Angiotensin-converting enzyme (ACE) inhibitors are rapidly absorbed with maximum bioavailability being reached within 30 minutes to 7 hours depending on the specific ACE inhibitor and dose. Elimination half-life ranges from between one to 12 hours. 1-15
Some ACE inhibitors may take several weeks of treatment to reach maximal blood pressure response, including captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, and rampipril.2-11,13
Maximal blood pressure response is usually reached within the first one to two weeks of dosing for benazepril, quinapril, and trandolapril.1,13, 15
Table 1: ACE inhibitor maximum bioavailability, elimination half-life, and time to maximal effect1-14
|
ACE Inhibitor
|
Tmax (h)
|
t1/2 (h)
|
Time to Maximal Effect
|
|
Benazepril (Lotensin)
|
0.5-1
|
10-11
|
2-3 days
|
|
Captopril (Capoten*)
|
1
|
<2
|
Several weeks
|
|
Enalapril oral solution (Epaned)
|
4-6
|
11
|
Several weeks
|
|
Enalapril (Vasotec)
|
1
|
11
|
Several weeks
|
|
Enalaprilat injection (Vasotec injection*)
|
1-4
|
11
|
Several weeks
|
|
Fosinopril (Monopril*)
|
3
|
12
|
Several weeks
|
|
Lisinopril oral solution (Qbrelis)
|
6
|
12
|
2-4 weeks
|
|
Lisinopril (Prinivil*, Zestril)
|
6
|
12
|
2-4 weeks
|
|
Moexipril (Univasc*)
|
1.5
|
12
|
2-4 weeks
|
|
Perindopril (Aceon*)
|
3-7
|
1
|
Several weeks
|
|
Quinapril (Accupril)
|
2
|
3
|
1-2 weeks
|
|
Ramipril (Altace)
|
1
|
2-4
|
2-4 weeks
|
|
Trandolapril (Mavik*)
|
1
|
6
|
1 week
|
*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.
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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