Comparative Pharmacology
Head-to-head clinical analysis: ENALAPRILAT versus ZESTORETIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ENALAPRILAT versus ZESTORETIC.
ENALAPRILAT vs ZESTORETIC
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.
Combination of lisinopril (ACE inhibitor) and hydrochlorothiazide (thiazide diuretic). Lisinopril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, decreasing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in distal convoluted tubule, increasing diuresis and reducing plasma volume.
1.25 mg IV over 5 minutes every 6 hours; may increase to 5 mg IV every 6 hours if needed.
Zestoretic (lisinopril/hydrochlorothiazide) is available in fixed-dose combinations. Typical adult dose: 10 mg/12.5 mg, 20 mg/12.5 mg, or 20 mg/25 mg orally once daily. Maximum dose: lisinopril 80 mg/day, hydrochlorothiazide 50 mg/day.
None Documented
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
Terminal half-life: 35 hours (prolonged in renal impairment; accumulates with CrCl <30 mL/min)
Lisinopril: terminal half-life approximately 12 hours (accumulation half-life 13.8 hours in patients with normal renal function). Hydrochlorothiazide: terminal half-life 5.6–14.8 hours (mean 9.6 hours).
Renal: 60-80% unchanged; biliary/fecal: minimal (<10%)
Lisinopril is excreted unchanged in urine; 100% renal elimination. Hydrochlorothiazide is excreted primarily by the kidney (≥95% as unchanged drug) via tubular secretion.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor + Diuretic
"The risk or severity of adverse effects can be increased when Enalaprilat is combined with Loxoprofen."