Comparative Pharmacology
Head-to-head clinical analysis: ALTACE versus AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALTACE versus AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE.
ALTACE vs AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Angiotensin-converting enzyme inhibitor; inhibits ACE, preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion.
Amlodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle, causing peripheral vasodilation and reduction of peripheral vascular resistance. Benazepril is a prodrug that is hydrolyzed to benazeprilat, a competitive inhibitor of angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II, thereby reducing vasoconstriction, aldosterone secretion, and sodium and water retention.
2.5-5 mg orally once daily initially, titrated to 10-20 mg once daily; maximum 20 mg/day
Oral, one capsule daily. Initial: 2.5 mg/10 mg for patients not on either drug; up to 10 mg/40 mg daily.
None Documented
None Documented
Ramiprilat: 13–17 hours (prolonged in renal impairment, up to 50 hours in severe renal insufficiency; multiple doses: 45–60 hours effective half-life due to tissue binding)
Amlodipine terminal half-life 30-50 hours (allows once-daily dosing; steady state reached after 7-10 days). Benazeprilat effective half-life 10-11 hours (accumulation minimal).
Renal: 60% (30% as ramiprilat, 30% as metabolites); Fecal: 40% (unabsorbed drug and biliary metabolites)
Amlodipine: 60% renal (10% unchanged, rest as metabolites), 20-25% biliary/feces. Benazepril: 11-12% renal (as unchanged benazepril and benazeprilat), 85-90% biliary (as benazeprilat conjugates).
Category C
Category D/X
ACE Inhibitor
ACE Inhibitor