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Brand Name :
APO-Cilazapril, Inhibace, MYLAN-Cilazapril
Synonyms :
cilazapril
Class :
Angiotensin-Converting Enzyme Inhibitor, Antihypertensive
Brand Name :
APO-Cilazapril, Inhibace, MYLAN-Cilazapril
Synonyms :
cilazapril
Class :
Angiotensin-Converting Enzyme Inhibitor, Antihypertensive
Dosage Forms & Strengths
Tablet
1 mg
2.5 mg
5 mg
Congestive Heart Failure (CHF)
Take initial dose of 0.5 mg orally one time a day then raise to 1 mg once daily in five days
It may further titrate as required to maintenance dose of 2.5 mg one time a day
Maximum dose not more than 2.5 mg one time a day
Take an initial dose of 2.5 mg one time a day
Maximum dose not more than 10 mg one time a day
Dosing modifications
Renal Impairment
For Heart failure
CrCl >40 ml/minute: take initial dose of 0.5 mg one time a day
CrCl 10 to 40 ml/minute: take initial dose of 0.25 to 0.5 mg one time a day
CrCl <10 ml/minute: Use not suggested
For Hypertension
CrCl >40 ml/minute: take initial dose of 1 mg one time a day
CrCl 10 to 40 ml/minute: take initial dose of 0.5 mg one time a day
CrCl <10 ml/minute: Use not suggested
Hepatic Impairment
For Hypertension
Take initial dose of ≤0.5 mg one time a day and use cautiously
Safety and efficacy not determined
Refer to adult dosing
may increase the adverse effect of angiotensin II receptor blockers
may increase the adverse effect of angiotensin II receptor blockers
may enhance the concentration of serum when combined with lithium
may enhance the concentration of serum when combined with lithium
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
may increase the toxic effect of angiotensin receptor II blockers
lisinopril/hydrochlorothiazide
may increase the toxic effect of angiotensin receptor II blockers
may increase the toxic effect of angiotensin receptor II blockers
may diminish the serum concentration when combined with angiotensin-converting enzyme inhibitors
may enhance the serum concentration when combined with lithium
may enhance the serum concentration of CYP3A4 Inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increased adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increased adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increased adverse effect when combined with angiotensin-converting enzyme inhibitors
may enhance the concentration of serum when combined with lithium
may enhance the concentration of serum when combined with lithium
may diminish the effects of indomethacin by pharmacodynamic antagonism
may diminish the effects of indomethacin by pharmacodynamic antagonism
may have an increasingly adverse effect when combined with sacubitril
may have an increasingly adverse effect when combined with ACE inhibitors
when both the drugs are combined, there might be an increase in the anticoagulant effect
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
May increase the adverse/toxic effect of NSAIDs
May increase the adverse/toxic effect of NSAIDs
May increase the adverse/toxic effect of NSAIDs
May increase the adverse/toxic effect of NSAIDs
May increase the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
may enhance the hypotensive effect of ACE Inhibitors
may enhance the hypotensive effect of ACE Inhibitors
may enhance the hypotensive effect of ACE Inhibitors
may enhance the hypotensive effect of ACE Inhibitors
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with NSAIDs
angiotensin-Converting Enzyme Inhibitors may enhance the hyperkalemic effect of finerenone
ACE Inhibitors may enhance the potential for allergic or hypersensitivity reactions to allopurinol
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
angiotensin-converting Enzyme (ACE) inhibitors may increase the risk of adverse effects of alteplase
icatibant may reduce the antihypertensive effect of ACE inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may increase the anti-coagulant action of anti-coagulants
choline magnesium trisalicylate
may enhance the nephrotoxic effect of ACE inhibitors
may diminish the antihypertensive activity when combined
may have an increased allergic or hypersensitivity reactions when combined with allopurinol
may have an increasingly adverse effect when combined with alteplase
may have an increased orthostatic hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may enhance the nephrotoxic effect of salicylates
polyethylene glycol and electrolytes
They may increase the nephrotoxic effect when combined with polyethylene Glycol-electrolyte Solution
Dipeptidyl Peptidase-IV Inhibitors: they may increase the toxic effect of angiotensin-converting enzyme inhibitors
Dipeptidyl Peptidase-IV Inhibitors: they may increase the toxic effect of angiotensin-converting enzyme inhibitors
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
may have an increasingly adverse effect when combined with iron dextran complex
spironolactone and hydrochlorothiazide
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
choline magnesium trisalicylate
may have an increased nephrotoxic effect when combined with angiotensin-converting enzyme inhibitors
may increase the hypotensive effect of angiotensin-converting enzyme inhibitors
may increase the hypotensive effect of angiotensin-converting enzyme inhibitors
may increase the hypotensive effect of angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
the risk of angioedema may be increased
angiotensin II receptor blockers increase the toxicity of ACE inhibitors
Actions and Spectrum
cilazapril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking the action of ACE, an enzyme that converts angiotensin I to angiotensin II.
Frequency defined
1-10%
Hypotension (≤2%)
Orthostatic hypotension (≤2%)
Increased gamma-glutamyl transferase (1%)
Increased serum alanine aminotransferase (1% to 3%)
Palpitations (≤1%)
Asthenia (≤2%), dizziness (3% to 8%)
Fatigue (2% to 3%), headache (3% to 5%)
Nausea (1% to 3%)
Proteinuria (≤1%)
Increased blood urea nitrogen (≤3%)
Abnormal white blood cell count differential (≤1%)
Increased serum creatinine (≤3%)
<1%
Acute myocardial infarction, angina pectoris, atrial fibrillation
Dermatitis, diaphoresis, erythematous rash, maculopapular rash
Pruritus, skin rash, urticaria
Atrioventricular block, bradycardia, cardiac arrhythmia
Decreased libido, hot flash
Hyperglycemia, increased lactate dehydrogenase, increased serum potassium
Cardiac decompensation, cardiogenic shock, chest pain, edema
Extrasystoles, flushing, syncope, tachycardia
Rectal hemorrhage, vomiting, xerostomia
Dysuria, impotence, polyuria,
Uremia, urinary frequency
Abdominal pain, anorexia, constipation, diarrhea, dysgeusia
Dyspepsia, flatulence, gastrointestinal hemorrhage
Increased serum bilirubin
Angioedema, facial edema
Anxiety, ataxia, cerebrovascular disease, confusion
Depression, drowsiness, hypoesthesia, insomnia
Anemia, immune thrombocytopenia, leukopenia, neutropenia
Purpuric disease, qualitative disorders of platelets
Malaise, migraine, nervousness, pain
Paresthesia, rigors, tremor, vertigo, voice disorder
Conjunctivitis, photophobia, visual disturbance
Tinnitus
Renal failure syndrome, renal pain
Arthralgia, gout
Lower leg cramp, myalgia
Bronchitis, bronchospasm
Dyspnea, epistaxis, pharyngitis
Respiratory tract infection
Rhinitis, sinusitis
Post marketing report
Increased serum alkaline phosphatase
Increased serum aspartate aminotransferase, jaundice
Pancreatitis
Cholestatic hepatitis, hepatocellular hepatitis
Visual hallucination
Pleural effusion
Black Box Warning
None
Contraindication/Caution:
Contraindication:
Caution:
Pregnancy consideration:
Pregnancy category: N/A
Lactation: Excretion into human milk is unknown
Pregnancy Categories:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category.
Pharmacology
cilazapril reduces the production of angiotensin II, a potent vasoconstrictor leading to vasodilation.
Pharmacodynamics
cilazapril decreases the levels of angiotensin II, which results in reduced aldosterone secretion.
Pharmacokinetics
Absorption
cilazapril undergoes extensive first-pass metabolism in the liver.
Distribution
cilazapril have high protein binding around 96% and distribute extensively throughout the body.
Metabolism
cilazapril is metabolized in the liver by esterase enzymes.
Elimination and excretion
cilazapril is eliminated through the kidneys.
Administration
cilazapril is administered orally and available in the tablet form.
Patient information leaflet
Generic Name: cilazapril
Why do we use cilazapril?
cilazapril is used in the management of heart failure and to improve survival a heart attack.
cilazapril is also used for the treatment of hypertension.
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