Comparative Pharmacology
Head-to-head clinical analysis: AMLODIPINE BESYLATE BENAZEPRIL HYDROCHLORIDE versus ZESTRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMLODIPINE BESYLATE BENAZEPRIL HYDROCHLORIDE versus ZESTRIL.
AMLODIPINE BESYLATE; BENAZEPRIL HYDROCHLORIDE vs ZESTRIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amlodipine is a dihydropyridine calcium channel blocker that inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle, leading to vasodilation and reduced peripheral vascular resistance. Benazepril is an angiotensin-converting enzyme (ACE) inhibitor that prevents the conversion of angiotensin I to angiotensin II, resulting in vasodilation, decreased aldosterone secretion, and reduced blood pressure.
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.
Oral, 1 capsule (amlodipine 2.5-10 mg / benazepril 10-40 mg) once daily. Start with amlodipine 2.5 mg / benazepril 10 mg, titrate based on response.
10 mg orally once daily initially; titrate to 20-40 mg orally once daily. Maximum 80 mg/day.
None Documented
None Documented
Amlodipine: terminal elimination half-life 30-50 hours (mean ~35 h), allowing once-daily dosing. Benazeprilat: effective half-life 10-11 hours; terminal half-life ~22 hours, with prolonged effects in renal impairment.
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.
Amlodipine: ~90% metabolized to inactive metabolites, ~10% excreted unchanged in urine; metabolites excreted renally (~60%) and fecally (~20-25%). Benazepril: hydrolyzed to benazeprilat, which undergoes renal excretion (~33% as unchanged drug and metabolites) and biliary/fecal excretion (~33%), with the remainder via other routes.
Primarily renal (approximately 70% unchanged), with the remainder excreted as inactive metabolites via feces and urine.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor