1.1. Adults
Angiotensin-converting enzyme (ACE) inhibitors are FDA-approved for use in adults for diabetic nephropathy (captopril only), heart failure, hypertension, and improved survival/reduction of complications post-myocardial infarction. Combination therapy is FDA-approved for the management of hypertension. ACE inhibitors are available as monotherapy as well as combination products with a calcium channel blocker or hydrochlorothiazide. Adult maximum daily doses for ACE inhibitors are summarized in Tables 1 and 2 for mono- and combination therapy, respectively. Dosages exceeding these recommendations will be reviewed.
Drug Name | Dosage Form/Strength | Treatment Indication | Maximum Recommended Dosage |
---|---|---|---|
benazepril (Lotensin®, generics) | 5 mg, 10 mg, 20 mg, 40 mg tablets | hypertension | 80 mg/day* |
captopril (generics) | 12.5 mg, 25 mg, 50 mg, 100 mg tablets | diabetic nephropathy/ proteinuria | 75 mg/day |
heart failure | 450 mg/day | ||
hypertension | 450 mg/day | ||
post-myocardial infarction | 150 mg/day | ||
enalapril (Vasotec®, generics; Epaned®) | 2.5 mg, 5 mg, 10 mg, 20 mg tablets; 1 mg/ml oral solution | asymptomatic left ventricular dysfunction | 20 mg/day |
heart failure | 40 mg/day | ||
hypertension | 40 mg/day | ||
fosinopril (generics) | 10 mg, 20 mg, 40 mg tablets | heart failure | 40 mg/day |
hypertension | 80 mg/day | ||
lisinopril (Zestril, generics; Qbrelis) | 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg tablets; 1 mg/ml oral solution | acute myocardial infarction | 10 mg/day |
heart failure | 40 mg/day | ||
hypertension | 80 mg/day | ||
moexipril (generics) | 7.5 mg, 15 mg tablets | hypertension | 30 mg/day |
perindopril (generics) | 2 mg, 4 mg, 8 mg tablets | hypertension |
16 mg/day elderly, renal function impairment: 8 mg/day |
myocardial infarction prophylaxis | 8 mg/day | ||
quinapril (Accupril®, generics) | 5 mg, 10 mg, 20 mg, 40 mg tablets | heart failure | 40 mg/day |
hypertension | 80 mg/day | ||
ramipril (Altace®, generics) | 1.25 mg, 2.5 mg, 5 mg, 10 mg capsules | heart failure (post myocardial infarction) | 10 mg/day |
hypertension | 20 mg/day | ||
myocardial infarction/ stroke prophylaxis in patients 55 years of age or older | 10 mg/day | ||
trandolapril (generics) | 1 mg, 2 mg, 4 mg tablets | hypertension | 8 mg/day |
post myocardial infarction (heart failure, left ventricular dysfunction) | 4 mg/day |
Legend:
- *Doses as high as 80 mg have provided increased response; however, experience with these higher dosages is limited.
Drug Name | Dosage Form/Strength | Maximum Recommended Dosage |
---|---|---|
amlodipine/benazepril (Lotrel®, generics) |
|
10 mg/40 mg/day |
benazepril/hydrochlorothiazide (Lotensin HCT®, generics) |
|
20 mg/25 mg/day |
enalapril/hydrochlorothiazide (Vaseretic®, generics) |
|
20 mg/50 mg/day |
fosinopril/hydrochlorothiazide (generics) |
|
80 mg/50 mg/day |
lisinopril/hydrochlorothiazide (Zestoretic®, generics) |
|
80 mg/50 mg/day |
moexipril/hydrochlorothiazide (generics) |
|
30 mg/50 mg/day |
perindopril/amlodipine (Prestalia®) |
|
14 mg/10 mg/day |
quinapril/hydrochlorothiazide (Accuretic®, generics) |
|
40 mg/25 mg/day |
trandolapril/verapamil (generics) |
|
4 mg/240 mg/day |