Cardiovascular Medicine Book

http://www.fpnotebook.com/

ACE Inhibitor

Aka: ACE Inhibitor, Angiotensin Converting Enzyme Inhibitor, Captopril, Capoten, Lisinopril, Prinivil, Zestril, Enalapril, Vasotec, Fosinopril, Monopril, Benzapril, Lotensin, Moexipril, Univasc, Perindopril, Aceon, Quinapril, Accupril, Ramipril, Altace, Trandopril, Mavik
Advertisement
  1. See Also
    1. Angiotensin Receptor Blocker
  2. Contraindications
    1. Absolute Contraindications
      1. Angioneurotic edema: even if not due to ACE Inhibitor
      2. Pregnancy (serious Teratogenicity - black box warning)
      3. Renal Artery Stenosis
      4. ACE Inhibitor related Allergic Reaction
    2. Relative Contraindications
      1. Aortic Stenosis
      2. Hypertrophic Cardiomyopathy
  3. Indications
    1. Hypertension
      1. Useless in low renin patients (esp. Black ethnicity)
      2. Low renin patients respond better to Diuretics
    2. Myocardial Infarction
      1. Early ACE Inhibitor in acute Myocardial Infarction
        1. Started within 24 hours of Anterior MI
        2. Significant reduction in CHF and death
        3. Significantly lower mortality at 1 year
      2. Reference
        1. Ambrosioni (1995) N Engl J Med 332:80-5
        2. Stenestrand (2001) JAMA 285:430-6
    3. Congestive Heart Failure
      1. Left ventricle Systolic Dysfunction
    4. Diabetic Nephropathy
    5. Renal insufficiency
  4. Mechanism
    1. Renin-Angiotensin System
  5. Preparations (Choose once daily dosing if possible)
    1. Captopril (Capoten)
      1. Hypertension: 25 mg PO bid-tid (maximum 450 mg/day)
      2. CHF: 6.25 - 12.5 mg PO tid (maximum 450 mg/day)
    2. Enalapril (Vasotec)
      1. Hypertension: 5 mg PO qd (maximum 40 mg/day)
      2. CHF: 2.5 mg PO qd-bid (maximum 40 mg/day)
      3. IV: 1.25 mg IV q6h
    3. Lisinopril (Prinivil, Zestril)
      1. Hypertension: 10 mg PO qd (target 20-40 mg/day)
      2. CHF: 5 mg PO qd (target 20 mg/day)
      3. Acute MI: 5 mg PO qd for 2 days then 10 mg qd
      4. Maximum 40 mg/day
    4. Fosinopril (Monopril)
      1. Hypertension: 10 mg PO qd (target 40 mg/day)
      2. CHF: 10 mg PO qd (target 20-40 mg/day)
      3. Maximum: 80 mg/day
    5. Benzapril (Lotensin)
      1. Hypertension: 10 mg PO qd (target 20-40 mg/day)
      2. Maximum: 80 mg/day
    6. Moexipril (Univasc): Take one hour before meals
      1. Hypertension: 7.5 mg PO qd (maximum 30 mg/day)
    7. Perindopril (Aceon)
      1. Hypertension: 4 mg PO qd (target 4-8 mg/day)
      2. Maximum 16 mg/day
    8. Quinapril (Accupril)
      1. Hypertension: 10 mg PO qd (target 20-40 mg/day)
      2. CHF: 5 mg PO bid, titrating weekly to 20-40 mg/day
      3. Maximum: 80 mg/day
    9. Ramipril (Altace)
      1. Hypertension: 2.5 mg PO qd (target 2.5-20 mg qd)
      2. CHF: 2.5 mg PO bid (target 5 mg bid)
      3. Maximum 20 mg/day
    10. Trandopril (Mavik)
      1. Hypertension: 1 mg PO qd (target 2 to 4 mg qd)
      2. CHF: 1 mg PO qd (target 4 mg qd)
      3. Maximum: 8 mg/day
  6. Adverse Effects
    1. Cough (dry and irritating)
      1. Characteristics
        1. Occurs in 5 to 20% of patients
          1. More common in women
          2. More common in black patients
        2. Not dose related
        3. Stops within 4 days of medication cessation
      2. Alternative medications
        1. Angiotensin Receptor Blocker (e.g. Losartan)
      3. Inhalers may relieve cough
        1. Tilade 2 puffs inhaled qid
        2. Cromolyn 20 mg inhaled qid
    2. Hyperkalemia (5% of patients)
      1. See Drug Interactions below
      2. Asociated with renal insufficiency, Diabetes Mellitus
    3. Teratogenicity in second or third trimester
      1. Fetal injury or death
      2. Pregnancy Class C if discontinued in first trimester
    4. Renal Insufficiency
      1. Renal Artery Stenosis (see monitoring below)
      2. No Creatinine level is absolute contraindication
      3. Baseline Serum Creatinine <3.0 mg/dl is safe
    5. Hypotension
      1. Restart ACE Inhibitor at half prior dose
      2. Decrease or hold dose of any concurrent Diuretic
    6. Angioedema
      1. ACE-Inhibitor induced Angioedema is not an Allergic Reaction (unlike typical Angioedema)
        1. Related to bradykinin accumulation
        2. Does not respond to typical Angioedema management (e.g. Corticosteroids, Antihistamines)
      2. More common in african american patients by factor of 2-4 fold
      3. Reaction can occur months to years after starting an ACE Inhibitor
      4. Treatment is withdrawal of medication and supportive care
      5. ACE-Inhibitor Angioedema will recur with ARB agents in 8% of patients
    7. Rare Adverse Reactions
      1. Rash
      2. Agranulocytosis
      3. Neutropenia
        1. Associated with comorbid renal insufficiency
        2. Associated with comorbid collagen vascular disease
  7. Drug Interactions
    1. Increases Lithium levels (follow levels)
    2. Decreased ACE Inhibitor levels with concurrent antacids
    3. Decreased Renal Function with concurrent NSAID use
    4. Agents predisposing to Hyperkalemia
      1. Bactrim
      2. Potassium supplements or salt substitute
      3. Beta Blockers
      4. NSAIDs
      5. Potassium sparing Diuretics
        1. Triamterene
        2. Spironolactone
  8. Monitoring
    1. Serum Potassium (if patient at risk)
    2. Serum Creatinine
      1. Timing
        1. Baseline
        2. Recheck in 4 days to 2 weeks
      2. Expect an increase in Chronic Kidney Disease
        1. Despite this, renal protective effect outweighs mild to moderate Creatinine increase
      3. Indication to consider stopping ACE Inhibitor
        1. Serum Creatinine increased >20% in 4 days
      4. Additional precautions when increasing dose
        1. Serum Creatinine should not increase >30%
  9. References
    1. (1987) N Engl J Med 316(23):1429-35
    2. Bicket (2002) Am Fam Physician 66(3):461-73
    3. Pfeffer (1992) N Engl J Med 327(10):669-77
    4. Yeun (2001) Postgrad Med 110(5):39-40
Medication Costs
CAPTOPRIL (on 2/10/2012 at Target.com)
CAPTOPRIL 12.5 MG Tablet #30 for $4.00 ($0.13/unit)
CAPTOPRIL 25 MG Tablet #30 for $4.00 ($0.13/unit)
CAPTOPRIL 50 MG Tablet #30 for $4.00 ($0.13/unit)
CAPTOPRIL 100 MG Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL (on 2/10/2012 at Target.com)
LISINOPRIL 2.5 MG Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL 5 MG Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL 10 MG Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL 20 MG Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL/HCTZ (on 2/10/2012 at Target.com)
LISINOPRIL/HCTZ 10-12.5 MG Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL/HCTZ 20-12.5 MG* Tablet #30 for $4.00 ($0.13/unit)
LISINOPRIL/HCTZ 20-25 MG* Tablet #30 for $4.00 ($0.13/unit)
ENALAPRIL (on 2/10/2012 at Target.com)
ENALAPRIL 2.5 MG Tablet #30 for $4.00 ($0.13/unit)
ENALAPRIL 5 MG Tablet #30 for $4.00 ($0.13/unit)
ENALAPRIL 10 MG Tablet #30 for $4.00 ($0.13/unit)
ENALAPRIL 20 MG Tablet #30 for $4.00 ($0.13/unit)
ENALAPRIL/HCTZ (on 2/10/2012 at Target.com)
ENALAPRIL/HCTZ 5/12.5 MG Tablet #30 for $4.00 ($0.13/unit)
Captopril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com)
Captopril-Hydrochlorothiazide 50-15mg Tablets #60 for $53.99 ($0.90/unit)
Captopril-Hydrochlorothiazide 25-15mg Tablets #90 for $47.99 ($0.53/unit)
Captopril-Hydrochlorothiazide 25-25mg Tablets #90 for $44.99 ($0.50/unit)
Captopril-Hydrochlorothiazide 50-25mg Tablets #60 for $54.99 ($0.92/unit)
Captopril (on 2/9/2012 at DrugStore.com)
Captopril 25mg Tablets #90 for $13.99 ($0.16/unit)
Captopril 12.5mg Tablets #100 for $12.99 ($0.13/unit)
Captopril 50mg Tablets #100 for $16.99 ($0.17/unit)
Captopril 100mg Tablets #90 for $19.99 ($0.22/unit)
Lisinopril (on 2/9/2012 at DrugStore.com)
Lisinopril 30mg Tablets #30 for $20.99 ($0.70/unit)
Lisinopril 2.5mg Tablets #30 for $12.99 ($0.43/unit)
Lisinopril 5mg Tablets #30 for $14.89 ($0.50/unit)
Lisinopril 10mg Tablets #30 for $13.99 ($0.47/unit)
Lisinopril 20mg Tablets #30 for $14.99 ($0.50/unit)
Lisinopril 40mg Tablets #30 for $17.99 ($0.60/unit)
Lisinopril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com)
Lisinopril-Hydrochlorothiazide 10-12.5mg Tablets #30 for $23.99 ($0.80/unit)
Lisinopril-Hydrochlorothiazide 20-12.5mg Tablets #30 for $21.99 ($0.73/unit)
Lisinopril-Hydrochlorothiazide 20-25mg Tablets #30 for $21.99 ($0.73/unit)
Prinivil (on 2/9/2012 at DrugStore.com)
Prinivil 90 5mg Tablets Bottle #1 for $102.98 ($102.98/unit)
Prinivil 10mg Tablets #60 for $75.99 ($1.27/unit)
Prinivil 20mg Tablets #30 for $45.99 ($1.53/unit)
Zestril (on 2/9/2012 at DrugStore.com)
Zestril 5mg Tablets #30 for $50.99 ($1.70/unit)
Zestril 10mg Tablets #30 for $55.11 ($1.84/unit)
Zestril 20mg Tablets #30 for $52.99 ($1.77/unit)
Zestril 30mg Tablets #30 for $71.99 ($2.40/unit)
Zestril 40mg Tablets #30 for $73.99 ($2.47/unit)
Zestril 2.5mg Tablets #30 for $37.99 ($1.27/unit)
Enalapril Maleate (on 2/9/2012 at DrugStore.com)
Enalapril Maleate 2.5mg Tablets #30 for $13.99 ($0.47/unit)
Enalapril Maleate 5mg Tablets #30 for $11.99 ($0.40/unit)
Enalapril Maleate 10mg Tablets #30 for $11.99 ($0.40/unit)
Enalapril Maleate 20mg Tablets #30 for $11.99 ($0.40/unit)
Enalapril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com)
Enalapril-Hydrochlorothiazide 10-25mg Tablets #30 for $27.99 ($0.93/unit)
Enalapril-Hydrochlorothiazide 5-12.5mg Tablets #30 for $23.99 ($0.80/unit)
Vasotec (on 2/9/2012 at DrugStore.com)
Vasotec 2.5mg Tablets #60 for $162.24 ($2.70/unit)
Vasotec 5mg Tablets #30 for $86.31 ($2.88/unit)
Vasotec 10mg Tablets #30 for $95.99 ($3.20/unit)
Vasotec 20mg Tablets #30 for $132.99 ($4.43/unit)
Fosinopril Sodium (on 2/9/2012 at DrugStore.com)
Fosinopril Sodium 10mg Tablets #60 for $60.99 ($1.02/unit)
Fosinopril Sodium 20mg Tablets #60 for $59.99 ($1.00/unit)
Fosinopril Sodium 40mg Tablets #30 for $31.99 ($1.07/unit)
Fosinopril Sodium-HCTZ (on 2/9/2012 at DrugStore.com)
Fosinopril Sodium-HCTZ 10-12.5mg Tablets #60 for $99.99 ($1.67/unit)
Fosinopril Sodium-HCTZ 20-12.5mg Tablets #60 for $89.99 ($1.50/unit)
Monopril (on 2/9/2012 at DrugStore.com)
Monopril 40mg Tablets #60 for $97.99 ($1.63/unit)
Monopril HCT (on 2/9/2012 at DrugStore.com)
Monopril HCT 10-12.5mg Tablets #60 for $94.99 ($1.58/unit)
Lotensin (on 2/9/2012 at DrugStore.com)
Lotensin 5mg Tablets #30 for $62.80 ($2.09/unit)
Lotensin 10mg Tablets #30 for $67.99 ($2.27/unit)
Lotensin 20mg Tablets #30 for $61.99 ($2.07/unit)
Lotensin 40mg Tablets #30 for $67.99 ($2.27/unit)
Lotensin HCT (on 2/9/2012 at DrugStore.com)
Lotensin HCT 10-12.5mg Tablets #30 for $62.99 ($2.10/unit)
Lotensin HCT 20-12.5mg Tablets #30 for $63.99 ($2.13/unit)
Lotensin HCT 20-25mg Tablets #30 for $64.99 ($2.17/unit)
Moexipril HCl (on 2/9/2012 at DrugStore.com)
Moexipril HCl 15mg Tablets #30 for $41.99 ($1.40/unit)
Moexipril HCl 7.5mg Tablets #30 for $40.99 ($1.37/unit)
Moexipril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com)
Moexipril-Hydrochlorothiazide 7.5-12.5mg Tablets #30 for $37.99 ($1.27/unit)
Moexipril-Hydrochlorothiazide 15-12.5mg Tablets #100 for $109.98 ($1.10/unit)
Moexipril-Hydrochlorothiazide 15-25mg Tablets #30 for $36.99 ($1.23/unit)
Univasc (on 2/9/2012 at DrugStore.com)
Univasc 7.5mg Tablets #30 for $61.99 ($2.07/unit)
Univasc 15mg Tablets #30 for $85.99 ($2.87/unit)
Perindopril Erbumine (on 2/9/2012 at DrugStore.com)
Perindopril Erbumine 4mg Tablets #100 for $80.99 ($0.81/unit)
Perindopril Erbumine 8mg Tablets #100 for $88.99 ($0.89/unit)
Perindopril Erbumine 2mg Tablets #100 for $75.99 ($0.76/unit)
Aceon (on 2/9/2012 at DrugStore.com)
Aceon 2mg Tablets #100 for $199.00 ($1.99/unit)
Aceon 4mg Tablets #30 for $77.99 ($2.60/unit)
Aceon 8mg Tablets #100 for $278.49 ($2.78/unit)
Quinapril-Hydrochlorothiazide (on 2/9/2012 at DrugStore.com)
Quinapril-Hydrochlorothiazide 10-12.5mg Tablets #30 for $35.99 ($1.20/unit)
Quinapril-Hydrochlorothiazide 20-25mg Tablets #90 for $90.99 ($1.01/unit)
Quinapril-Hydrochlorothiazide 20-12.5mg Tablets #90 for $86.99 ($0.97/unit)
Quinapril HCl (on 2/9/2012 at DrugStore.com)
Quinapril HCl 10mg Tablets #30 for $19.99 ($0.67/unit)
Quinapril HCl 5mg Tablets #30 for $23.99 ($0.80/unit)
Quinapril HCl 20mg Tablets #30 for $26.97 ($0.90/unit)
Quinapril HCl 40mg Tablets #30 for $21.99 ($0.73/unit)
Accupril (on 2/9/2012 at DrugStore.com)
Accupril 5mg Tablets #30 for $69.27 ($2.31/unit)
Accupril 10mg Tablets #30 for $62.99 ($2.10/unit)
Accupril 20mg Tablets #30 for $67.99 ($2.27/unit)
Accupril 40mg Tablets #30 for $66.99 ($2.23/unit)
Ramipril (on 2/9/2012 at DrugStore.com)
Ramipril 2.5mg Capsules #30 for $49.99 ($1.67/unit)
Ramipril 5mg Capsules #30 for $52.99 ($1.77/unit)
Ramipril 10mg Capsules #30 for $62.99 ($2.10/unit)
Ramipril 1.25mg Capsules #100 for $99.99 ($1.00/unit)
Altace (on 2/9/2012 at DrugStore.com)
Altace 1.25mg Capsules #30 for $67.99 ($2.27/unit)
Altace 2.5mg Capsules #30 for $77.99 ($2.60/unit)
Altace 5mg Capsules #30 for $81.99 ($2.73/unit)
Altace 10mg Capsules #30 for $90.99 ($3.03/unit)
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Angiotensin-Converting Enzyme Inhibitors (C0003015)

Definition (CHV) a class of druges mainly used for hypertension treatment
Definition (CHV) a class of druges mainly used for hypertension treatment
Definition (CHV) a class of druges mainly used for hypertension treatment
Definition (NCI) A drug that is used to lower blood pressure. An ACE inhibitor is a type of antihypertensive agent.
Definition (CSP) class of antihypertensive agents which act by inhibiting the proteolytic activation of angiotensin.
Definition (MSH) A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility.
Definition (NCI) A class of agents that target at angiotensin-converting enzyme (ACE), which catalyzes conversion of angiotensin I to angiotensin II. As a result these inhibitors cause vasodilation and mild natriuresis. In addition, ACE inhibitors induce prostaglandin synthesis, which also plays a role in their antihypertensive effects.
Concepts Pharmacologic Substance (T121)
MSH D000806
SnomedCT 41549009, 372733002
English ACE Inhibitors, Angiotensin Converting Enzyme Antagonists, Angiotensin Converting Enzyme Inhibitors, Angiotensin-Converting Enzyme Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antagonists, Angiotensin Converting Enzyme, Antagonists, Angiotensin-Converting Enzyme, Antagonists, Kininase II, Enzyme Antagonists, Angiotensin-Converting, Enzyme Inhibitors, Angiotensin-Converting, Inhibitors, ACE, Inhibitors, Angiotensin Converting Enzyme, Inhibitors, Angiotensin-Converting Enzyme, Inhibitors, Kininase II, Kininase II Antagonists, Kininase II Inhibitors, Angiotensin I-Converting Enzyme Inhibitors, ACE inhibitor, NOS, Angiotensin-converting enzyme inhibitor agent, NOS, KININASE II INHIB, INHIB ACE, ACE INHIB, ANGIOTENSIN I CONVERTING ENZYME INHIB, ANTAG ANGIOTENSIN CONVERTING ENZYME, ANGIOTENSIN CONVERTING ENZYME ANTAG, INHIB ANGIOTENSIN CONVERTING ENZYME, ANTAG KININASE II, INHIB KININASE II, KININASE II ANTAG, ACE INHIBITORS, Angiotensin-Converting Enzyme Inhibitor, angiotensin converting enzyme inhibitor, ACE inhibitors, angiotensin-converting enzyme inhibitors (medication), angiotensin-converting enzyme inhibitors, ACE INHIBITOR, Angiotensin Converting Enzyme Inhibitor, [CV800] ACE INHIBITORS, Angiotensin Converting Enzyme Inhibitor [EPC], ace inhibitors, angiotensin-converting enzyme (ACE) inhibitors, ace inhibitor, angiotensin-converting enzyme inhibitor, Angiotensin I Converting Enzyme Inhibitors, ACE inhibitor, Angiotensin-converting enzyme inhibitor, Angiotensin-converting enzyme inhibitor agent (product), Angiotensin-converting enzyme inhibitor agent (substance), Angiotensin-converting enzyme inhibitor agent, ACE Inhibitor, Angiotensin-converting Enzyme (ACE) Inhibitors
Swedish ACE-hämmare
Czech enzym konvertující angiotensin - inhibitory, inhibitory ACE
Finnish Angiotensiinikonvertaasin estäjät
Italian Antagonosti dell'enzima convertitore di angiotensina, Inibitori della chinasi II, Antagonisti della chinasi II, Inibitori ACE, Inibitori dell'enzima convertitore di angiotensina I, Inibitori dell'enzima convertitore di angiotensina
Russian ANGIOTENZIN-PREVRASHCHAIUSHCHEGO FERMENTA INGIBITORY, KININAZY II INGIBITORY, АНГИОТЕНЗИН-ПРЕВРАЩАЮЩЕГО ФЕРМЕНТА ИНГИБИТОРЫ, КИНИНАЗЫ II ИНГИБИТОРЫ
Japanese ACE阻害剤, アンギオテンシン変換酵素阻害剤, アンジオテンシン変換酵素抑制剤, キニナーゼ2阻害剤, ACE阻害薬, Angiotensin変換酵素阻害薬, アンギオテンシン変換酵素阻害薬, アンジオテンシン変換酵素阻害剤, アンジオテンシン変換酵素阻害薬, キニナーゼII阻害剤
Croatian ANGIOTENZIN, DJELOVANJE ENZIMSKIH INHIBITORA
French IEC (Inhibiteurs de l'Enzyme de Conversion), Inhibiteurs ACE, Inhibiteurs de la kininase II, Inhibiteurs de l'angiotensin converting enzyme, Inhibiteurs de l'enzyme de conversion de l'angiotensine, Inhibiteurs de l'enzyme de conversion, Inhibiteurs ECA
Polish Inhibitory enzymu konwertującego angiotensynę, Inhibitory ACE, Inhibitory kinazy II, Inhibitory konwertazy angiotensyny
Spanish IECA, agente inhibidor de la enzima convertidora de angiotensina (producto), agente inhibidor de la enzima convertidora de angiotensina (sustancia), agente inhibidor de la enzima convertidora de angiotensina, droga inhibidora de la enzima convertidora de angiotensina, inhibidor de la ECA, inhibidor de la convertasa, Inhibidores de ACE, Inhibidores de la Enzima Convertidora de Angiotensina, Inhibidores de Quininasa II
German ACE-Hemmer, Angiotensin-Converting-Enzym-Hemmer, Kininase-II-Blocker, Angiotensin-Konversionsenzym-Inhibitoren
Portuguese Inibidores da ACE, Inibidores da Enzima Conversora da Angiotensina, Inibidores da Quininase II
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Captopril (C0006938)

Definition (NCI) A drug used to treat high blood pressure that is also being studied in the prevention of side effects caused by radiation therapy used in the treatment of cancer. It belongs to the family of drugs called ACE inhibitors.
Definition (MSH) A potent and specific inhibitor of PEPTIDYL-DIPEPTIDASE A. It blocks the conversion of ANGIOTENSIN I to ANGIOTENSIN II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the RENIN-ANGIOTENSIN SYSTEM and inhibits pressure responses to exogenous angiotensin.
Definition (NCI) A sulfhydryl-containing analog of proline with antihypertensive activity and potential antineoplastic activity. Captopril competitively inhibits angiotensin converting enzyme (ACE), thereby decreasing levels of angiotensin II, increasing plasma renin activity, and decreasing aldosterone secretion. This agent may also inhibit tumor angiogenesis by inhibiting endothelial cell matrix metalloproteinases (MMPs) and endothelial cell migration. Captopril may also exhibit antineoplastic activity independent of effects on tumor angiogenesis. (NCI04)
Definition (CSP) potent and specific inhibitor of peptidyl dipeptidase A; it acts to suppress the renin-angiotensin system and inhibits blood pressure responses to exogenous angiotensin.
Definition (PDQ) A sulfhydryl-containing analog of proline with antihypertensive activity and potential antineoplastic activity. Captopril competitively inhibits angiotensin converting enzyme (ACE), thereby decreasing levels of angiotensin II, increasing plasma renin activity, and decreasing aldosterone secretion. This agent may also inhibit tumor angiogenesis by inhibiting endothelial cell matrix metalloproteinases (MMPs) and endothelial cell migration. Captopril may also exhibit antineoplastic activity independent of effects on tumor angiogenesis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37824&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37824&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C340" NCI Thesaurus)
Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D002216
SnomedCT 29439004, 387160004
English (S)-1-(3-Mercapto-2-methyl-1-oxopropyl)-L-proline, L-Proline, 1-(3-mercapto-2-methyl-1-oxopropyl)-, (S)-, captopril, captopril (medication), CAPTOPRIL, Captopril [Chemical/Ingredient], Captopril (product), Captopril (substance), CPT, Captopril
Swedish Kaptopril
Czech kaptopril
Finnish Kaptopriili
Russian KAPTOPRIL, SQ 14225, КАПТОПРИЛ
Japanese カプトプリル
French (S)-1-(3-Mercapto-2-méthyl-1-oxopropyl)-L-proline, Captopril
Croatian KAPTOPRIL
Polish Kaptopryl
Spanish captopril (producto), captopril (sustancia), captoprilo, captopril, Captopril
German Captopril
Italian Captopril
Portuguese Captopril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Enalapril (C0014025)

Definition (CHV) a drug used to treat hypertension
Definition (CSP) 1-carboxy-3-phenylpropyl-L-alanyl- L-proline (as 1'-ethyl ester, maleate 1:1), is an ACE inhibitor used as an antihypertensive.
Definition (MSH) One of the ANGIOTENSIN-CONVERTING ENZYME INHIBITORS that is used to treat hypertension.
Definition (NCI) An antihypertensive agent that can also be used to slow or prevent the progression of heart disease in people with childhood cancer treated with drugs that may be harmful to the heart.
Definition (NCI) A dicarbocyl-containing peptide and angiotensin-converting enzyme (ACE) inhibitor with antihypertensive activity. As a prodrug, enalapril is converted by de-esterification into its active form enalaprilat. Enalaprilat competitively binds to and inhibits ACE, thereby blocking the conversion of angiotensin I to angiotensin II. This prevents the potent vasoconstrictive actions of angiotensin II and results in vasodilation. Enalapril also decreases angiotensin II-induced aldosterone secretion by the adrenal cortex, which leads to an increase in sodium excretion and subsequently increases water outflow.
Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D004656
SnomedCT 15222008, 372658000
English Enalapril, enalapril, L-Proline, 1-(N-(1-(ethoxycarbonyl)-3-phenylpropyl)-L-alanyl)-, (S)-, Enalapril [Chemical/Ingredient], Enalapril (product), Enalapril (substance), ENALAPRIL
Swedish Enalapril
Czech enalapril
Finnish Enalapriili
Russian ANALAPRILA MALEAT, ENALAPRIL, MK-421, АНАЛАПРИЛА МАЛЕАТ, ЭНАЛАПРИЛ
Japanese エナラート, レリート, エナリン, ラリルドン, レニベース, レニベーゼ, レニメック, エナラプリルMEEK, レノペント, エナラプリルM, エナラメルク, カルネート, シンベノン, ファルプリル, スパシオール, マレイン酸エナラプリル, ザクール, セリース, レビンベース, エナラプリルマレイン酸塩, アリカンテ, エナラプリル
Croatian ENALAPRIL
Spanish enalaprilo, enalapril (producto), enalapril (sustancia), enalapril, Enalapril
Polish Enalapryl
French Énalapril
German Enalapril
Italian Enalapril
Portuguese Enalapril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Lisinopril (C0065374)

Definition (NCI) An orally bioavailable, long-acting angiotensin-converting enzyme (ACE) inhibitor with antihypertensive activity. Lisinopril, a synthetic peptide derivative, specifically and competitively inhibits ACE, which results in a decrease in the production of the potent vasoconstrictor angiotensin II and, so, diminished vasopressor activity. In addition, angiotensin II-stimulated aldosterone secretion by the adrenal cortex is decreased which results in a decrease in sodium and water retention and an increase in serum potassium.
Definition (CHV) a drug used to treat hypertension and congestive heart failure
Definition (CHV) a drug used to treat hypertension and congestive heart failure
Definition (NCI) A drug used to treat high blood pressure and certain heart conditions. It is also being studied in the prevention and treatment of side effects caused by some anticancer drugs. It blocks certain enzymes that cause blood vessels to constrict (narrow). It is a type of angiotensin-converting enzyme (ACE) inhibitor.
Definition (MSH) One of the ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACE inhibitors), orally active, that has been used in the treatment of hypertension and congestive heart failure.
Definition (CSP) lysine derivative of the active form of enalapril; an angiotensin converting enzyme inhibitor used in the treatment of hypertension.
Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D017706
SnomedCT 108575001, 386873009
English Lisinopril, Lysinopril, L-Proline, 1-(N2-(1-carboxy-3-phenylpropyl)-L-lysyl)-, dihydrate, (S)-, lisinopril, N2-[(1S)-1-Carboxy-3-phenylpropyl]-L-lysyl-L-proline, Dihydrate, lisinopril (medication), LISINOPRIL, Lisinopril [Chemical/Ingredient], lysinopril, Lisinopril (product), Lisinopril (substance)
Swedish Lisinopril
Czech lisinopril
Finnish Lisinopriili
Russian LIZINOPRIL, ЛИЗИНОПРИЛ
Japanese リシノプリル, リジノプリル
Croatian LIZINOPRIL
Spanish lisinoprilo, lisinopril (producto), lisinopril (sustancia), lisinopril, Lisinopril
Polish Lizynopryl
French Lisinopril
German Lisinopril
Italian Lisinopril
Portuguese Lisinopril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


moexipril (C0066685)

Definition (NCI) A non-sulfhydryl angiotensin converting enzyme (ACE) inhibitor with antihypertensive activity. As a prodrug, moexipril is hydrolyzed into its active form moexiprilat, which competitively inhibits ACE, thereby blocking the conversion of angiotensin I to angiotensin II. This prevents the actions of the potent vasoconstrictor angiotensin II and leads to vasodilation. It also prevents angiotensin II-induced aldosterone secretion by the adrenal cortex, thereby promoting diuresis and natriuresis.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C058302
SnomedCT 108566003, 373442003
English 2-((1-ethoxycarbony)-3-phenylpropylamino-1-oxopropyl)-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinoline-3-carboxylic acid, moexipril, MOEXIPRIL, moexipril [Chemical/Ingredient], Moexipril, Moexipril (product), Moexipril (substance)
Spanish moexipril (producto), moexipril (sustancia), moexiprilo, moexipril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


quinapril (C0072857)

Definition (NCI) A prodrug and non-sulfhydryl angiotensin converting enzyme (ACE) inhibitor with antihypertensive activity. Quinapril is hydrolized into its active form quinaprilat, which binds to and inhibits ACE, thereby blocking the conversion of angiotensin I to angiotensin II. This abolishes the potent vasoconstrictive actions of angiotensin II and leads to vasodilatation. Quinapril also causes a decrease in angiotensin II-induced aldosterone secretion by the adrenal cortex, thereby promoting diuresis and natriuresis, and increases bradykinin levels.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C041125
SnomedCT 108578004, 386874003
English 2-(2-((1-(ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)-1,2,3,4-tetrahydro-3-isoquinolinecarboxylic acid, 3-Isoquinolinecarboxylic acid, 2-(2-((1-(ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)-1,2,3,4-tetrahydro-, monohydrochloride, (3S-(2(R*(R*)),3R*))-, quinapril, quinapril (medication), quinapril [Chemical/Ingredient], Quinapril, Quinapril (product), Quinapril (substance), QUINAPRIL
Spanish quinapril (producto), quinapril (sustancia), quinaprilo, quinapril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Ramipril (C0072973)

Definition (MSH) A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat.
Definition (NCI) A prodrug and nonsulfhydryl angiotensin converting enzyme (ACE) inhibitor with antihypertensive activity. Ramipril is converted in the liver by de-esterification into its active form ramiprilat, which inhibits ACE, thereby blocking the conversion of angiotensin I to angiotensin II. This abolishes the potent vasoconstrictive actions of angiotensin II and leads to vasodilatation. This agent also causes an increase in bradykinin levels and a decrease in angiotensin II-induced aldosterone secretion by the adrenal cortex, thereby promoting diuresis and natriuresis.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D017257
SnomedCT 108564000, 386872004
English Ramipril, Cyclopenta(b)pyrrole-2-carboxylic acid, 1-(2-((1-(ethoxycarbonyl)-3-phenylpropyl)amino)-1-oxopropyl)octahydro-, (2S-(1(R*(R*)),2alpha,3abeta,6abeta))-, ramipril, ramipril (medication), RAMIPRIL, Ramipril [Chemical/Ingredient], Ramipril (product), Ramipril (substance)
Swedish Ramipril
Czech ramipril
Finnish Ramipriili
Russian RAMIPRIL, РАМИПРИЛ
Japanese ラミプリル
Croatian RAMIPRIL
Polish Ramipryl
Spanish ramipril (producto), ramipril (sustancia), ramiprilo, ramipril, Ramipril
French Ramipril
German Ramipril
Italian Ramiprile
Portuguese Ramipril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Fosinopril (C0118168)

Definition (MSH) A phosphinic acid-containing angiotensin-converting enzyme inhibitor that is effective in the treatment of hypertension. It is a prodrug that is converted to its active metabolite fosinoprilat.
Definition (NCI) A phosphinic acid-containing angiotensin-converting enzyme (ACE) inhibitor with antihypertensive activity. As an ester prodrug, fosinopril is hydrolysed by esterases to its active metabolite fosinoprilat. Fosinoprilat specifically and competitively inhibits angiotensin-converting enzyme thereby decreasing the formation of the potent vasoconstrictor angiotensin II, resulting in diminished vasopressor activity. In addition, angiotensin II-mediated aldosterone secretion by adrenal cortex is decreased, which results in a decrease of sodium retention and an increase in water outflow.
Concepts Organophosphorus Compound (T115) , Pharmacologic Substance (T121)
MSH D017328
SnomedCT 108569005, 372510000
English Fosenopril, Fosinopril, L-Proline, 4-cyclohexyl-1-(((2-methyl-1-(1-oxopropoxy)propoxy)(4-phenylbutyl)phosphinyl)acetyl)-, (1(S*(R*)),2alpha,4beta)-, fosinopril, Fosinopril [Chemical/Ingredient], Fosinopril (product), Fosinopril (substance), FOSINOPRIL
Swedish Fosinopril
Czech fosinopril
Finnish Fosinopriili
Russian FOSENOPRIL, FOSINOPRIL, ФОСЕНОПРИЛ, ФОСИНОПРИЛ
Japanese ホセノプリル, ホシノプリル
Italian Fosenopril, Fosinopril
Polish Fozynopryl, Fosenopryl
Spanish fosinopril (producto), fosinopril (sustancia), fosinoprilo, fosinopril, Fosenopril, Fosinopril
French Fosénopril, Fosinopril
German Fosenopril, Fosinopril
Portuguese Fosenopril, Fosinopril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Perindopril (C0136123)

Definition (NCI) A non-sulfhydryl angiotensin converting enzyme (ACE) inhibitor with antihypertensive activity. Upon hydrolysis, perindopril is converted to its active form perindoprilat, inhibiting ACE and the conversion of angiotensin I to angiotensin II; consequently, angiotensin II-mediated vasoconstriction and angiotensin II-stimulated aldosterone secretion from the adrenal cortex are inhibited and diuresis and natriuresis ensue.
Definition (MSH) An angiotensin-converting enzyme inhibitor. It is used in patients with hypertension and heart failure.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D020913
SnomedCT 350606002, 129486004, 372916001
English perindopril, Perindopril, 1H-Indole-2-carboxylic acid, 1-(2-((1-(ethoxycarbonyl)butyl)amino)-1-oxopropyl)octahydro-, Pirindopril, (2S,3aS,7aS)-1-((S)-N-((S)-1-Carboxybutyl)alanyl)hexahydro-2-indolinecarboxylic Acid, 1-ethyl Ester, Perindopril [Chemical/Ingredient], pirindopril, Perindopril (product), Perindopril (substance), PERINDOPRIL
Swedish Perindopril
Czech perindopril
Spanish Perindopril, perindopril (producto), perindoprilo (producto), perindoprilo, perindopril (sustancia), perindoprilo (sustancia), perindopril
Finnish Perindopriili
Russian PERINDOPRIL, ПЕРИНДОПРИЛ
Japanese ペリンドプリル
Polish Peryndopryl
French Périndopril
German Perindopril
Italian Perindopril
Portuguese Perindopril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Accupril (C0244580)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C041125
English Accupril, accupril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Capoten (C0591224)

Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D002216
English capoten, Capoten
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Zestril (C0678140)

Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D017706
English zestril, Zestril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Prinivil (C0701176)

Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D017706
English prinivil, Prinivil
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Lotensin (C0721436)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C044946
English Lotensin, lotensins, lotensin, Cibacen, Cibacène, Novartis brand of benazepril hydrochloride
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Mavik (C0721596)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C052035
English Mavik, Gopten, mavik, Knoll brand of trandolapril, Abbott brand of trandolapril
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Univasc (C0724125)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C058302
English Perdix, univasc, univascs, Moex, Schwarz brand of moexipril hydrochloride, Univasc
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Vasotec (C0728763)

Concepts Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D015773
English Vasotec, vasotec, Biovail Brand of Enalaprilat Anhydrous, Merck Frosst Brand of Enalaprilat Anhydrous
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Monopril (C0728957)

Concepts Organophosphorus Compound (T115) , Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D017328
English monopril, Monopril, Staril, Bristol Myers Squibb Brand of Fosinopril Sodium, Bristol-Myers Squibb Brand of Fosinopril Sodium, Fosinorm, Newace
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Aceon (C0875950)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
English Aceon, aceon
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Altace (C0878061)

Definition (CHV) brand name of a high blood pressure medication
Definition (CHV) brand name of a high blood pressure medication
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D017257
English Altace, tritace, altace [brand name], altace, triatec, Triatec, Tritace, Astra Brand of Ramipril, Aventis Brand of Ramipril, Aventis Pharma Brand of Ramipril, Delix, Hoechst Brand of Ramipril, Monarch Brand of Ramipril, Ramace, Zabien, Acovil
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Navigation Tree