Comparative Pharmacology
Head-to-head clinical analysis: LEXXEL versus SULAR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEXXEL versus SULAR.
LEXXEL vs SULAR
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.
Nisoldipine is a dihydropyridine calcium channel blocker that inhibits the influx of calcium ions through L-type calcium channels in vascular smooth muscle and cardiac muscle. This leads to vasodilation, reduced peripheral vascular resistance, and decreased myocardial oxygen demand.
1 tablet (felodipine 5 mg / enalapril 5 mg) orally once daily, may increase to 2 tablets once daily after 2-4 weeks if needed.
10-20 mg orally once daily; maximum 60 mg/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.
Terminal half-life of 24-50 hours, mean ~34 hours; extended in elderly and hepatic impairment, dose adjustment may be needed
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.
Renal: 50-60% as metabolites, 10% as unchanged drug; Fecal: ~35%; Biliary: <5%
Category C
Category C
ACE Inhibitor + Calcium Channel Blocker
Calcium Channel Blocker