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Zestril, Prinivil
First-line treatment for hypertension and heart failure. Monitor potassium levels and renal function.
Brand Names: Zestril, Prinivil, Qbrelis
Class: ACE Inhibitor
Schedule: Prescription Only
Half-life: 12 hours
Metabolism: Hepatic (minimal)
Fetal Toxicity
Discontinue when pregnancy is detected. Can cause injury/death to developing fetus.
Hypertension
Initial: 10 mg daily; Maintenance: 20-40 mg daily
Heart Failure
Initial: 2.5-5 mg daily; Titrate to max 40 mg daily
Elderly/Renal Impairment
Start with 2.5-5 mg daily; adjust based on CrCl
Diuretics
Risk of first-dose hypotension. Consider holding diuretic for 2-3 days prior to initiation.
ARBs/Aliskiren
Increased risk of hyperkalemia, hypotension, and renal impairment.
NSAIDs
May diminish antihypertensive effect and increase renal impairment risk.
Dizziness (12%), headache (6%), cough (4%), hyperkalemia (3%)
Angioedema (0.1-0.7%), renal failure, hypotension, hepatotoxicity