What are the most commonly used Angiotensin-Converting Enzyme (ACE) inhibitors, including their brand and generic names?

Most Commonly Used ACE Inhibitors with Brand and Generic Names

The most commonly used ACE inhibitors include lisinopril (Prinivil, Zestril), enalapril (Vasotec), ramipril (Altace), and captopril (Capoten), which are widely prescribed for hypertension, heart failure, and diabetic nephropathy. 1

Comprehensive List of ACE Inhibitors

First-Line/Most Commonly Used ACE Inhibitors

• Lisinopril

  • Brand names: Prinivil, Zestril
  • Dosing: 10-40 mg once daily
  • Notable features: Does not require hepatic activation, linear dose-response relationship 1, 2

• Enalapril

  • Brand name: Vasotec
  • Dosing: 5-40 mg daily in 1-2 divided doses
  • Notable features: Prodrug requiring hepatic activation 1

• Ramipril

  • Brand name: Altace
  • Dosing: 1.25-20 mg daily in 1-2 divided doses
  • Notable features: Reduced mortality in post-MI patients 1, 2

• Captopril

  • Brand name: Capoten
  • Dosing: 6.25-50 mg three times daily
  • Notable features: First ACE inhibitor developed, shortest half-life (1 hour) 1, 3

Other Commonly Used ACE Inhibitors

• Benazepril

  • Brand name: Lotensin
  • Dosing: 10-40 mg daily in 1-2 divided doses 1

• Fosinopril

  • Brand name: Monopril
  • Dosing: 10-80 mg daily
  • Notable features: Dual elimination (renal and hepatic) 1, 3

• Quinapril

  • Brand name: Accupril
  • Dosing: 10-80 mg daily in 1-2 divided doses 1

• Perindopril

  • Brand name: Aceon
  • Dosing: 4-16 mg daily in 1-2 divided doses 1

• Trandolapril

  • Brand name: Mavik
  • Dosing: 1-4 mg daily
  • Notable features: Long half-life, good trough-to-peak ratio 1, 4

• Moexipril

  • Brand name: Univasc
  • Dosing: 7.5-30 mg daily in 1-2 divided doses
  • Notable features: Should be taken 1 hour before meals 1, 4

Clinical Considerations

Pharmacokinetic Differences

• Half-life variations: Range from 1 hour (captopril) to over 24 hours (trandolapril) 3
• Bioavailability: Varies widely from 11% (trandolapril) to >60% (captopril) 3
• Elimination routes: Most are primarily eliminated through kidneys, but benazepril, fosinopril, ramipril, and trandolapril also have significant hepatic elimination 3

Important Adverse Effects

• Cough: Occurs in up to 20% of patients, more common in women and Asian patients 1
• Angioedema: Occurs in <1% of patients but more frequent in Black patients; requires permanent discontinuation of all ACE inhibitors 1
• Hyperkalemia: Especially in patients with renal impairment or those taking potassium-sparing diuretics 1
• Acute renal failure: More common in patients with bilateral renal artery stenosis, volume depletion, or heart failure 1

Dosing Considerations

• Renal impairment: Dose adjustment required for most ACE inhibitors when creatinine clearance is <30 mL/min 3
• Heart failure: Start with low doses and titrate gradually 1
• Elderly patients: Consider starting at lower doses 4

ACE inhibitors remain first-line agents for hypertension, heart failure, and diabetic nephropathy due to their proven mortality benefits and generally favorable side effect profile compared to other antihypertensive classes.