn\u00edch t\u00fddnech po porodu p\u0159ed\u010dasn\u011b narozen\u00e9ho d\u00edt\u011bte; obecn\u011b p\u0159ijateln\u00e9 pozd\u011bji.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>\u0160et\u0159\u00edc\u00ed drasl\u00edk diuretika<\/strong> (spironolakton, eplerenon, amilorid, triamteren) \u2014 aditivn\u00ed hyperkalemie; monitorovat K<sup>+<\/sup> pe\u010dliv\u011b. Tato kombinace se klinicky pou\u017e\u00edv\u00e1 u HF-REF, ale vy\u017eaduje pe\u010dliv\u00e9 sledov\u00e1n\u00ed.<\/li>\n<li><strong>Dopl\u0148ky drasl\u00edku<\/strong> a n\u00e1hrady soli obsahuj\u00edc\u00ed drasl\u00edk \u2014 riziko hyperkal\u00e9mie<\/li>\n<li><strong>NSAID<\/strong> (ibuprofen, diklofenak, naproxen) \u2014 sni\u017euj\u00ed antihypertenzn\u00ed \u00fa\u010dinek ACE inhibitor\u016f A zvy\u0161uj\u00ed riziko akutn\u00edho po\u0161kozen\u00ed ledvin (\u201ctrojit\u00fd \u00fader\u201d = ACEi + diuretikum + NSAID). Chronick\u00e9 kombinaci se vyh\u00fdbejte.<\/li>\n<li><strong>Lithium<\/strong> \u2014 ACE inhibitory sni\u017euj\u00ed ren\u00e1ln\u00ed clearance lithia; hladiny lithia pe\u010dliv\u011b monitorujte<\/li>\n<li><strong>Jin\u00e1 antihypertenziva<\/strong> \u2014 obvykle komplement\u00e1rn\u00ed; monitorujte TK<\/li>\n<li><strong>Sacubitril\/valsartan (Entresto)<\/strong> \u2014 nekombinovat; vy\u017eaduje 36hodinovou p\u0159est\u00e1vku k prevenci rizika angioed\u00e9mu<\/li>\n<li><strong>Allopurinol<\/strong> \u2014 ojedin\u011bl\u00e9 zpr\u00e1vy o zv\u00fd\u0161en\u00e9 hypersenzitivit\u011b; klinicky nev\u00fdznamn\u00e9<\/li>\n<li><strong>Aliskiren<\/strong> \u2014 kombinaci u diabetu a CKD se vyh\u00fdbejte (studie ALTITUDE p\u0159ed\u010dasn\u011b ukon\u010dena pro \u0161kodlivost<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">ACE inhibitory p\u0159ehledn\u011b<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">ACE inhibitor<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Aktivace<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Nejvhodn\u011bj\u0161\u00ed pro \/ kl\u00ed\u010dov\u00e1 studie<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">Ramipril (Ramcor, Rami Race, Ramgee, Ramisave)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prodrug (j\u00e1tra \u2192 ramipril\u00e1t)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">C\u00e9vn\u00ed ochrana (HOPE); po IM (AIRE)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/enapril\/\">Enalapril (Enapril)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prodrug (j\u00e1tra \u2192 enalapril\u00e1t)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Srde\u010dn\u00ed selh\u00e1n\u00ed (CONSENSUS, SOLVD)<\/td>\n<\/tr>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/lispro\/\">Lisinopril (Lispro, Hypernil)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Aktivn\u00ed l\u00e1tka (nevy\u017eaduje j\u00e1tra)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Preferov\u00e1no p\u0159i jatern\u00edm posti\u017een\u00ed; SF (ATLAS); po IM (GISSI-3)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/coversyl\/\">Perindopril (Coversyl)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prodrug (j\u00e1tra \u2192 perindopril\u00e1t)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Nejdel\u0161\u00ed polo\u010das; hypertenze (ASCOT-BPLA); ischemick\u00e1 choroba srde\u010dn\u00ed (EUROPA); prevence c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody (PROGRESS)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kaptopril<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Aktivn\u00ed l\u00e1tka<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kr\u00e1tk\u00fd polo\u010das (6 h); historick\u00e1 referen\u010dn\u00ed l\u00e1tka; nyn\u00ed z\u0159\u00eddka prvn\u00ed volba<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">ACE inhibitory vs. ARB \u2014 co zvolit?<\/h2>\n<p>Blok\u00e1tory angiotensinov\u00fdch receptor\u016f (ARB \u2014 <a href=\"https:\/\/medsbase.com\/cs\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/olmin\/\">olmesartan<\/a>, valsartan, irbesartan) p\u016fsob\u00ed na stejn\u00e9 renin-angiotenzinov\u00e9 dr\u00e1ze, ale blokuj\u00ed angiotensin II na jeho AT1 receptoru nam\u00edsto blokov\u00e1n\u00ed jeho tvorby. Klinick\u00fd \u00fa\u010dinek na krevn\u00ed tlak je v z\u00e1sad\u011b ekvivalentn\u00ed. Rozd\u00edly:<\/p>\n<ul>\n<li><strong>\u017d\u00e1dn\u00fd such\u00fd ka\u0161el<\/strong> u ARB \u2014 nezvy\u0161uj\u00ed hladiny bradykininu. ARB jsou prvn\u00ed volbou po ka\u0161li zp\u016fsoben\u00e9m ACE inhibitory.<\/li>\n<li><strong>Angioed\u00e9m je u ARB vz\u00e1cn\u00fd, ale mo\u017en\u00fd<\/strong> \u2014 NEza\u010d\u00ednejte ARB do 4 t\u00fddn\u016f po epizod\u011b angioed\u00e9mu zp\u016fsoben\u00e9ho ACE inhibitory; dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed ARB u pacient\u016f s p\u0159edchoz\u00edm angioed\u00e9mem zp\u016fsoben\u00fdm ACE inhibitory je obecn\u011b p\u0159ijateln\u00e9, ale vy\u017eaduje monitorov\u00e1n\u00ed.<\/li>\n<li><strong>Cena<\/strong> \u2014 generick\u00e9 ACE inhibitory jsou na v\u011bt\u0161in\u011b trh\u016f o n\u011bco levn\u011bj\u0161\u00ed ne\u017e generick\u00e9 ARB<\/li>\n<li><strong>D\u016fkazy pro srde\u010dn\u00ed selh\u00e1n\u00ed<\/strong> \u2014 ACE inhibitory maj\u00ed o n\u011bco siln\u011bj\u0161\u00ed historick\u00e9 d\u016fkazy o sn\u00ed\u017een\u00ed mortality; ARB byly v nov\u011bj\u0161\u00edch studi\u00edch potvrzeny jako ekvivalentn\u00ed a pou\u017e\u00edvaj\u00ed se, kdy\u017e ACE inhibitory nejsou tolerov\u00e1ny.<\/li>\n<li><strong>NEKOMBINUJTE ACE inhibitory + ARB<\/strong> \u2014 studie ONTARGET prok\u00e1zala \u0161kodlivost (v\u00edce hyperkal\u00e9mie, AKI, hypotenze) bez dal\u0161\u00edho p\u0159\u00ednosu pro sn\u00ed\u017een\u00ed mortality<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Store Angiotensin below 25&deg;C in the original blister pack. Protect from moisture. Keep out of reach of children.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">How long does Angiotensin take to lower blood pressure?<\/h3>\n<p>Po\u010d\u00e1te\u010dn\u00ed pokles TK do 1-2 hodin po prvn\u00ed d\u00e1vce; pln\u00fd antihypertenzn\u00ed \u00fa\u010dinek nast\u00e1v\u00e1 za 2-4 t\u00fddny, kdy se pln\u011b uprav\u00ed renin-angiotenzinov\u00fd syst\u00e9m. M\u011b\u0159te dom\u00e1c\u00ed TK ve stejnou denn\u00ed dobu pro sledov\u00e1n\u00ed \u00fa\u010dinku.<\/p>\n<h3 class=\"wp-block-heading\">Why did I develop a cough after starting Angiotensin?<\/h3>\n<p>ACE inhibitory zvy\u0161uj\u00ed hladinu bradykininu v d\u00fdchac\u00edch cest\u00e1ch, co\u017e zp\u016fsobuje charakteristick\u00fd <strong>such\u00fd, p\u0159etrv\u00e1vaj\u00edc\u00ed ka\u0161el u a\u017e 20 % u\u017eivatel\u016f<\/strong>. Obvykle za\u010d\u00edn\u00e1 b\u011bhem dn\u016f a\u017e t\u00fddn\u016f, nezlep\u0161uje se s antitusiky a neust\u00e1v\u00e1 p\u0159i pokra\u010dov\u00e1n\u00ed v u\u017e\u00edv\u00e1n\u00ed l\u00e9ku. Pokud je ka\u0161el obt\u011b\u017euj\u00edc\u00ed, p\u0159ejd\u011bte na ARB (<a href=\"https:\/\/medsbase.com\/cs\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/olmin\/\">olmesartan<\/a>) \u2014 ka\u0161el ustoup\u00ed b\u011bhem 1-4 t\u00fddn\u016f po vysazen\u00ed ACE inhibitoru.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Angiotensin in pregnancy?<\/h3>\n<p><strong>Ne \u2014 ACE inhibitory jsou v t\u011bhotenstv\u00ed absolutn\u011b kontraindikov\u00e1ny.<\/strong> Zp\u016fsobuj\u00ed fet\u00e1ln\u00ed ren\u00e1ln\u00ed agenezi, oligohydramnion, plicn\u00ed hypopl\u00e1zii a hypopl\u00e1zii lebky. Okam\u017eit\u011b p\u0159esta\u0148te u\u017e\u00edvat, pokud dojde k t\u011bhotenstv\u00ed, a p\u0159ejd\u011bte na bezpe\u010dn\u00e9 antihypertenzivum v t\u011bhotenstv\u00ed \u2014 <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a>, methyldopa, nifedipin nebo hydralazin. \u017deny v reproduk\u010dn\u00edm v\u011bku by m\u011bly pou\u017e\u00edvat spolehlivou antikoncepci.<\/p>\n<h3 class=\"wp-block-heading\">My creatinine went up after starting Angiotensin &mdash; should I stop?<\/h3>\n<p>A <strong>zv\u00fd\u0161en\u00ed kreatininu a\u017e o 30 %<\/strong> b\u011bhem prvn\u00edch 1\u20132 t\u00fddn\u016f je <strong>o\u010dek\u00e1van\u00e9<\/strong> a p\u0159ijateln\u00e9 \u2014 odr\u00e1\u017e\u00ed intraren\u00e1ln\u00ed hemodynamickou adaptaci, kdy\u017e je odstran\u011bna angiotenzin-II-dependentn\u00ed konstrikce eferentn\u00ed arterioly, nikoli nefrotoxicitu. Zv\u00fd\u0161en\u00ed &gt;30 % nazna\u010duje mo\u017enou bilater\u00e1ln\u00ed sten\u00f3zu ren\u00e1ln\u00ed arterie, hypovolemii nebo interakci s NSAID \u2014 l\u00e9\u010divo vysa\u010fte a prove\u010fte vy\u0161et\u0159en\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Can I drink alcohol on Angiotensin?<\/h3>\n<p>Moderate alcohol is generally acceptable but alcohol is additive with the vasodilator effect &mdash; you may feel dizzy on standing up after drinking. Heavy drinking also independently raises BP; reducing alcohol often improves BP control independent of Angiotensin.<\/p>\n<h3 class=\"wp-block-heading\">Should I avoid potassium-rich foods on Angiotensin?<\/h3>\n<p>M\u00edrn\u00fd p\u0159\u00edjem potravin bohat\u00fdch na drasl\u00edk (ban\u00e1ny, pomeran\u010de, \u0161pen\u00e1t, avok\u00e1do) je pro v\u011bt\u0161inu pacient\u016f v po\u0159\u00e1dku. Vyhn\u011bte se dopl\u0148k\u016fm drasl\u00edku (tablety slow-K) a n\u00e1hrad\u00e1m soli obsahuj\u00edc\u00edm chlorid draseln\u00fd, pokud nejsou v\u00fdslovn\u011b p\u0159edeps\u00e1ny \u2014 v kombinaci s ACE inhibitory, zejm\u00e9na u CKD nebo s drasl\u00edk \u0161et\u0159\u00edc\u00edmi diuretiky, mohou zp\u016fsobit nebezpe\u010dnou hyperkal\u00e9mii.<\/p>\n<h3 class=\"wp-block-heading\">Can I take ibuprofen while on Angiotensin?<\/h3>\n<p>Ob\u010dasn\u00e9 kr\u00e1tkodob\u00e9 u\u017e\u00edv\u00e1n\u00ed NSAID je obvykle p\u0159ijateln\u00e9, ale <strong>chronick\u00e9 denn\u00ed u\u017e\u00edv\u00e1n\u00ed NSAID<\/strong> (ibuprofen, diklofenak, naproxen) sni\u017euj\u00ed antihypertenzn\u00ed \u00fa\u010dinek ACE inhibitor\u016f A v\u00fdrazn\u011b zvy\u0161uj\u00ed riziko akutn\u00edho po\u0161kozen\u00ed ledvin (AKI) \u2014 zejm\u00e9na v kombinaci s diuretikem (\u201ctrojit\u00e1 hrozba\u201d = ACEi + diuretikum + NSAID). P\u0159i chronick\u00e9 bolesti je paracetamol bezpe\u010dn\u011bj\u0161\u00ed; u z\u00e1n\u011bt\u016f proberte alternativy s l\u00e9ka\u0159em.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Angiotensin with my other BP medications?<\/h3>\n<p>Ano \u2014 ACE inhibitory se dob\u0159e kombinuj\u00ed s <strong>blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">amlodipin<\/a>, nifedipin), <strong>thiazidov\u00fdmi diuretiky<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">HCTZ<\/a>, indapamid), <strong>beta-blok\u00e1tory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/betablock-xl\/\">metoprolol<\/a>), a <strong>antagonisty aldosteronu<\/strong> (spironolakton \u2014 sledujte hladinu K<sup>+<\/sup>). <strong>Nekombinujte s ARB<\/strong> (studie ONTARGET prok\u00e1zala \u0161kodlivost bez benefit\u016f).<\/p>\n<h3 class=\"wp-block-heading\">Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Vezm\u011bte si l\u00e9k, jakmile si vzpomenete, pokud nen\u00ed t\u00e9m\u011b\u0159 \u010das na dal\u0161\u00ed d\u00e1vku \u2014 v tom p\u0159\u00edpad\u011b vynechejte zapomenutou d\u00e1vku a pokra\u010dujte v obvykl\u00e9m re\u017eimu. Ned\u00e1vejte dvojit\u00e9 d\u00e1vky. Jedna vynechan\u00e1 d\u00e1vka v\u00fdznamn\u011b neovlivn\u00ed kontrolu krevn\u00edho tlaku, proto\u017ee ACE inhibitory maj\u00ed dlouhotrvaj\u00edc\u00ed farmakologick\u00e9 \u00fa\u010dinky d\u00edky vazb\u011b na tk\u00e1n\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Where can I buy Angiotensin online?<\/h3>\n<p>You can buy Angiotensin (lisinopril 5 \/ 10 mg, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">Aquazide \u2014 Hydrochlorothiazid<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/concor\/\">Concor \u2014 Bisoprolol 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/coversyl\/\">Coversyl \u2014 Perindopril 2\/4\/8 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">Ramcor \u2014 Ramipril 1,25\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ramgee\/\">Ramgee \u2014 Ramipril 2,5\/5 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ramisave\/\">Ramisave \u2014 Ramipril 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/combutol\/\">Combutol<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ivepred\/\">Ivepred<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/hydrocl\/\">Hydrocl<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/betablock-xl\/\">Betablock XL<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/seroflo-autohaler\/\">Seroflo Autohaler<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Angiotensin is lisinopril 5\/10 mg tablets \u2014 hydrophilic ACE inhibitor that does not require hepatic activation (unlike ramipril and enalapril), making it an option in mild hepatic impairment. Once-daily dosing. ATLAS (1999) showed high-dose lisinopril (32.5-35 mg) reduced HF hospitalisations more than low-dose in severe heart failure; GISSI-3 established post-MI benefit. Uses: hypertension, heart failure, post-MI LV dysfunction, diabetic nephropathy. Dry cough in 5-10%; angioedema rare but more frequent in Black\/African-American patients.<\/p>","protected":false},"featured_media":58401,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3342,3260,3356],"product_tag":[4485,3410],"class_list":{"0":"post-58400","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-general-health","9":"product_cat-heart-blood-pressure","10":"product_cat-high-blood-pressure-medication","11":"product_tag-angiotensin","12":"product_tag-lisinopril","14":"first","15":"instock","16":"shipping-taxable","17":"purchasable","18":"product-type-variable","19":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/58400","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=58400"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/58401"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=58400"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=58400"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=58400"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=58400"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}