Comparative Pharmacology
Head-to-head clinical analysis: LEXXEL versus MONOPRIL HCT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEXXEL versus MONOPRIL HCT.
LEXXEL vs MONOPRIL-HCT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
LEXXEL is a combination of felodipine, a dihydropyridine calcium channel blocker that inhibits calcium influx into vascular smooth muscle and cardiac muscle, causing vasodilation and reduced myocardial contractility, and enalapril, an angiotensin-converting enzyme (ACE) inhibitor that prevents conversion of angiotensin I to angiotensin II, reducing vasoconstriction, aldosterone secretion, and sodium reabsorption.
Fosinopril is an angiotensin-converting enzyme (ACE) inhibitor that inhibits the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion; hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, increasing electrolyte and water excretion.
1 tablet (felodipine 5 mg / enalapril 5 mg) orally once daily, may increase to 2 tablets once daily after 2-4 weeks if needed.
1 tablet (10-20 mg fosinopril / 12.5-25 mg hydrochlorothiazide) orally once daily; maximum dose 80 mg fosinopril / 50 mg hydrochlorothiazide per day.
None Documented
None Documented
Enalapril: ~1.3 hours; Enalaprilat: terminal half-life ~35-38 hours, with multiple-dose accumulation half-life ~11 hours; effective half-life for ACE inhibition ~24 hours.
Fosinoprilat: 11.5-12 h (terminal half-life extended in renal and hepatic impairment); hydrochlorothiazide: 5.6-14.8 h (varies with renal function).
Renal: ~35-50% as unchanged drug (enalaprilat), biliary/fecal: ~15-30% as metabolites and unchanged drug; total renal elimination of enalaprilat accounts for ~60-80% of dose.
Fosinopril: renal (44%), biliary (46%); hydrochlorothiazide: renal (>95% as unchanged drug).
Category C
Category C
ACE Inhibitor + Calcium Channel Blocker
ACE Inhibitor/Diuretic Antihypertensive