Table 1Characteristics and current indications of ACE inhibitors and ARBs evaluated in this review23–27

DrugTrade name(s)Half-life or other relevant pharmacokinetic featureLabeled indicationsDosingDose adjustments for special populations
ACE Inhibitors
CaptoprilCapotenT1/2 = 2 hoursHTN, HF, LVD post MI, diabetic nephropathy6.25–100 mg three times dailyUse lower initial doses in patients with renal impairment; titrate slowly
CilazoprilVariousT1/2 = 32–45 hoursNot FDA approved1–5 mg dailyStart with 0.5 mg if CrCl 10–40 mL/min or if HF
EnalaprilVasotecT1/2 = 11 hoursHTN, HF, asymptomatic LVD5–40 mg divided once or twice dailyStart with 2.5 mg daily in patients with CrCl ≤ 30 mL/min, HF, or hyponatremia
FosinoprilMonoprilT1/2 = 11.5–14 hoursHTN, HF as adjunctive therapy10–80 mg divided once or twice dailyUse close medical supervision in patients with HF; consider 5mg if renal impairment also present or if diuresed
PerindoprilAceonT1/2 = 3–10 hours (active metabolite)Stable CAD, HTN4–8 mg daily; max 16 mg daily if normal renal functionStart with 2 mg daily if > 70 years old or renal insufficiency, 2 mg–4 mg if on diuretic; Not studied in CrCl < 30 mL/min
QuinaprilAccuprilT1/2 = 3 hours (active metabolite)HTN, HF as adjunctive therapy10–80 mg divided once or twice dailyStart with 2.5 mg if CrCl 10–30 mL/min or 5 mg if CrCl 30–60 mL/min
RamiprilAltaceT1/2 = 13–17 hours (active metabolite)Reduce risk of MI, stroke, and death from CV causes, HTN, HF post MI2.5–20 mg divided once or twice dailyStart with 1.25 mg in patients with renal impairment; only 25% of normal doses may be needed if CrCl < 40mL/min
TrandolaprilMavikT1/2 = 6 hours (parent drug); 10 hours (active metabolite)HTN, HF or LVSD post MI1–4 mg daily up to 4 mg twice dailyStart with 0.5 mg if concomitant diuretic, CrCl < 30 mL/min, or cirrhosis
ZofenoprilVariousT1/2 = 5 hoursNot FDA approved7.5–60 mg dailyTitrate slowly in HF
ARBs
CandesartanAtacandT1/2 = 9 hoursHTN, HF in patients with LVD2–32 mg dailyStart at lower doses if moderate hepatic impairment or volume depleted
TelmisartanMicardisT1/2 = 24 hoursHTN20–80 mg dailyUse under close medical supervision if volume depleted or hepatic or biliary disorders

Abbreviations: CrCl=creatinine clearance; FDA=Food and Drug Administration; HF=heart failure; HTN=hypertension; LVSD=left ventricular systolic dysfunction; mg=milligram; MI=myocardial infarction; mL/min=milliliters per minute; T1/2=half-life

From: Introduction

Cover of Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease
Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease [Internet].
Comparative Effectiveness Reviews, No. 18.
Coleman CI, Baker WL, Kluger J, et al.

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