Comparative Pharmacology
Head-to-head clinical analysis: AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE versus CAPOZIDE 25 25.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE versus CAPOZIDE 25 25.
AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE vs CAPOZIDE 25/25
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Captopril: angiotensin-converting enzyme (ACE) inhibitor that blocks conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide: thiazide diuretic that inhibits sodium-chloride symporter in distal convoluted tubule, increasing sodium, chloride, and water excretion.
Oral, one capsule daily. Initial: 2.5 mg/10 mg for patients not on either drug; up to 10 mg/40 mg daily.
1 tablet (captopril 25 mg / hydrochlorothiazide 25 mg) orally once daily initially; may titrate up to 2 tablets per day as needed.
None Documented
None Documented
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).
Captopril: ~2 hours (increased in renal impairment). Hydrochlorothiazide: 6-15 hours (prolonged in renal impairment). Clinical context: trough effect may diminish with once-daily dosing; twice-daily dosing often used.
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).
Captopril: renal 95% (40-50% unchanged), biliary/fecal <5%. Hydrochlorothiazide: renal >95% (unchanged), biliary/fecal minimal.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor and Diuretic Combination