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In yet another embodiment, R 7 is a carboxyalkynyl group.

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With greater impairment, however, peak and trough lisinopril levels increase, time to peak concentration increases and time to attain steady state is prolonged [see Dosage and Administration (24)]. In a preferred embodiment the mutation is selected from the group comprising: A56V, F78S, S85G, S85R, Y110C, L13H, Y132C, I164L, P167S, L170V, I174V, I174T, or E183K.