Lisinopril use in a large military medical center

The results of a drug use evaluation of lisinopril at a large teaching military medical center are reported. Indicators and thresholds were developed and approved by the Pharmacy and Therapeutics Committee. The medical charts of 227 patients for whom lisinopril was prescribed from June 1991 to June 1992 were reviewed for appropriateness of prescribing, appropriateness of monitoring, occurrence of any adverse drug reactions, and detection of drug interactions. Prescribing was appropriate in 97% and monitoring was appropriate in all reviewed cases. The most common adverse drug reactions detected were cough (7%), hypotension (3%), and rash (2%). Patients were also prescribed several drugs that may interact with lisinopril. Lisinopril appeared to be well tolerated and efficacious. Forty patients (18%) experienced adverse drug reactions related to lisinopril. There did not appear to be any major deficiencies with lisinopril prescribing and no corrective action needed to be taken other than educational activities for the appropriate use of lisinopril. Information from this drug use evaluation is useful in formulary decision making.