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Because blood pressure could potentially fall, patients at risk for hypotension, should start therapy under very close medical supervision, usually in a hospital. Such patients should be followed closely for the first two weeks of treatment and whenever the dose of lisinopril and/ or diuretic is increased. Similar considerations apply to patients with ischemic heart or cerebrovascular disease in whom an excessive fall in blood pressure could result in a myocardial infarction or cerebrovascular accident (see ADVERSE REACTIONS). If hypotension occurs, the patient should be placed in supine position and, if necessary, receive an intravenous infusion of normal saline. A transient hypotensive response may not be a contraindication to further doses. These can usually be given to hypertensive patients without difficulty once the blood pressure has increased after volume expansion. However, lower doses of PRINIVIL ® and/ or reduced concomitant diuretic therapy should be considered. If hypotension occurs during treatment following acute myocardial infarction, consideration should be given to PRINIVIL ® discontinuation (see ADVERSE REACTIONS, and DOSAGE AND ADMINISTRATION, Treatment Following Acute Myocardial Infarction). Text Continues Below
In some patients with congestive heart failure who have normal or low blood pressure, additional lowering of systemic blood pressure may occur with PRINIVIL ® . If hypotension occurs, a reduction of dose or
discontinuation of therapy should be considered. Neutropenia/ Agranulocytosis Agranulocytosis and bone marrow depression have been caused by angiotensin-converting enzyme inhibitors. Several cases of agranulocytosis and neutropenia have been reported in which a causal relationship to lisinopril cannot be excluded. Current experience with the drug shows the incidence to be rare. Periodic monitoring of white blood cell counts should be considered, especially in patients with collagen vascular disease and renal disease. Page: << Prev | 1 | 2 | 3 | 4 | 5 | Next >>
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