Comparative Pharmacology
Head-to-head clinical analysis: AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE versus CAPOZIDE 50 25.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE versus CAPOZIDE 50 25.
AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE vs CAPOZIDE 50/25
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 is an angiotensin-converting enzyme (ACE) inhibitor that inhibits the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide is a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, increasing excretion of sodium and water.
Oral, one capsule daily. Initial: 2.5 mg/10 mg for patients not on either drug; up to 10 mg/40 mg daily.
One tablet (captopril 50 mg / hydrochlorothiazide 25 mg) orally once daily; may increase to two tablets daily if 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: dosing interval typically 12-24 hours.
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: 95% renal (primarily unchanged). Hydrochlorothiazide: 95% renal (unchanged).
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor/Diuretic Combination