Comparative Pharmacology
Head-to-head clinical analysis: LEXXEL versus VASCOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEXXEL versus VASCOR.
LEXXEL vs VASCOR
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.
VASCOR (bepridil) is a calcium channel blocker that inhibits calcium ion influx across cardiac and smooth muscle cells, reducing contractility and oxygen demand. It also has class I and IV antiarrhythmic properties.
1 tablet (felodipine 5 mg / enalapril 5 mg) orally once daily, may increase to 2 tablets once daily after 2-4 weeks if needed.
Bepridil hydrochloride (Vascor) is typically dosed as 200 mg to 400 mg orally once daily.
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 elimination half-life: 6-8 hours (normal renal/hepatic function). May be prolonged in hepatic impairment; unchanged in renal impairment.
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.
Primarily hepatic metabolism; ~70% excreted in feces as metabolites, ~30% in urine (largely as metabolites). <2% excreted unchanged in urine.
Category C
Category C
ACE Inhibitor + Calcium Channel Blocker
Calcium Channel Blocker