Comparative Pharmacology
Head-to-head clinical analysis: TRANDOLAPRIL versus ZESTRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: TRANDOLAPRIL versus ZESTRIL.
TRANDOLAPRIL vs ZESTRIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Trandolapril is a prodrug that is hydrolyzed to its active metabolite trandolaprilat, which inhibits angiotensin-converting enzyme (ACE), blocking the conversion of angiotensin I to angiotensin II. This reduces vasoconstriction, aldosterone secretion, and sodium reabsorption, leading to decreased blood pressure and preload/afterload reduction.
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.
1–2 mg orally once daily; maximum 4 mg once daily.
10 mg orally once daily initially; titrate to 20-40 mg orally once daily. Maximum 80 mg/day.
None Documented
None Documented
Clinical Note
moderateTrandolapril + Etacrynic acid
"The risk or severity of adverse effects can be increased when Trandolapril is combined with Etacrynic acid."
Clinical Note
moderateTrandolapril + Furosemide
"The risk or severity of adverse effects can be increased when Trandolapril is combined with Furosemide."
Clinical Note
moderateTrandolapril + Bumetanide
"The risk or severity of adverse effects can be increased when Trandolapril is combined with Bumetanide."
Clinical Note
moderateTrandolapril: 6 hours; Trandolaprilat: 24 hours (terminal); effective half-life for ACE inhibition: ~24 hours allowing once-daily dosing
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: 33% (as trandolaprilat); Fecal: 66% (as trandolapril and trandolaprilat); Biliary: minimal
Primarily renal (approximately 70% unchanged), with the remainder excreted as inactive metabolites via feces and urine.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor
Trandolapril + Benzydamine
"The risk or severity of adverse effects can be increased when Trandolapril is combined with Benzydamine."