Comparative Pharmacology
Head-to-head clinical analysis: BENAZEPRIL HYDROCHLORIDE versus CAPOZIDE 25 15.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BENAZEPRIL HYDROCHLORIDE versus CAPOZIDE 25 15.
BENAZEPRIL HYDROCHLORIDE vs CAPOZIDE 25/15
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Benazepril is a prodrug that is hydrolyzed to benazeprilat, a competitive inhibitor of angiotensin-converting enzyme (ACE). This prevents conversion of angiotensin I to angiotensin II, resulting in decreased vasoconstriction, reduced aldosterone secretion, and lower blood pressure.
Combination of captopril (ACE inhibitor) and hydrochlorothiazide (thiazide diuretic). Captopril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, decreasing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in the distal convoluted tubule, increasing diuresis and reducing plasma volume.
Initial: 10 mg orally once daily. Titrate to 20-40 mg daily (as single dose or two divided doses). Maximum: 80 mg/day. Route: Oral.
Oral: 1 tablet (captopril 25 mg / hydrochlorothiazide 15 mg) once daily initially; titrate to a maximum of 2 tablets twice daily based on blood pressure response.
None Documented
None Documented
Benazeprilat terminal elimination half-life is approximately 10-11 hours in patients with normal renal function; clinically, steady-state is reached in 2-3 days. Half-life is prolonged in renal impairment (up to 22 hours in moderate to severe impairment), necessitating dose adjustment.
Captopril: ~2 hours (terminal) in normal renal function; increases to 20-60 hours in severe renal impairment. Hydrochlorothiazide: 6-15 hours (terminal), prolonged in renal impairment.
Primarily renal (80-90% of absorbed dose excreted in urine, with approximately 20-30% as benazeprilat and the rest as inactive metabolites); biliary/fecal elimination accounts for the remainder (10-20%).
Captopril: 95% renally excreted, primarily as unchanged drug and metabolites (disulfide dimers). Hydrochlorothiazide: at least 95% renally excreted as unchanged drug.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor and Diuretic Combination