II. Contraindications
- Absolute Contraindications
- Angioedema history
- Regardless of cause (even if not due to ACE Inhibitor)
- Pregnancy (serious Teratogenicity - black box warning)
- Renal Artery Stenosis
- ACE Inhibitor related Allergic Reaction
- Angioedema history
- Relative Contraindications
III. Indications
-
Hypertension
- Useless in low renin patients (esp. Black ethnicity)
- Low renin patients respond better to Diuretics
-
Myocardial Infarction
- Early ACE Inhibitor in acute Myocardial Infarction
- Started within 24 hours of Anterior MI
- Significant reduction in CHF and death
- Significantly lower mortality at 1 year
- Reference
- Early ACE Inhibitor in acute Myocardial Infarction
-
Congestive Heart Failure
- Left ventricle Systolic Dysfunction
- Diabetic Nephropathy
- Renal Insufficiency
IV. Mechanism
V. Safety
- Pregnancy: Category D
- Category C if stopped in first trimester
- Serious Teratogenicity risk to fetus if continued into second or third trimester
-
Lactation
- Unknown
- Risk of Hypotension in newborns
VI. Preparations (Choose once daily dosing if possible)
- Benzapril (Lotensin)
- Hypertension: 10 mg orally daily (target 20-40 mg/day)
- Maximum: 80 mg/day
- Renal Dosing
- GFR <30: Start at 5 mg
- Primarily renal excretion (as benzeprilat)
- Available as unscored generic tablets: 5, 10, 20 and 40 mg
- Captopril (Capoten)
- Hypertension: 25 mg orally twice to three times daily (maximum 450 mg/day)
- CHF: 6.25 - 12.5 mg orally three times daily (maximum 450 mg/day)
- Primarily Renal Dosing
- Available as scored generic tablets: 12.5, 25, 50 and 100 mg
- Enalapril (Vasotec)
- Hypertension: 5 mg orally daily (maximum 40 mg/day)
- CHF, GFR<30: 2.5 mg orally daily to twice daily (maximum 40 mg/day)
- IV (Hypertensive Emergency): 1.25 mg IV every 6 hours
- Excretion both renal and hepatic
- Available as scored tablets: 2.5, 5, 10 and 20 mg
- Fosinopril (Monopril)
- Hypertension: 10 mg orally daily (target 40 mg/day)
- CHF: 10 mg orally daily (target 20-40 mg/day)
- Renal Impairment: 5 mg orally daily at start
- Maximum: 80 mg/day
- Excretion both renal and hepatic
- Available as scored tablets (10 mg) and unscored tablets (20 and 40 mg)
- Lisinopril (Prinivil, Zestril)
- Hypertension: 10 mg orally daily (target 20-40 mg/day)
- CHF: 5 mg orally daily (target 20 mg/day)
- Acute MI: 5 mg orally daily for 2 days then 10 mg orally daily
- Renal Dosing
- GFR 10-30: 2.5 to 5 mg orally daily to start
- GFR <10: 2.5 mg orally daily to start
- Maximum 40 mg/day
- Primarily renal excretion
- Available as generic/Prinivil scored tablets (10, 20 and 40 mg)
- Available as generic/Zestril unscored tabs (2.5, 5, 10, 20, 30 and 40 mg)
- Moexipril (Univasc): Take one hour before meals
- Hypertension: 7.5 mg orally daily (maximum 30 mg/day)
- Primarily hepatic metabolism
- Available as generic scored tablets (7.5, 15 mg)
- Perindopril (Aceon)
- Hypertension: 4 mg orally daily (target 4-8 mg/day)
- Maximum 16 mg/day
- Primarily renal metabolism
- Available as generic unscored tablets (2, 4, 8 mg)
- Quinapril (Accupril)
- Hypertension: 10 mg orally daily (target 20-40 mg/day)
- CHF: 2.5 mg to 5 mg orally twice daily
- Low dose is especially important if concurrent Diuretic use
- Titrating weekly to 20-40 mg/day
- Renal Dosing
- GFR 30-60: 5 mg orally daily to start
- GFR 10-30: 2.5 mg orally daily to start
- Maximum: 80 mg/day (no benefit above 40 mg/day)
- Excretion is 50-60% renal
- Available as generic scored tablets (5 mg) and unscored tablets (10,20 and 40 mg)
- Ramipril (Altace)
- Hypertension: 2.5 mg orally daily (target 2.5-20 mg orally daily)
- CHF or MI: 2.5 mg orally twice daily (target 5 mg orally twice daily)
- Renal Impairment or Diuretic use: 1.25 mg orally daily to start
- Maximum 20 mg/day
- Excretion both renal and hepatic
- Available as generic capsule (1.25, 2.5, 5, 10 mg)
- Trandopril (Mavik)
- Hypertension: 1 mg orally daily (target 2 to 4 mg orally daily)
- CHF: 0.5 to 1 mg orally daily (target 4 mg orally daily)
- Maximum: 8 mg/day
- Excretion 66% hepatic and 33% renal
- Available as generic scored tablet (1 mg) and unscored tablet (2 and 4 mg)
VII. Adverse Effects
-
Cough (dry and irritating)
- Characteristics
- Occurs in 5 to 20% of patients
- More common in women
- More common in black patients
- Not dose related
- Stops within 4 days of medication cessation
- Occurs in 5 to 20% of patients
- Alternative medications
- Inhalers may relieve cough
- Tilade 2 puffs inhaled four times daily
- Cromolyn 20 mg inhaled four times daily
- Characteristics
-
Hyperkalemia (5% of patients)
- See Drug Interactions below
- Asociated with Renal Insufficiency, Diabetes Mellitus
-
Teratogenicity in second or third trimester
- Fetal injury or death
- Pregnancy Class C if discontinued in first trimester
-
Renal Insufficiency
- Renal Artery Stenosis (see monitoring below)
- No Creatinine level is absolute contraindication
- Baseline Serum Creatinine <3.0 mg/dl is safe
-
Hypotension
- Restart ACE Inhibitor at half prior dose
- Decrease or hold dose of any concurrent Diuretic
-
Angioedema
-
ACE inhibitor Induced Angioedema is not an Allergic Reaction (unlike typical Angioedema)
- Related to bradykinin accumulation
- Does not respond to typical Angioedema management (e.g. Corticosteroids, Antihistamines)
- Occurs in 1 of 300 patients
- More common in african american patients by factor of 2-4 fold
- Reaction can occur months to years after starting an ACE Inhibitor
- Treatment is withdrawal of medication and supportive care
- See Angioedema for management
- Reactions may be severe and life threatening with complete airway closure
- May respond to agents used for Hereditary Angioedema (e.g. Icatibant, Berinert)
- Do not re-challenge with ACE Inhibitor
- ACE Inhibitor Angioedema will recur with ARB agents in 8% of patients
- Avoid Angiotensin Receptor Blocker (ARB) unless a very compelling reason exists
- If ARB is used, wait at least 4 weeks after ACE Inhibitor has been discontinued
- Avoid using ARB in moderate to severe ACE Inhibitor Angioedema episode
-
ACE inhibitor Induced Angioedema is not an Allergic Reaction (unlike typical Angioedema)
- Rare Adverse Reactions
- Rash
- Agranulocytosis
- Neutropenia
- Associated with comorbid Renal Insufficiency
- Associated with comorbid collagen vascular disease
VIII. Drug Interactions
- Increases Lithium levels (follow levels)
- Decreased ACE Inhibitor levels with concurrent Antacids
- Decreased Renal Function with concurrent NSAID use
- Agents predisposing to Hyperkalemia
IX. Monitoring
- Serum Potassium (if patient at risk)
-
Serum Creatinine
- Timing
- Baseline
- Recheck in 4 days to 2 weeks
- Expect an increase in Chronic Kidney Disease
- Despite this, renal protective effect outweighs mild to moderate Creatinine increase
- Indication to consider stopping ACE Inhibitor
- Serum Creatinine increased >20% in 4 days
- Additional precautions when increasing dose
- Serum Creatinine should not increase >30%
- Timing
Images: Related links to external sites (from Bing)
Related Studies
Lisinopril-HCTZ (on 6/18/2017 at Walmart.com) | ||
Lisinopril-HCTZ 10mg-12.5mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril-HCTZ 10mg-12.5mg | #90 tablets for $10.00 | $0.11 each |
Lisinopril-HCTZ 20mg-12.5mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril-HCTZ 20mg-12.5mg | #90 tablets for $10.00 | $0.11 each |
Lisinopril-HCTZ 20mg-25mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril-HCTZ 20mg-25mg | #90 tablets for $10.00 | $0.11 each |
Lisinopril (on 6/18/2017 at Walmart.com) | ||
Lisinopril 10mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril 10mg | #90 tablets for $10.00 | $0.11 each |
Lisinopril 2.5mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril 2.5mg | #90 tablets for $10.00 | $0.11 each |
Lisinopril 20mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril 20mg | #90 tablets for $10.00 | $0.11 each |
Lisinopril 5mg | #30 tablets for $4.00 | $0.13 each |
Lisinopril 5mg | #90 tablets for $10.00 | $0.11 each |
Enalapril-HCTZ (on 6/18/2017 at Walmart.com) | ||
Enalapril-HCTZ 5mg-12.5mg | #30 tablets for $4.00 | $0.13 each |
Enalapril-HCTZ 5mg-12.5mg | #90 tablets for $10.00 | $0.11 each |
captopril (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
CAPTOPRIL 100 MG TABLET | Generic | $1.85 each |
CAPTOPRIL 12.5 MG TABLET | Generic | $0.73 each |
CAPTOPRIL 25 MG TABLET | Generic | $0.88 each |
CAPTOPRIL 50 MG TABLET | Generic | $1.50 each |
CAPTOPRIL-HYDROCHLOROTHIAZIDE 25-15 MG TABLET | Generic | $0.94 each |
CAPTOPRIL-HYDROCHLOROTHIAZIDE 50-25 MG TABLET | Generic | $1.58 each |
lisinopril (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
LISINOPRIL 10 MG TABLET | Generic | $0.02 each |
LISINOPRIL 2.5 MG TABLET | Generic | $0.01 each |
LISINOPRIL 20 MG TABLET | Generic | $0.02 each |
LISINOPRIL 30 MG TABLET | Generic | $0.06 each |
LISINOPRIL 40 MG TABLET | Generic | $0.05 each |
LISINOPRIL 5 MG TABLET | Generic | $0.02 each |
LISINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB | Generic | $0.03 each |
LISINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB | Generic | $0.04 each |
LISINOPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB | Generic | $0.04 each |
prinivil (on 6/8/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
PRINIVIL 20 MG TABLET | Generic | $0.02 each |
zestril (on 12/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ZESTRIL 10 MG TABLET | Generic | $0.02 each |
enalapril (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ENALAPRIL MALEATE 10 MG TAB | Generic | $0.22 each |
ENALAPRIL MALEATE 2.5 MG TAB | Generic | $0.22 each |
ENALAPRIL MALEATE 20 MG TAB | Generic | $0.32 each |
ENALAPRIL MALEATE 5 MG TABLET | Generic | $0.25 each |
ENALAPRIL-HYDROCHLOROTHIAZIDE 10-25 MG TABLET | Generic | $0.17 each |
ENALAPRIL-HYDROCHLOROTHIAZIDE 5-12.5 MG TAB | Generic | $0.15 each |
fosinopril (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
FOSINOPRIL SODIUM 10 MG TAB | Generic | $0.14 each |
FOSINOPRIL SODIUM 20 MG TAB | Generic | $0.13 each |
FOSINOPRIL SODIUM 40 MG TAB | Generic | $0.19 each |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB | Generic | $0.74 each |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB | Generic | $0.83 each |
moexipril (on 3/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
MOEXIPRIL HCL 15 MG TABLET | Generic | $0.82 each |
MOEXIPRIL HCL 7.5 MG TABLET | Generic | $0.71 each |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5 MG TAB | Generic | $0.86 each |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25 MG TABLET | Generic | $0.83 each |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5 MG TAB | Generic | $0.69 each |
perindopril (on 4/19/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
PERINDOPRIL ERBUMINE 4 MG TAB | Generic | $0.49 each |
PERINDOPRIL ERBUMINE 8 MG TAB | Generic | $0.57 each |
quinapril (on 3/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
QUINAPRIL 10 MG TABLET | Generic | $0.15 each |
QUINAPRIL 20 MG TABLET | Generic | $0.14 each |
QUINAPRIL 40 MG TABLET | Generic | $0.14 each |
QUINAPRIL 5 MG TABLET | Generic | $0.14 each |
QUINAPRIL-HYDROCHLOROTHIAZIDE 10-12.5 MG TAB | Generic | $0.52 each |
QUINAPRIL-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB | Generic | $0.55 each |
QUINAPRIL-HYDROCHLOROTHIAZIDE 20-25 MG TAB | Generic | $0.37 each |
accupril (on 6/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ACCUPRIL 10 MG TABLET | Generic | $0.15 each |
ACCUPRIL 20 MG TABLET | Generic | $0.14 each |
ACCUPRIL 40 MG TABLET | Generic | $0.14 each |
ramipril (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
RAMIPRIL 1.25 MG CAPSULE | Generic | $0.18 each |
RAMIPRIL 10 MG CAPSULE | Generic | $0.08 each |
RAMIPRIL 2.5 MG CAPSULE | Generic | $0.08 each |
RAMIPRIL 5 MG CAPSULE | Generic | $0.08 each |
altace (on 6/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ALTACE 10 MG CAPSULE | Generic | $0.08 each |
ALTACE 2.5 MG CAPSULE | Generic | $0.08 each |
ALTACE 5 MG CAPSULE | Generic | $0.08 each |
Ontology: Angiotensin-Converting Enzyme Inhibitors (C0003015)
Definition (CHV) | a class of drugs mainly used for hypertension treatment |
Definition (CHV) | a class of drugs mainly used for hypertension treatment |
Definition (CHV) | a class of drugs mainly used for hypertension treatment |
Definition (NCI_NCI-GLOSS) | A drug that is used to lower blood pressure. An ACE inhibitor is a type of antihypertensive agent. |
Definition (NCI) | Any substance that inhibits angiotensin-converting enzyme (ACE), an enzyme that catalyzes the conversion of angiotensin I to angiotensin II. Inhibition of ACE results in a reduction in angiotensin II and angiotensin II-induced aldosterone secretion, causing vasodilation and natriuresis. |
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. |
Concepts | Pharmacologic Substance (T121) |
MSH | D000806 |
SnomedCT | 41549009, 372733002 |
LNC | LP31444-0 |
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, 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, [CV800] ACE INHIBITORS, ace inhibitors, angiotensin-converting enzyme (ACE) inhibitors, ace inhibitor, Angiotensin I Converting Enzyme Inhibitors, Angiotensin converting enzyme--Inhibitors, angiotensin-converting enzyme inhibitor, 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, NOS, Angiotensin-converting enzyme inhibitor agent, NOS, ACE Inhibitor, Angiotensin-converting Enzyme (ACE) Inhibitors |
Swedish | ACE-hämmare |
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 |
Czech | inhibitory angiotensin-konvertujícího enzymu, enzym konvertující angiotensin - inhibitory, inhibitory angiotensin konvertujícího enzymu, inhibitory angiotenzin konvertujícího enzymu, ACE-I, ACE inhibitory, inhibitory ACE |
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 |
Ontology: Captopril (C0006938)
Definition (NCI_NCI-GLOSS) | 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 (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 (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 (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 | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D002216 |
SnomedCT | 29439004, 387160004 |
LNC | LP32689-9, LP18914-9, MTHU006862 |
English | captopril, (S)-1-(3-Mercapto-2-methyl-1-oxopropyl)-L-proline, L-Proline, 1-(3-mercapto-2-methyl-1-oxopropyl)-, (S)-, 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 |
Ontology: Enalapril (C0014025)
Definition (CHV) | a drug used to treat hypertension |
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. |
Definition (NCI_NCI-GLOSS) | 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 (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. |
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D004656 |
SnomedCT | 15222008, 372658000 |
LNC | LP171394-2 |
English | Enalapril, L-Proline, 1-(N-(1-(ethoxycarbonyl)-3-phenylpropyl)-L-alanyl)-, (S)-, Enalapril [Chemical/Ingredient], ENALAPRIL, enalapril, Enalapril (product), Enalapril (substance) |
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 |
Ontology: Lisinopril (C0065374)
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) | 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 (NCI_NCI-GLOSS) | 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 | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D017706 |
SnomedCT | 108575001, 386873009 |
LNC | LP171618-4 |
English | Lisinopril, Lysinopril, L-Proline, 1-(N2-(1-carboxy-3-phenylpropyl)-L-lysyl)-, dihydrate, (S)-, lisinopril, lisinopril (medication), LISINOPRIL, Lisinopril [Chemical/Ingredient], lysinopril, N2-[(1S)-1-Carboxy-3-phenylpropyl]-L-lysyl-L-proline, Dihydrate, 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 |
Ontology: 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 | Pharmacologic Substance (T121) , Organic Chemical (T109) |
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 |
Ontology: 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 | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C041125 |
SnomedCT | 108578004, 386874003 |
LNC | LP171631-7 |
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, Quinapril (product), Quinapril (substance) |
Spanish | quinaprilo, quinapril (producto), quinapril (sustancia), quinapril |
Ontology: Ramipril (C0072973)
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. |
Definition (MSH) | A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D017257 |
SnomedCT | 108564000, 386872004 |
LNC | LP171634-1 |
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 |
Ontology: Fosinopril (C0118168)
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. |
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. |
Concepts | Pharmacologic Substance (T121) , Organophosphorus Compound (T115) |
MSH | D017328 |
SnomedCT | 108569005, 372510000 |
LNC | LP171400-7 |
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, Fosinopril (product), Fosinopril (substance) |
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 |
Ontology: 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 | Pharmacologic Substance (T121) , Organic Chemical (T109) |
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, Perindopril (product), Perindopril (substance) |
Swedish | Perindopril |
Czech | perindopril |
Finnish | Perindopriili |
Russian | PERINDOPRIL, ПЕРИНДОПРИЛ |
Japanese | ペリンドプリル |
Spanish | perindopril (producto), perindoprilo (producto), perindoprilo, perindopril (sustancia), perindoprilo (sustancia), perindopril, Perindopril |
Polish | Peryndopryl |
French | Périndopril |
German | Perindopril |
Italian | Perindopril |
Portuguese | Perindopril |
Ontology: Accupril (C0244580)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C041125 |
English | Accupril, accupril |
Ontology: Capoten (C0591224)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D002216 |
English | capoten, Capoten |
Ontology: Zestril (C0678140)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D017706 |
English | zestril, Zestril |
Ontology: Prinivil (C0701176)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D017706 |
English | prinivil, Prinivil |
Ontology: Lotensin (C0721436)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C044946 |
English | Lotensin, lotensin, Cibacen, Cibacène, Novartis brand of benazepril hydrochloride |
Ontology: Mavik (C0721596)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C052035 |
English | Mavik, mavik, Gopten, Knoll brand of trandolapril, Abbott brand of trandolapril |
Ontology: Univasc (C0724125)
Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) |
MSH | C058302 |
English | univasc, Perdix, Moex, Schwarz brand of moexipril hydrochloride, Univasc |
Ontology: Vasotec (C0728763)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | D015773 |
English | Vasotec, vasotec, Biovail Brand of Enalaprilat Anhydrous, Merck Frosst Brand of Enalaprilat Anhydrous |
Ontology: Monopril (C0728957)
Concepts | Amino Acid, Peptide, or Protein (T116) , Organophosphorus Compound (T115) , 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 |
Ontology: Aceon (C0875950)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
English | Aceon, aceon |
Ontology: Altace (C0878061)
Definition (CHV) | brand name of a high blood pressure medication |
Definition (CHV) | brand name of a high blood pressure medication |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
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 |