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Preclinical data reveal no special hazard for humans based on conventional studies of general pharmacologyrepeated dose toxicitygenotoxicityand carcinogenic potentialAngiotensin-converting enzyme inhibitorsas a classhave been shown to induce adverse effects on the late foetal developmentresulting in foetal death and congenital effectsin particular affecting the skullFoetotoxicityintrauterine growth retardation and patent ductus arteriosus have also been reportedThese developmental anomalies are thought to be partly due to a direct action of ACE inhibitors on the foetal renin-angiotensin system and partly due to ischaemia resulting from maternal hypotension and decreases in foetal-placental blood flow and oxygen/nutrients delivery to the foetus.
In some patients with heart failure who have normal or low blood pressureadditional lowering of systemic blood pressure may occur with ZestrilThis effect is anticipated and is not usually a reason to discontinue treatmentIf hypotension becomes symptomatica reduction of dose or discontinuation of Zestril may be necessary.
Once you have started taking Zestril your doctor may take blood testsYour doctor may then adjust your dose so you take the right amount of medicine for you.
Tell your doctor right away if you have any serious side effectsincludingfaintingsymptoms of a high potassium blood levelsuch as muscle weaknessslow/irregular heartbeat
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there are some cholesterol medications and some other blood pressure medications such as norvasc amlodipine that do have interactions with grapefruit, but lisinopril zestril does not have this interaction.
