Angiotensin-converting enzyme (ACE) inhibitors come in tablet, oral solution, and injectable forms. Their available strengths range from 1-1.25 mg/mL for oral solutions and injections and 2-100 mg for tablets. ACE inhibitors reach maximum bioavailability in 0.5 to 7 hours. Elimination half-life ranges from 2 to 12 hours.
Table 1: ACE inhibitor maximum bioavailability, elimination half-life, dosage form, available strengths, and usual maintenance dosage range.1-15
|
ACE Inhibitor
|
Tmax (h)
|
t1/2 (h)
|
Dosage Form
|
Available Strengths (mg)
|
Usual Maintenance Dosage Range (mg)
|
|
Benazepril (Lotensin)
|
0.5-1
|
10-11
|
Tablet
|
10, 20, 40
|
10-80
|
|
Captopril (Capoten*)
|
1
|
<2
|
Tablet
|
12.5, 25, 50, 100
|
25-150
|
|
Enalapril oral solution (Epaned)
|
4-6
|
11
|
Oral solution
|
1/mL
|
5-40
|
|
Enalapril (Vasotec)
|
1
|
11
|
Tablet
|
2.5, 5, 10, 20
|
10-40
|
|
Enalaprilat injection (Vasotec injection*)
|
1-4
|
11
|
Injection
|
1.25/mL
|
1.25 every 6 hours over 5 minutes
|
|
Fosinopril (Monopril*)
|
3
|
12
|
Tablet
|
10, 20, 40
|
10-80
|
|
Lisinopril oral solution (Qbrelis)
|
6
|
12
|
Oral solution
|
1/mL
|
20-40
|
|
Lisinopril (Prinivl*, Zestril)
|
6
|
12
|
Tablet
|
2.5, 5, 10, 20, 30, 40
|
20-40
|
|
Moexipril (Univasc*)
|
1.5
|
12
|
Tablet
|
7.5, 15
|
7.5-30
|
|
Perindopril (Aceon*)
|
3-7
|
1
|
Tablet
|
2, 4, 8
|
4-8
|
|
Quinapril (Accupril)
|
2
|
3
|
Tablet
|
5, 10, 20, 40
|
20-80
|
|
Ramipril (Altace)
|
1
|
2-4
|
Tablet
|
1.25, 2.5, 5, 10
|
2.5-20
|
|
Trandolapril (Mavik*)
|
1
|
6
|
Tablet
|
1, 2, 4
|
2-4
|
*Brand names with asterisks beside them have been discontinued in the US. The generic versions of these drugs continue to be FDA approved and are available in the US.
Most ACE inhibitors control blood pressure for 24 hours with a once or twice daily dosing. After oral dosing, ACE inhibitors are absorbed rapidly with a wide range of bioavailability (10% for trandolapril to 75% for captopril).1-14
Most ACE inhibitors can be taken with or without food, including benazepril, enalapril, fosinopril, lisinopril, quinapril, ramipril, and trandolapril.1,4,6,8-9,12-14 Captopril and moexipril should be taken on an empty stomach to maximize bioavailability.2,10-11
A 2015 systematic comparison of all clinically used ACE inhibitors confirmed that most are rapidly absorbed with maximum bioavailability being reached within 0.5 to 6 hours depending on the specific ACE inhibitor and dose.15
References
- Lotensin [package insert]. Parsippany, NJ: Validus Pharmaceuticals LLC; 2019.
- Capoten [package insert]. Chestnut Ridge, NY: Par Pharmaceutical; 2017.
- Epaned [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
- Vasotec [package insert]. Bridgewater, NJ: Bausch Health US LLC; 2018.
- Enalaprilat [package insert]. Lake Forest, IL: Hospira, Inc.; 2021.
- Monopril [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; 2003.
- Qbrelis [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
- Prinivil [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2021.
- Zestril [package insert]. Morristown, NJ: Almatica Pharma LLC; 2020.
- Univasc [package insert]. Smyrna, GA: USB, Inc; 2012.
- Aceon [package insert]. Cincinnati, OH: Patheon Pharmaceuticals, Inc.; 2017.
- Accupril [package insert]. New York, NY: Parke Davis, Pfizer; 2021.
- Altace [package insert]. New York, NY: Pfizer Laboratories; 2022.
- Mavik [package insert]. Whippany, NJ: Halo Pharmaceutical Inc.; 2017.
- Regulski M, Regulska K, Stanisz BJ, et al. Chemistry and pharmacology of angiotensin-converting enzyme inhibitors. Curr Pharm Des 2015; 21 (13): 1764-1775.
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