DRUG OF THE MONTH:ZESTRIL (LISINOPRIL)

As its name implies, Zestril is supposed to put the spring back into the step of the elderly by treating high blood pressure and heart failure. Marketed by Zeneca, it is one of the powerful ACE inhibitors, and so comes with a range of side effects th

The common side effects include hypotension, or low blood pressure, and so from that dizziness and headaches. Other likely reactions include diarrhea, cough, nausea and fatigue.

Another concern can be angioedema, where the tissues fill with fluids causing swelling. In most cases, the swelling goes down once the treatment is stopped, but emergency care needs to be given if the swelling is blocking the airways or affects the tongue or larynx.

Ironically, one reaction can be heart attack, the very thing the drug is supposed to prevent, although this is a rarer occurrence. Other less common reactions include abdominal pain, dry mouth, hepatitis, jaundice, mood swings, mental confusion, acute kidney failure and impotence.

People on the drug who suddenly develop a nonproductive cough or skin rash can be almost certain that it has been caused by the treatment, and the symptoms disappear once it is stopped.

Any cautious doctor should begin the treatment with just 2.5 mg daily which the manufacturer says is too little to have any beneficial effect, but should show any adverse reactions. The usual dose range is between 10 to 20 mg a day, and the maximum recommended amount is 40 mg. The dose should be increased over a two to four week period. Any treatment must begin in hospital.

Because of its possible effects on the kidneys, patients who already suffer kidney problems should naturally enough not take the drug, or any other ACE inhibitor. As studies have never been carried out on children or nursing mothers, neither group is advised to start treatment.