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Oral Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin II Receptor Blockers for Hypertension

Oral Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin II Receptor Blockers for Hypertension

Drug

Usual Dose

Selected Adverse Effects

ACE inhibitors*

Benazepril

5–40 mg once a day

Rash, cough, angioedema, hyperkalemia (particularly in patients with renal insufficiency or taking nonsteroidal anti-inflammatory drugs, potassium-sparing diuretics, or potassium supplements), dysgeusia, reversible acute kidney injury if stenosis affecting one or both kidneys threatens renal function, proteinuria (rare at recommended doses), neutropenia (rare), hypotension with initiation of treatment (particularly in patients with high plasma renin activity or with hypovolemia due to diuretics or other conditions)

Captopril

12.5–150 mg twice a day

Enalapril

2.5–40 mg once a day

Fosinopril

10–80 mg once a day

Lisinopril

5–40 mg once a day

Perindopril erbumine

4–8 mg once a day

Quinapril

5–80 mg once a day

Ramipril

1.25–20 mg once a day

Trandolapril

1–4 mg once a day

Angiotensin II receptor blockers

Azilsartan

80 mg once a day

In patients > 65, initial dose 40 mg once a day

Dizziness, angioedema (very rare); theoretically, same adverse effects as ACE inhibitors on renal function (except proteinuria and neutropenia), serum potassium, and blood pressure

Candesartan

8–32 mg once a day

Eprosartan

400–1200 mg once a day

Irbesartan

75–300 mg once a day

Losartan

25–100 mg once a day

Olmesartan

20–40 mg once a day

Telmisartan

20–80 mg once a day

Valsartan

80–320 mg once a day

* All ACE inhibitors and angiotensin II receptor blockers are contraindicated in pregnancy (category C during 1st trimester; category D during 2nd and 3rd trimesters).