Help with using Lisinopril for Hypertension!

[Multivinum]

The patient (50 years old) had a very high systolic pressure ranging 180-210 mmHg. Used Lisinopril for 4 days in this way: 20 mg in 7 am , and 20 mg Lisinopril in 7 pm (so total = 40 mg Lisinopril per day). During the day (systolic) hypertension goes 150-160 mmHg and only in 2-4pm it is 130 mmHg (and at 10-12 pm). What should be done for this patient. Maybe trying a diuretic (hydrochlorthiazid) and lowering the dose of Lisinopril? Please tell what do you think of the doses to start trying, how often and when during the day? (P.S. if you think of another drug/combination may be more effective trying, it would be a great help).

[curmudgen]

Lisinopril doesn't have a diuretic in it unless it is the combination lisinopril-hctz

[alleycat2]

lisinopril already has a diuretic in it. Wait a few more days for results.

[curmudgen]

Take these questions to your physician.  In some cases optimal blood pressure reduction may take one to two weeks. You are seeing some improvement even after 4 days. Adding or subtracting drugs without physician supervision is not a good idea.