Comparative Pharmacology
Head-to-head clinical analysis: LEXXEL versus ZESTRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEXXEL versus ZESTRIL.
LEXXEL vs ZESTRIL
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.
Lisinopril competes with angiotensin I for binding to angiotensin-converting enzyme (ACE), inhibiting its activity, thereby preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to decreased blood pressure, reduced aldosterone secretion, and decreased sodium and water retention.
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 mg orally once daily initially; titrate to 20-40 mg orally once daily. Maximum 80 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 elimination half-life is about 12 hours for lisinopril; in heart failure, half-life may be prolonged. Steady-state achieved in 2-3 days.
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 renal (approximately 70% unchanged), with the remainder excreted as inactive metabolites via feces and urine.
Category C
Category C
ACE Inhibitor + Calcium Channel Blocker
ACE Inhibitor