Comparative Pharmacology
Head-to-head clinical analysis: ALTACE versus ZESTRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALTACE versus ZESTRIL.
ALTACE vs ZESTRIL
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.
Lisinopril competes with angiotensin I for binding to angiotensin-converting enzyme (ACE), inhibiting its activity, thereby preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to decreased blood pressure, reduced aldosterone secretion, and decreased sodium and water retention.
2.5-5 mg orally once daily initially, titrated to 10-20 mg once daily; maximum 20 mg/day
10 mg orally once daily initially; titrate to 20-40 mg orally once daily. Maximum 80 mg/day.
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)
Terminal elimination half-life is about 12 hours for lisinopril; in heart failure, half-life may be prolonged. Steady-state achieved in 2-3 days.
Renal: 60% (30% as ramiprilat, 30% as metabolites); Fecal: 40% (unabsorbed drug and biliary metabolites)
Primarily renal (approximately 70% unchanged), with the remainder excreted as inactive metabolites via feces and urine.
Category C
Category C
ACE Inhibitor
ACE Inhibitor