Lapril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.
Lapril is an angiotensin converting enzyme (ACE) inhibitor. It works by blocking a substance in the body that causes the blood vessels to tighten. As a result, Lapril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.
Lapril is also used in combination with other medicines to treat congestive heart failure and cut down on the number of hospital visits for heart problems.
Lapril is available only with your doctor's prescription..
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
Lapril is indicated for the treatment of hypertension.
Lapril is effective alone or in combination with other antihypertensive agents, especially thiazide-type diuretics. The blood pressure lowering effects of Lapril and thiazides are approximately additive.
Lapril is indicated for the treatment of symptomatic congestive heart failure, usually in combination with diuretics and digitalis. In these patients Lapril improves symptoms, increases survival, and decreases the frequency of hospitalization.
Asymptomatic Left Ventricular Dysfunction
In clinically stable asymptomatic patients with left ventricular dysfunction (ejection fraction ≤35 percent), Lapril decreases the rate of development of overt heart failure and decreases the incidence of hospitalization for heart failure.
In using Lapril consideration should be given to the fact that another angiotensin converting enzyme inhibitor, captopril, has caused agranulocytosis, particularly in patients with renal impairment or collagen vascular disease, and that available data are insufficient to show that Lapril does not have a similar risk.
In considering use of Lapril, it should be noted that in controlled clinical trials ACE inhibitors have an effect on blood pressure that is less in black patients than in non-blacks. In addition, it should be noted that black patients receiving ACE inhibitors have been reported to have a higher incidence of angioedema compared to non-blacks.
How should I use Lapril?
Use Lapril solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Take Lapril solution by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
Shake well before each use.
Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
Continue to take Lapril solution even if you feel well. Do not miss any doses.
If you miss a dose of Lapril solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Lapril solution.
Uses of Lapril in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
Lapril is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat heart failure and to help prevent people with a certain heart problem (left ventricular dysfunction) from developing heart failure.
Lapril belongs to a class of drugs known as ACE inhibitors. It works by relaxing blood vessels so blood can flow more easily.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to help protect the kidneys from harm due to diabetes.
How to use Lapril
Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily.
If you are using the suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight.
Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.
For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this medication. For the treatment of heart failure, it may take weeks to months before you get the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).
Lapril Maleate is available for oral administration as tablets containing Lapril maleate 5 mg, 10 mg and 20 mg.
Lapril Maleate is the maleate salt of Lapril, a derivative of two amino-acids, L-alanine and L-proline. Following oral administration, Lapril is rapidly absorbed and then hydrolyzed to enalaprilat, which is a highly specific, long-acting, non-sulphydryl angiotensin converting enzyme inhibitor.
Tablets Lapril Maleate contain the maleate salt of Lapril, the ethyl ester of the parent diacid, enalaprilat. Lapril maleate is chemically described as (S)-1-[N-[1-(ethoxycarbonyl)-3-phenylpropyl]-L-alanyl]-L-proline, (Z)-2-butenedioate salt (1:1). The empirical formula is C20H28N205·C4H4O4.
Lapril maleate is a white to off-white crystalline powder with a molecular weight of 492.53. It is sparingly soluble in water, soluble in ethanol, and freely soluble in methanol and dimethylformamide.
Since absorption of Tablets Lapril Maleate is not affected by food, the tablets may be administered before, during, or after meals.
Essential Hypertension: The initial dose is 10 to 20 mg, depending on the degree of hypertension, and is given once daily. In mild hypertension the recommended initial dose is 10 mg daily. For other degrees of hypertension the initial dose is 20 mg daily. The usual maintenance dose is one 20 mg tablet taken once daily. The dosage should be adjusted according to the needs of the patient to a maximum of 40 mg daily.
Renovascular Hypertension: Since blood pressure and renal function in such patients may be particularly sensitive to ACE inhibition, therapy should be initiated with a lower starting dose (e.g. 5 mg or less). The dosage should then be adjusted according to the needs of the patient. Most patients may be expected to respond to one 20 mg tablet taken once daily. For patients with hypertension who have been treated recently with diuretics, caution is recommended.
Concomitant Diuretic Therapy in Hypertension: Symptomatic hypotension may occur following the initial dose of Lapril Maleate; this is more likely in patients who are being treated currently with diuretics. Caution is recommended, therefore, since these patients may be volume- or salt-depleted. The diuretic therapy should be discontinued for 2-3 days prior to initiation of therapy with Lapril Maleate. If this is not possible, the initial dose of Lapril Maleate should be low (5 mg or less) to determine the initial effect on the blood pressure. Dosage should then be adjusted according to the needs of the patient.
Dosage in Renal Insufficiency: Generally, the intervals between the administration of Lapril should be prolonged and/or the dosage reduced.
Heart Failure/Asymptomatic Left Ventricular Dysfunction: The initial dose of Lapril Maleate in patients with symptomatic heart failure or asymptomatic left ventricular dysfunction is 2.5 mg, and it should be administered under close medical supervision to determine the initial effect on the blood pressure. Lapril Maleate may be used in the management of symptomatic heart failure usually with diuretics and, where appropriate, digitalis. In the absence of, or after effective management of, symptomatic hypotension following initiation of therapy with Lapril Maleate in heart failure, the dose should be increased gradually to the usual maintenance dose of 20 mg, given in a single dose or two divided doses, as tolerated by the patient. This dose titration may be performed over a 2 to 4 week period, or more rapidly if indicated by the presence of residual signs and symptoms of heart failure. In patients with symptomatic heart failure, this dosage regimen was effective in reducing mortality.
Blood pressure and renal function should be monitored closely both before and after starting treatment with Lapril Maleate because hypotension and (more rarely) consequent renal failure have been reported. In patients treated with diuretics, the dose should be reduced if possible before beginning treatment with Lapril Maleate. The appearance of hypotension after the initial dose of Lapril Maleate does not imply that hypotension will recur during chronic therapy with Lapril Maleate and does not preclude continued use of the drug. Serum potassium also should be monitored.
Administration: Lapril Maleate is available for oral administration as tablets. Since absorption of Tablets Lapril Maleate is not affected by food, the tablets, may be administered before, during, or after meals.
Hypotension: Patients on Diuretic Therapy: Patients on diuretics and especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Lapril or enalaprilat. The possibility of hypotensive effects with Lapril or enalaprilat can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Lapril or enalaprilat. If it is necessary to continue the diuretic, provide close medical supervision after the initial dose for at least two hours and until blood pressure has stabilized for at least an additional hour..
Agents Causing Renin Release: The antihypertensive effect of Lapril and Lapril IV is augmented by antihypertensive agents that cause renin release (e.g., diuretics).
Non-steroidal Anti-inflammatory Agents: In some patients with compromised renal function who are being treated with nonsteroidal anti-inflammatory drugs, the co-administration of Lapril may result in a further deterioration of renal function. These effects are usually reversible.
In a clinical pharmacology study, indomethacin or sulindac was administered to hypertensive patients receiving Lapril. In this study there was no evidence of a blunting of the antihypertensive action of Lapril. However, reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE inhibitors.
Other Cardiovascular Agents: Lapril Bp and Lapril IV have been used concomitantly with beta adrenergic-blocking agents, methyldopa, nitrates, calcium-blocking agents, hydralazine, prazosin and digoxin without evidence of clinically significant adverse interactions.
Lapril Bp IV has been used concomitantly with digitalis without evidence of clinically significant adverse reactions.
Agents Increasing Serum Potassium: Lapril Bp and Lapril IV attenuate potassium loss caused by thiazide-type diuretics. Potassium-sparing diuretics (e.g., spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. Therefore, if concomitant use of these agents is indicated because of demonstrated hypokalemia, they should be used with caution and with frequent monitoring of serum potassium. Potassium sparing agents should generally not be used in patients with heart failure receiving Lapril.
Lithium: Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs which cause elimination of sodium, including ACE inhibitors. A few cases of lithium toxicity have been reported in patients receiving concomitant Lapril/Lapril IV and lithium and were reversible upon discontinuation of both drugs. It is recommended that serum lithium levels be monitored frequently if Lapril is administered concomitantly with lithium.
Lapril Maleate has been demonstrated to be generally well tolerated. In clinical studies, the overall incidence of side effects was no greater with Lapril Maleate than with placebo. For the most part, side effects have been mild and transient in nature, and have not required discontinuation of therapy.
The following side effects have been associated with the use of Tablets Lapril Maleate: Dizziness and headache were the more commonly reported side effects. Fatigue and asthenia were reported in 2-3% of patients. Other side effects occurred in less than 2% of patients, and included hypotension, orthostatic hypotension, syncope, nausea, diarrhea, muscle cramps, rash, and cough. Less frequently renal dysfunction, renal failure, and oliguria have been reported.
Hypersensitivity/Angioneurotic Edema: Angioneurotic edema of the face, extremities, lips, tongue, glottis and/or larynx has been reported rarely. In very rare cases, intestinal angioedema has been reported with angiotensin converting enzyme inhibitors including Lapril.
Side effects which occurred very rarely, either during controlled clinical trials or after the drug was marketed, include: Cardiovascular: Myocardial infarction or cerebrovascular accident, possibly secondary to excessive hypotension in high risk patients, chest pain, palpitations, rhythm disturbances, angina pectoris, Raynaud's phenomenon.
Endocrine: Syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Gastrointestinal: Ileus, pancreatitis, hepatic failure, hepatitis - either hepatocellular or cholestatic, jaundice, abdominal pain, vomiting, dyspepsia, constipation, anorexia, stomatitis.
Metabolic: Cases of hypoglycemia in diabetic patients on oral antidiabetic agents or insulin have been reported.
A symptom complex has been reported which may include some or all of the following: Fever, serositis, vasculitis, myalgia/myositis, arthralgia/arthritis, a positive ANA, elevated ESR, eosinophilia, and leukocytosis. Rash, photosensitivity or other dermatologic manifestations may occur.
Laboratory Test Findings: Clinically important changes in standard laboratory parameters were rarely associated with administration of Lapril Maleate. Increases in blood urea and serum creatinine, and elevations of liver enzymes and/or serum bilirubin have been seen. These are usually reversible upon discontinuation of Lapril Maleate. Hyperkalemia and hyponatremia have occurred.
Decreases in hemoglobin and hematocrit have been reported.
Since the drug was marketed a small number of cases of neutropenia, thrombocytopenia, bone marrow depression, and agranulocytosis have been reported in which a causal relationship to therapy with Lapril Maleate could not be excluded.
Do not use this medication if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant.
You should not use this medication if you are allergic to Lapril, or similar medicines such as such as benazepril (Lotensin), captopril (Capoten Capozide), fosinopril (Monopril), Lapril (Prinivil, Prinzide, Zestoretic, Zestril), moexipril (Univasc, Uniretic), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik, Tarka), and others.
Before you take Lapril, tell your doctor if you have kidney or liver disease, heart disease, diabetes, or a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.
Tell your doctor about all other medicines you use.
Conditions that may cause very low blood pressure include: vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low salt diet, or taking diuretics (water pills). Follow your doctor's instructions about the type and amount of liquids you should drink while taking Lapril. Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.
If you need surgery, tell the surgeon ahead of time that you are using Lapril. You may need to stop using the medicine for a short time. Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.
DailyMed. "HYDROCHLOROTHIAZIDE; LISINOPRIL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
DailyMed. "ENALAPRIL MALEATE; HYDROCHLOROTHIAZIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
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