how does fluoxetine interact with lisinopril?

Fluoxetine is a medication that requires a prescription and is offered in various forms such as capsules, delayed-release capsules, tablets, and solutions, all of which are ingested orally. (Delayed-release capsules are designed to be absorbed into the body at a slower rate.)

The oral capsule form of fluoxetine is marketed under the brand name Prozac, but it is also available in a generic version, which is typically more cost-effective compared to branded versions. However, generic versions may not always be accessible in every strength or form as the branded ones.

Fluoxetine oral capsules may be utilized in combination therapy, necessitating concurrent use with other medications. Specifically, for managing depressive episodes associated with bipolar I disorder and treatment-resistant depression, this medication must be administered alongside olanzapine.

Lisinopril 

Lisinopril is prescribed for managing hypertension, which aids in reducing the risk of strokes, heart attacks, and kidney issues. Additionally, it is utilized in treating heart failure and enhancing survival rates post a heart attack. Lisinopril is categorized under ACE inhibitors, operating by easing blood vessel tension for improved blood circulation.

How to use lisinopril

Take this medicine orally as instructed by your doctor, either with or without food, usually once daily.

If you're using the liquid form of this medication, shake the bottle thoroughly before each dose. Measure the dose carefully using a special measuring device or spoon; avoid using a regular household spoon as it may lead to incorrect dosing.

The dosage is determined based on your medical condition and how you respond to the treatment. For children, the dosage is also determined by their weight.

To minimize the risk of side effects, your doctor may advise starting with a low dose and gradually increasing it. Follow your doctor's instructions closely.

Use this medication regularly to derive the most benefit from it. To help you remember, take it at the same time each day. Continue taking this medication even if you feel well, as many individuals with high blood pressure don't experience symptoms.

It may take 2 to 4 weeks to see the full benefits of this medication for high blood pressure treatment, and weeks to months for heart failure treatment. Inform your doctor if your condition doesn't improve or worsens (e.g., if your blood pressure readings stay high or increase).

Read Also: Medical Options to Treat Incontinence: What You Need to Know

Pros and Cons of fluoxetine and lisinopril

Fluoxetine (Prozac):

Pros:

• Effective for Depression
• FDA Approved
• Fewer Side Effects
• Long Half-Life

Cons:

• Side Effects
• Activation Syndrome
• Withdrawal Symptoms
• Drug Interactions

Lisinopril (Prinivil, Zestril):

Pros:

• Effective for Hypertension
• Heart Protection
• Well-Tolerated
• Once-Daily Dosage

Cons:

• Side Effects
• Angioedema
• Kidney Issues
• Pregnancy Concerns

Differences Between fluoxetine and lisinopril

Fluoxetine: 

It is primarily used to treat depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder.

Lisinopril: 

It is used to treat high blood pressure (hypertension), heart failure, and to improve survival after a heart attack.

Alternative to fluoxetine and lisinopril

Alternative to Fluoxetine (SSRI):

Sertraline (Zoloft): 

Another SSRI used to treat depression, anxiety disorders, PTSD, OCD, and panic disorder.

Alternative to Lisinopril (ACE Inhibitor):

Enalapril (Vasotec): 

Another ACE inhibitor used to treat high blood pressure and heart failure.

Interactions between your drugs

Lisinopril

Lisinopril belongs to the class of drugs called Angiotensin Converting Enzyme Inhibitors and is utilized for treating various conditions. These conditions include:

• Alport Syndrome (off-label use)
• Coronary Artery Disease (off-label use)
• Diabetic Kidney Disease (off-label use)
• Heart Attack
• Heart Failure
• High Blood Pressure
• Migraine Prevention (off-label use)
• Nephropathy (off-label use)
• Polycystic Kidney Disease (off-label use)

Additionally, it's important to note that lisinopril has interactions with a total of 396 other drugs.

Prozac

There are 667 drugs known to interact with Prozac. Prozac belongs to the drug class known as selective serotonin reuptake inhibitors (SSRIs) and is used to treat the following conditions:

• Anxiety and Stress
• Bulimia
• Depression
• Major Depressive Disorder
• Obsessive Compulsive Disorder (OCD)
• Panic Disorder
• Postpartum Depression
• Premenstrual Dysphoric Disorder (PMDD)
• Schizoaffective Disorder

Drug and food interactions

fluoxetine food

AVOID GENERALLY: The use of alcohol may enhance certain effects of medications that act on the central nervous system. Combining them could lead to increased central nervous system depression and potentially impair judgment, cognitive function, and motor skills.

MANAGEMENT: Patients taking medications affecting the central nervous system should be informed about this interaction and advised to refrain from consuming alcohol or limit its intake. Those who are mobile should be cautioned against engaging in activities that require full mental alertness and motor coordination until they understand the impact of these medications on them. They should also report any excessive or prolonged central nervous system effects that disrupt their usual activities to their doctor.

lisinopril  food

AVOID IN GENERAL: Consuming moderate to high amounts of dietary potassium can lead to hyperkalemia in certain patients taking angiotensin-converting enzyme (ACE) inhibitors. This risk is sometimes associated with the use of potassium-rich salt substitutes. ACE inhibitors can contribute to hyperkalemia by inhibiting the renin-aldosterone-angiotensin (RAA) system.

MANAGEMENT: Patients on ACE inhibitors should be counseled to steer clear of diets with moderate to high levels of potassium. Special consideration should be given to monitoring the potassium content in salt substitutes.

lisinopril  food

MONITORING: Various psychotherapeutic and central nervous system (CNS)-active medications (such as anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, and muscle relaxants) may lead to lowered blood pressure, especially during treatment initiation and dose adjustment. When combined with antihypertensive drugs and other medications that lower blood pressure, particularly vasodilators and alpha-blockers, there may be an increased risk of lowered blood pressure and orthostatic hypotension.

MANAGEMENT: It is recommended to exercise caution and closely monitor patients for signs of hypotension when these medications are used together. Some experts suggest avoiding alcohol when taking vasodilating antihypertensive drugs. Patients should be instructed to avoid sudden changes in posture from sitting or lying down and to inform their doctor if they experience symptoms like dizziness, fainting, lightheadedness, orthostatic intolerance, or rapid heartbeat.

Conclusion

The interaction between fluoxetine (Prozac) and lisinopril (an ACE inhibitor) is complex and multifaceted. Both medications have the potential to affect the central nervous system and cardiovascular system. When used together, they may lead to additive effects such as increased risk of hypotension (low blood pressure) and potential central nervous system depression.

It is crucial for healthcare providers to monitor patients closely when fluoxetine and lisinopril are co-administered. Patients should be educated about the potential interactions and advised to report any concerning symptoms such as dizziness, fainting, or changes in mood or behavior promptly.

In conclusion, while fluoxetine and lisinopril can be used together under careful medical supervision, close monitoring and patient education are essential to ensure safety and efficacy.