Hypertension Treatments: ACE Inhibitors

HYPERTENSION TREATMENTS: ACE INHIBITORS
Generic	Brand	Strength	Form	Usual Dose
ACE INHIBITORS
benazepril HCl	Lotensin	5mg, 10mg, 20mg, 40mg	tabs	Adults: If not on diuretic: initially 10mg daily. Usual maintenance: 20−40mg daily in 1 or 2 divided doses; usual max 80mg/day. If on diuretic: initially 5mg once daily. If BP not controlled on benazepril alone, may add low dose diuretic. CrCl <30mL/min/1.73m²: initially 5mg daily; max 40mg/day. Children: <6yrs or CrCl <30mL/min/1.73m²: not recommended. ≥6yrs: initially 0.2mg/kg daily; usual max 0.6mg/kg/day (or 40mg/day).
captopril	—	12.5mg, 25mg, 50mg, 100mg	scored tabs	Adults: Take 1hr before meals. Initially 25mg 2−3 times daily. After 1−2wks may increase to 50mg 2−3 times daily. If control unsatisfactory, see full labeling. Titrate to usual dose after several days. Monitor closely for 1st 2wks and if dose increased; max 450mg/day. Renal impairment: See full labeling. Children: Not established.
enalapril maleate	Epaned	1mg/mL	oral soln	Adults: If on diuretics, CrCl ≤30mL/min, or on dialysis (give on dialysis days): initially 2.5mg daily; max 40mg. Others: initially 5mg daily; may titrate up to max 40mg daily in 1−2 divided doses. Vasotec: if on diuretics, suspend diuretic for 2−3 days before initiation if possible. Monitor closely for 1st 2wks. Children: Neonates, preterm infants, or CrCl <30mL/min: not recommended. Initially 0.08mg/kg (up to 5mg) once daily; max 0.58mg/kg (or 40mg) daily. Suspension form may be prepared if unable to swallow tabs: see full labeling.
enalapril maleate	Vasotec	2.5mg, 5mg, 10mg, 20mg	scored tabs
fosinopril sodium	—	10mg+, 20mg, 40mg	tabs	Adults: Initially 10mg once daily. Usual maintenance: 20−40mg daily in 1−2 divided doses; max 80mg/day. If on diuretic: suspend diuretic for 2−3 days before starting if possible; resume diuretic if pressure not controlled with fosinopril alone. If diuretic cannot be discontinued: give 10mg and monitor carefully. Children: <6yrs (≤50kg): not recommended. ≥6yrs (>50kg): 5−10mg once daily.
lisinopril	—	5mg, 10mg, 20mg	scored tabs	Adults: Initially and if not on diuretics: 10mg once daily. Usual range: 20−40mg once daily. Doses up to 80mg have been used. If BP not controlled by lisinopril alone, may add low-dose diuretic. After adding diuretic, may need to reduce lisinopril dose. If on diuretics: initially 5mg daily. CrCl 10–30mL/min: initially 5mg daily; max 40mg daily as tolerated. CrCl <10mL/min or hemodialysis: initially 2.5mg once daily. Children: <6yrs or CrCl <30mL/min/1.73m²: not recommended. ≥6yrs: initially 0.07mg/kg (max 5mg) once daily; usual max 0.61mg/kg (40mg) once daily.
	Qbrelis	1mg/mL	oral soln
	Zestril	2.5mg, 5mg+, 10mg, 20mg, 30mg, 40mg	tabs
moexipril HCl	—	7.5mg, 15mg	scored tabs	Adults: Take 1hr before meals. Initially and if not on diuretics: 7.5mg once daily; usual range 7.5−30mg/day in 1−2 divided doses. If on diuretic: suspend diuretic for 2−3 days before starting therapy; resume diuretic if BP not controlled by moexipril alone. If diuretic cannot be discontinued: initially 3.75mg once daily. CrCl <40mL/min: initially 3.75mg once daily; max 15mg/day. Children: Not established.
perindopril erbumine	—	2mg, 4mg, 8mg	scored tabs	Adults: If not on diuretic: initially 4mg once daily; may increase to max 16mg/day. Usual maintenance 4–8mg daily in 1–2 divided doses. If on diuretic: consider reducing diuretic dose prior to starting therapy. Elderly: usual max 8mg/day. CrCl <30mL/min: not recommended; CrCl ≥30mL/min: initially 2mg/day: max 8mg/day. Children: Not established.
quinapril HCl	Accupril	5mg+, 10mg, 20mg, 40mg	tabs	Adults: Initially and if not on diuretics: 10 or 20mg once daily; may adjust dose at intervals of ≥2wks. Usual maintenance: 20–80mg daily in 1–2 divided doses. If on diuretics: suspend diuretic for 2–3 days before starting; resume diuretic if BP not controlled by quinapril alone. If diuretic cannot be discontinued, or if CrCl 30–60mL/min: initially 5mg daily. CrCl 10–30mL/min: initially 2.5mg daily. Elderly: initially 10mg once daily. Children: Not established.
ramipril	Altace	1.25mg, 2.5mg, 5mg, 10mg	gel caps	Adults: Initially and if not on diuretics: 2.5mg once daily. Maintenance: 2.5−20mg daily in 1−2 divided doses. May add a diuretic if BP is not controlled. CrCl <40mL/min: 1.25mg once daily; max 5mg/day. Children: Not established.
trandolapril	—	1mg+, 2mg, 4mg	tabs	Adults: If not on diuretic: initially 1mg once daily in non-black patients; 2mg in black patients. If on diuretic: suspend diuretic for 2−3 days before starting therapy; resume diuretic if BP not controlled with trandolapril alone. If diuretic cannot be discontinued (supervise closely until stabilized), or in renal impairment (CrCl<30mL/min) or hepatic cirrhosis: initially 0.5mg once daily. For all: adjust at 1‑week intervals; usual range 2−4mg once daily; usual max 8mg/day; may give in 2 divided doses. Children: Not established.

Generic	Brand	Strength	Form	Usual Dose
ACE INHIBITOR + DIURETIC
benazepril HCl/ hydrochloro– thiazide	Lotensin HCT	10mg/ 12.5mg, 20mg/ 12.5mg, 20mg/ 25mg	scored tabs	Adults: Switching from monotherapy with either component: initially 10/12.5mg once daily; may increase after 2–3wks as needed up to max 20/25mg daily. Or, substitute for individually titrated components. Children: Not established.
enalapril maleate/ hydrochloro– thiazide	Vaseretic	10mg/ 25mg	scored tabs	Adults: Switching from monotherapy with either component: start 10/25 once daily; max 20mg/day enalapril and 50mg/day HCTZ. Titrate HTCZ after 2−3wks. Or, substitute for individually titrated components. Children: Not established.
fosinopril sodium/ hydrochloro– thiazide	—	10mg/ 12.5mg, 20mg/ 12.5mg	tabs	Adults: Not for initial therapy. Give once daily. Usual range: fosinopril: 10−20mg; HCTZ: 12.5−50mg. Severe renal impairment (CrCl<30mL/min): not recommended. Children: Not recommended.
lisinopril/HCTZ	—	10mg/ 12.5mg, 20mg/ 12.5mg, 20mg/ 25mg	tabs	Adults: Switching from monotherapy with either component: initially 10mg/12.5mg or 20mg/12.5mg once daily, then adjust. Allow 2–3wks for titration of HCTZ component. If on diuretic: if possible, suspend diuretic for 2–3 days, then adjust. Or, substitute for individually titrated components. CrCl <30mL/min: not recommended. Children: Not established.
lisinopril/HCTZ	Zestor– etic	10mg/ 12.5mg, 20mg/ 12.5mg, 20mg/ 25mg	tabs
moexipril HCl/ hydrochloro– thiazide	—	7.5mg/ 12.5mg, 15mg/ 12.5mg, 15mg/ 25mg	scored tabs	Adults: Not for initial therapy. Take 1hr before a meal. Switching from monotherapy with either component: 1 tab once daily, then adjust; usual max 30mg/50mg per day. Allow 2–3wks for titration of HCTZ component. Or, substitute for individually-titrated components. Children: Not established.
quinapril HCl/HCTZ	—	10mg/ 12.5mg+, 20mg/ 12.5mg+, 20mg/ 25mg	tabs	Adults: Not for initial therapy. Switching from quinapril monotherapy: initially 10mg/12.5mg or 20mg/12.5mg once daily; allow 2–3wks before increasing HCTZ component. Switching from HCTZ 25mg/day monotherapy: initially 10mg/12.5mg or 20mg/12.5mg once daily. Adjust based on response and serum potassium. Or, substitute for individually titrated components. CrCl ≤30mL/min: not recommended. Children: Not established.
CALCIUM CHANNEL BLOCKER + ACE INHIBITOR
amlodipine besylate/ benazepril HCl	Lotrel	2.5mg/ 10mg, 5mg/ 10mg, 5mg/ 20mg, 5mg/ 40mg, 10mg/ 20mg, 10mg/ 40mg	caps	Adults: Not for initial therapy. Not adequately controlled with amlodipine or benazepril monotherapy, or unable to achieve BP control with amlodipine without developing edema: initially 2.5mg/10mg once daily; may titrate up to 10mg/40mg once daily if BP uncontrolled. Or, substitute for individually titrated components. CrCl ≤30mL/min: not recommended. Hepatic impairment, elderly: consider lower doses. Children: Not established.
perindopril arginine/ amlodipine	Prestalia	3.5mg/ 2.5mg, 7mg/ 5mg, 14mg/ 10mg	tabs	Adults: Initially 3.5mg/2.5mg once daily. Adjust at 7−14 day intervals; max 14mg/10mg once daily. Renal impairment (CrCl 30–80mL/min): max 7mg/5mg; (CrCl <30mL/min): not recommended. Children: Not established.
trandolapril/ verapamil HCl ER	—	1mg/ 240mg, 2mg/ 180mg, 2mg/ 240mg, 4mg/ 240mg	tabs	≥18yrs: Not for initial therapy. 1 tab daily. Titrate individual components. Take with food. <18yrs: Not established.
NOTES
Key: + = scored Not an inclusive list of medications, official indications, and/or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 2/2024)

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