Lisinopril how many times a day

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This content does not have an English version. This content does not have an Arabic version. These concentrations correlate with the degree of left ventricular dysfunction and mortality in patients with HF.

The effect to reduce morbidity and mortality in heart failure has been show throughout the class of ace-inhibitors. A majority of the studies used to show the benefit of lisinopril in heart failure have only used once daily dosing. Only one study has compared and evaluated the effects of the administration lisinopril using once-daily or twice-daily regimens on RAAS and autonomic nervous activity in patients with HFrEF.

This study by Hirooka et al. The patients were then crossed over to the other dosing schedule for 3 more months. Blood levels were drawn for plasma concentrations of creatinine, blood urea nitrogen, BNP norepinephrine NE , plasma renin activity PRA , and aldosterone were measured. Overall the hemodynamic parameters were similar during once-daily and twice-daily use of lisinopril. There was also no differences in the plasma concentrations of BNP and aldosterone, but power was not set in the study.

However, the plasma concentration of norepinephrine was significantly lower, and the plasma renin activity was also lower with the twice-daily administration regimen. The authors hypothesized that twice daily administration may lower the activation of the sympathetic nervous system as compared to the once daily dosing, which is important in the prevention of heart failure worsening.

While we know these concentrations correlate with the degree of left ventricular dysfunction and mortality in patients with HFrEF, we still need to show clinical outcomes when these concentrations change.

The strengths of this study include using appropriate medication dose and randomization was similar among groups before the treatment crossover. Another strength was the total daily doses remained the same among the groups, so the beneficial effect seen was not due to a higher dose.