CACE inhibitors and angiotensin II receptor antagonists

1. ACE inhibitors reduce preload, afterload, right atrial pressure, pulmonary capillary wedge pressure, arterial blood pressure, and systemic vascular resistance.

ACE Inhibitors

Drug

Initial dose

Ususal dose (max dose)

Captopril (Capoten)

6.25 mg bid, tid

12.5-25 mg bid, tid (150 mg/d)

Enalapril (Vasotec)

2.5-5 mg qd

10-20 mg bid (40 mg/d)

Lisinopril (Prinivil/Zestril)

5-10 mg qd

20-40 mg qd (80 mg/d)

Ramipril (Altace)

1.25-2.5 mg bid

5 mg bid (20 mg/d)

Benazepril (Lotensin)

10 mg qd

20-40 mg qd, (40 mg/d) bid

Fosinopril (Monopril)

10 mg qd

20-40 mg qd (40 mg/d)

Quinapril (Accupril)

5 mg bid

20-40 mg bid (80 mg/d)

Perindopril (Aceon)

1 mg qd

1-4 mg qd (16 mg/d)

Moexipril (Univasc)

7.5 mg qd

7.5-15 mg qd (30 mg/d)

Trandolapril (Mavik)

1-2 mg qd (2 mg in backs)

2-4 mg qd (8 mg/d)

2. In patients who cannot tolerate or have contraindications to ACE inhibitors, ARAs should be considered. ARAs offer advantages that appear similar to the ACE inhibitors. Side effects such as cough and angioedema are rare.

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