Captopril, enalapril, fosinopril, lisinopril, quinapril, ramipril, trandolapril:
Captopril, lisinopril, ramipril, trandolapril:
Enalapril:
Ramipril:
Captopril:
Perindopril:
Contraindicated in:
Use Cautiously in:
Exercise Extreme Caution in:
CV: hypotension, chest pain, edema, tachycardia.
Derm: flushing, pruritus, rashes.
Endo: hyperuricemia.
F and E: hyperkalemia.
GI: taste disturbances, abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting.
GU: erectile dysfunction, proteinuria, renal dysfunction, renal failure.
Hemat: AGRANULOCYTOSIS, neutropenia (captopril only).
MS: back pain, muscle cramps, myalgia.
Neuro: dizziness, drowsiness, fatigue, headache, insomnia, vertigo, weakness.
Resp: cough, dyspnea.
Misc: ANGIOEDEMA, fever.
Drug-Drug:
Drug-Food:
Benazepril
(generic available)
Captopril
(generic available)
Enalapril
(generic available)
Enalaprilat
(generic available)
Fosinopril
(generic available)
Lisinopril
(generic available)
Moexipril
(generic available)
Perindopril
(generic available)
Quinapril
(generic available)
Ramipril
(generic available)
Trandolapril
(generic available)
Benazepril
Renal Impairment
Renal Impairment
Captopril
Renal Impairment
Enalapril/Enalaprilat
Renal Impairment
Renal Impairment
Fosinopril
Lisinopril
Renal Impairment
Renal Impairment
Moexipril
Renal Impairment
Perindopril
Renal Impairment
Quinapril
Renal Impairment
Ramipril
Renal Impairment
Trandolapril
Renal Impairment
Hepatic Impairment
benazepril: Lotensin
Enalapril/Enalaprilat: Epaned, Vasotec
lisinopril: Prinivil
quinapril: Accupril
ramipril: Altace
Absorption: Benazepril 37% absorbed after oral administration. Captopril 6075% absorbed after oral administration (↓ by food). Enalapril 5575% absorbed after oral administration. Enalaprilat IV administration results in complete bioavailability. Fosinopril 36% absorbed after oral administration. Lisinopril 25% absorbed after oral administration (much variability). Moexipril 13% bioavailability as moexiprilat after oral administration (↓ by food). Perindopril 25% bioavailability as perindoprilat after oral administration. Quinapril 60% absorbed after oral administration (high-fat meal may ↓ absorption). Ramipril 5060% absorbed after oral administration. Trandolapril 70% bioavailability as trandolapril at after oral administration.
Distribution: All ACE inhibitors cross the placenta. Benazepril, captopril, enalapril, fosinopril, quinapril, and trandolapril Enter breast milk. Lisinopril Minimal penetration of CNS. Ramipril Probably does not enter breast milk. Trandolapril Enters breast milk.
Protein Binding: Benazepril 95%, Fosinopril 99.4%, Moexipril 90%, Quinapril 97%.
Metabolism/Excretion: Benazepril Converted by the liver to benazeprilat, the active metabolite. 20% excreted by kidneys; 1112% nonrenal (biliary elimination). Captopril 50% metabolized by the liver to inactive compounds, 50% excreted unchanged by the kidneys. Enalapril, enalaprilat Enalapril is converted by the liver to enalaprilat, the active metabolite; primarily eliminated by the kidneys. Fosinopril Converted by the liver and GI mucosa to fosinoprilat, the active metabolite 50% excreted in urine, 50% in feces. Lisinopril 100% eliminated by the kidneys. Moexipril Converted by liver and GI mucosa to moexiprilat, the active metabolite; 13% excreted in urine, 53% in feces. Perindopril Converted by the liver to perindoprilat, the active metabolite; primarily excreted in urine. Quinapril Converted by the liver, GI mucosa, and tissue to quinaprilat, the active metabolite: 96% eliminated by the kidneys. Ramipril Converted by the liver to ramiprilat, the active metabolite; 60% excreted in urine, 40% in feces. Trandolapril Converted by the liver to trandolaprilat, the active metabolite; 33% excreted in urine, 66% in feces.
Half-life: Benazeprilat 1011 hr. Captopril 2 hr (↑ in renal impairment). Enalapril 2 hr (↑ in renal impairment). Enalaprilat 3538 hr (↑ in renal impairment). Fosinoprilat 12 hr. Lisinopril 12 hr (↑ in renal impairment). Moexiprilat 29 hr (↑ in renal impairment). Perindoprilat 310 hr (↑ in renal impairment). Quinaprilat 3 hr (↑ in renal impairment). Ramiprilat 1317 hr (↑ in renal impairment). Trandolaprilat 22.5 hr (↑ in renal impairment).
(effect on BP single dose)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
Benazepril | within 1 hr | 24 hr | 24 hr |
Captopril | 1560 min | 6090 min | 612 hr |
Enalapril PO | 1 hr | 48 hr | 1224 hr |
Enalapril IV | 15 min | 14 hr | 46 hr |
Fosinopril | within 1 hr | 26 hr | 24 hr |
Lisinopril | 1 hr | 6 hr | 24 hr |
Moexipril | within 1 hr | 36 hr | up to 24 hr |
Perindoprilat | within 12 hr | 37 hr | up to 24 hr |
Quinapril | within 1 hr | 24 hr | up to 24 hr |
Ramipril | within 12 hr | 36 hr | 24 hr |
Trandolapril | within 12 hr | 410 hr | up to 24 hr |