Dot gov

Official websites use the Texas HHS logo.
The Texas HHS logo means this is an official website of Texas Health and Human Services.

HTTPS

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

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.

Table 1: ACE Inhibitors as Monotherapy - Maximum Daily Adult Dose1-15
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.
Table 2: Adult Maximum Dosage Recommendations for ACE Inhibitor Combination Therapy in Hypertension Management1,2,16-25
Drug Name Dosage Form/Strength Maximum Recommended Dosage
amlodipine/benazepril (Lotrel®, generics)
  • 2.5 mg/10 mg (generic only)
  • 5 mg/10 mg
  • 5 mg/20 mg
  • 5 mg/40 mg (generic only)
  • 10 mg/20 mg
  • 10 mg/40 mg capsules
10 mg/40 mg/day
benazepril/hydrochlorothiazide (Lotensin HCT®, generics)
  • 5 mg/6.25 mg (generic only)
  • 10 mg/12.5 mg
  • 20 mg/12.5 mg
  • 20 mg/25 mg tablets
20 mg/25 mg/day
enalapril/hydrochlorothiazide (Vaseretic®, generics)
  • 5 mg/12.5 mg (generic only)
  • 10 mg/25 mg tablets
20 mg/50 mg/day
fosinopril/hydrochlorothiazide (generics)
  • 10 mg/12.5 mg
  • 20 mg/12.5 mg tablets
80 mg/50 mg/day
lisinopril/hydrochlorothiazide (Zestoretic®, generics)
  • 10 mg/12.5 mg
  • 20 mg/12.5 mg
  • 20 mg/25 mg tablets
80 mg/50 mg/day
moexipril/hydrochlorothiazide (generics)
  • 7.5 mg/12.5 mg
  • 15 mg/12.5 mg
  • 15 mg/25 mg tablets
30 mg/50 mg/day
perindopril/amlodipine (Prestalia®)
  • 3.5 mg/2.5 mg
  • 7 mg/5 mg
  • 14 mg/10 mg tablets
14 mg/10 mg/day
quinapril/hydrochlorothiazide (Accuretic®, generics)
  • 10 mg/12.5 mg
  • 20 mg/12.5 mg
  • 20 mg/25 mg tablets
40 mg/25 mg/day
trandolapril/verapamil (generics)
  • 1 mg/240 mg
  • 2 mg/180 mg
  • 2 mg/240 mg
  • 4 mg/240 mg extended-release tablets
4 mg/240 mg/day