Drug products: Lisinopril 2care4, Lisinopril Actavis, Lisinopril Alpharma, Lisinopril Alternova, Lisinopril Arrow, Lisinopril AstraZeneca, Lisinopril Copyfarm, Lisinopril EssPharm, Lisinopril Mylan, Lisinopril Orifarm, Lisinopril Ranbaxy, Lisinopril ratiopharm, Lisinopril Sandoz, Lisinopril STADA®, Lisinopril/Hydrochlorthiazid Alternova, Lisinopril/Hydrochlorthiazid Sandoz, Lisinopril/Hydroklortiazid Actavis, Lisinopril/Hydroklortiazid Copyfarm, Lisinopril/Hydroklortiazid STADA, Vivatec®, Zestoretic, Zestril, Zestril®
ATC code: C09AA03, C09BA03
Substances: lisinopril, lisinopril dihydrate
Lisinopril reduces the blood pressure as efficiently in men and women.
Cough is a common non-dose dependent side effect of ACE-inhibitors which is more common in women. Angiotensin receptor blockers may then be an alternative.
There are no clinically relevant sex differences in lisinopril efficacy or pharmacokinetics reported, but the non-dose dependent side effect cough is more common among women.
A pharmacokinetic study (16 men, 16 women) examined the sex-related differences after a single 20 mg dose of lisinopril. There were no differences in plasma concentration between men and women, or in effects on blood pressure or heart rate . No studies with a clinically relevant sex analysis regarding the dosing of lisinopril have been found and no sex differentiation in dosing has been recommended by the manufacturer .
Clinical trials have shown that men and women have similar antihypertensive responses to lisinopril [14-16]. However, in the large ALLHAT study, black men responded better to lisinopril compared to amlodipine than black women when receiving the same dose [17,18].Pulse pressure (the difference between systolic blood pressure and diastolic pressure) is suggested to be a predictor of cardiovascular disease, and may be influenced by genetics. A study examined whether RAAS polymorphism had different impact on pulse pressure in men and women taking lisinopril showed no sex differences .A double-blind, placebo-controlled dose-response study of lisinopril in hypertensive children (6-16 years) reported that the dose response was consistent between boys and girls .
In a Norwegian double-blind multicenter study (206 men, 206 women), nearly three times more women than men spontaneously reported cough with lisinopril (12.6% vs. 4.4%) [9, 21].Several studies have reported a female predominance in the prevalence of ACE inhibitor induced cough [1-9]. The pathogenesis of the cough reaction is unknown. Different threshold for coughing in men and women have been proposed , as well as ethnic differences in cough tendency . One study suggests that sex hormones do not have any influence on cough, since most of the women in the study were postmenopausal .
Swedish users, please consult Janusmed Interactions (Janusmed interaktioner).
Lisinopril should not be used in pregnant women. Swedish users, please consult Janusmed Birth Defects (Janusmed fosterpåverkan).
Date of litterature search: 2013-12-16
Reviewed by: Mia von Euler
Approved by: Karin Schenck-Gustafsson