From the Research
Trandolapril is the ACE inhibitor with the longest half-life, making it an excellent choice for once-daily dosing and consistent blood pressure control. Its half-life ranges from 16-24 hours, with its active metabolite trandolaprilat having an even longer half-life of up to 24 hours 1. This extended duration of action provides stable 24-hour blood pressure control and may improve medication adherence through convenient once-daily dosing. The typical starting dose is 1 mg once daily, which can be titrated up to 4 mg daily based on blood pressure response. Other long-acting ACE inhibitors include perindopril (half-life of 10-30 hours) and ramipril (half-life of 13-17 hours), which are also effective options 1.
Some key points to consider when choosing an ACE inhibitor include:
- Half-life: Trandolapril has a longer half-life compared to other ACE inhibitors, making it suitable for once-daily dosing 1.
- Pharmacokinetics: Trandolapril is characterized by a carboxyl functional group and requires hepatic activation to form its active metabolite, trandolaprilat 1.
- Dosage adjustments: Trandolapril requires dosage reductions in patients with renal impairment, and its pharmacokinetics are not altered by concomitant administration with warfarin 1.
- Efficacy: Trandolapril has been shown to be effective in reducing blood pressure and improving outcomes in patients with hypertension, heart failure, and myocardial infarction 1, 2.
Overall, trandolapril's long half-life and stable pharmacokinetics make it a suitable choice for patients who require consistent blood pressure control and may improve medication adherence.