Comparative Pharmacology
Head-to-head clinical analysis: AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE versus PRINZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE versus PRINZIDE.
AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE vs PRINZIDE
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.
PRINZIDE is a combination of lisinopril (an ACE inhibitor) and hydrochlorothiazide (a thiazide diuretic). Lisinopril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, leading to vasodilation and decreased aldosterone secretion. Hydrochlorothiazide inhibits sodium and chloride reabsorption in the distal convoluted tubule, promoting diuresis and reducing plasma volume.
Oral, one capsule daily. Initial: 2.5 mg/10 mg for patients not on either drug; up to 10 mg/40 mg daily.
Oral, 1-2 tablets daily; each tablet contains 25 mg hydrochlorothiazide and 5 mg lisinopril. Adjust based on blood pressure response; maximum daily dose: 2 tablets.
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).
Lisinopril: terminal half-life 12 hours (effective half-life 30 hours due to prolonged ACE binding). Hydrochlorothiazide: terminal half-life 6-15 hours (biphasic, initial phase 2-4 h, terminal phase 6-15 h) with prolonged terminal phase in renal impairment.
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).
Lisinopril is excreted unchanged in urine (100% renal elimination); hydrochlorothiazide is excreted 95% renally as unchanged drug and 5% via bile.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor / Diuretic Combination