Comparative Pharmacology
Head-to-head clinical analysis: ENALAPRILAT versus PRESTALIA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ENALAPRILAT versus PRESTALIA.
ENALAPRILAT vs PRESTALIA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Enalaprilat is an angiotensin-converting enzyme (ACE) inhibitor that blocks the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion, leading to decreased blood pressure and cardiac workload.
PRESTALIA is a fixed-dose combination of perindopril, an angiotensin-converting enzyme inhibitor, and amlodipine, a dihydropyridine calcium channel blocker. Perindopril inhibits ACE, reducing angiotensin II formation, leading to vasodilation and decreased aldosterone secretion. Amlodipine inhibits calcium ion influx across cardiac and vascular smooth muscle cell membranes, causing vasodilation and reduced peripheral resistance.
1.25 mg IV over 5 minutes every 6 hours; may increase to 5 mg IV every 6 hours if needed.
One tablet orally once daily, preferably in the morning. PRESTALIA is a fixed-dose combination of perindopril arginine (2.5 mg, 5 mg, or 10 mg) and amlodipine (5 mg or 10 mg). Initial dose: 3.5 mg perindopril arginine/2.5 mg amlodipine or 5 mg perindopril arginine/5 mg amlodipine. Titrate based on blood pressure response. Maximum dose: 10 mg perindopril arginine/10 mg amlodipine.
None Documented
Clinical Note
moderateEnalaprilat + Benzydamine
"The risk or severity of adverse effects can be increased when Enalaprilat is combined with Benzydamine."
Clinical Note
moderateEnalaprilat + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Enalaprilat."
Clinical Note
moderateEnalaprilat + Droxicam
"The risk or severity of adverse effects can be increased when Enalaprilat is combined with Droxicam."
Clinical Note
moderateEnalaprilat + Loxoprofen
None Documented
Terminal half-life: 35 hours (prolonged in renal impairment; accumulates with CrCl <30 mL/min)
Perindoprilat: 30–120 hours (terminal, prolonged in renal impairment; effective half-life for accumulation ~24h). Indapamide: 14–24 hours (terminal).
Renal: 60-80% unchanged; biliary/fecal: minimal (<10%)
Perindopril: 75% renal (as perindoprilat), 25% biliary/fecal. Indapamide: 70% renal, 20% biliary/fecal.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor/Calcium Channel Blocker Combination
"The risk or severity of adverse effects can be increased when Enalaprilat is combined with Loxoprofen."