Table 11-8

*Table 11-8.* Antihypertensive drugs: ACE inhibitors and angiotensin II receptor blockers.
Drug	Proprietary Name	Initial Dosage	DosageRange	Cost per Unit	Cost of 30 Days Treatment (Average Dosage)¹		Adverse Effects	Comments
ACE INHIBITORS
Benazepril	Lotensin	10 mg once daily	5-40 mg in 1 or 2 doses	$1.05/20 mg	$31.50		Cough, hypotension, dizziness, renal dysfunction, hyperkalemia, angioedema; taste alteration and rash (may be more frequent with captopril); rarely, proteinuria, blood dyscrasia. Contraindicated in pregnancy.	More fosinopril is excreted by the liver in patients with renal dysfunction (dose reduction may or may not be necessary). Captopril and lisinopril are active without metabolism. Captopril, enalapril, lisinopril, and quinapril are approved for congestive heart failure.
Captopril	Capoten	25 mg twice daily	50-300 mg in 2 or 3 doses	$0.65/25 mg	$39.00
Enalapril	Vasotec	5 mg once daily	5-40 mg in 1 or 2 doses	$1.52/20 mg	$45.60
Fosinopril	Monopril	10 mg once daily	10-80 mg in 1 or 2 doses	$1.19/20 mg	$35.70
Lisinopril	Prinivil, Zestril	5-10 mg once daily	5-40 mg once daily	$1.06/20 mg	$31.80
Moexipril	Univasc	7.5 mg once daily	7.5-30 mg in 1 or 2 doses	$1.33/7.5 mg	$39.90
Perindopril	Aceon	4 mg once daily	4-16 mg in 1 or 2 doses	$2.07/8 mg	$62.10
Quinapril	Accupril	10 mg once daily	10-80 mg in 1 or 2 doses	$1.22/20 mg	$36.60
Ramipril	Altace	2.5 mg once daily	2.5-20 mg in 1 or 2 doses	$1.67/5 mg	$50.10
Trandolapril	Mavik	1 mg once daily	1-8 mg once daily	$1.20/4 mg	$36.00
ANGIOTENSIN II RECEPTOR BLOCKERS
Candesartan cilexitil	Atacand	16 mg once daily	8-32 mg once daily	$1.68/16 mg		$50.40	Hyperkalemia, renal dysfunction, rare angioedema. Combinations have additional side effects. Contraindicated in pregnancy.	Losartan has a very flat dose-response curve. Valsartan and irbesartan have wider dose-response ranges and longer durations of action. Addition of low-dose diuretic (separately or as combination pills) increases the response.
Candesartan cilexitil/HCTZ	Atacand HCT	16 mg/12.5 mg once daily	8-32 mg of candesartan once daily	$2.27/16 mg/12.5 mg		$68.10
Eprosartan	Teveten	600 mg once daily	400-800 mg in 1-2 doses	$1.51/600 mg		$45.30
Eprosartan/HCTZ	Teveten HCT	600 mg/12.5 mg once daily	600 mg/12.5 mg or 600 mg/25 mg once daily	$1.51/600 mg/12.5 mg		$45.30
Irbesartan	Avapro	150 mg once daily	150-300 mg once daily	$1.69/150 mg		$50.70
Irbesartan and hydrochlorothiazide	Avalide	150 mg/12.5 mg once daily	150-300 mg irbesartan daily	$2.09/150 mg		$62.70
Losartan	Cozaar	50 mg once daily	25-100 mg in 1 or 2 doses	$1.77/50 mg		$53.10
Losartan and hydrochlorothiazide	Hyzaar	50 mg/12.5 mg once daily	One or 2 tablets once daily	$1.77/50 mg/12.5 mg/tablet		$53.10	Hyperkalemia, renal dysfunction, rare angioedema. Combinations have additional side effects. Contraindicated in pregnancy.	Losartan has a very flat dose-response curve. Valsartan and irbesartan have wider dose-response ranges and longer durations of action. Addition of low-dose diuretic (separately or as combination pills) increases the response.
Olmesartan	Benicar	20 mg once daily	20-40 mg daily	$1.68/20 mg		$50.40
Olmesartan and HCTZ	Benicar HCT	20 mg/12.5 mg daily	20-40 mg olmesartan daily	$1.81/20 mg/12.5 mg		$54.30
Telmisartan	Micardis	40 mg once daily	20-80 mg once daily	$1.84/40 mg		$55.20
Telmisartan and HCTZ	Micardis HCT	40 mg/12.5 mg once daily	20-80 mg telmisartan daily	$1.97/40 mg/12.5 mg		$59.10
Valsartan	Diovan	80 mg once daily	80-320 mg once daily	$2.04/160 mg		$61.20
Valsartan and HCTZ	Diovan HCT	80 mg/12.5 mg once daily	80-320 mg valsartan daily	$2.22/160 mg/12.5 mg		$66.60

¹Average wholesale price (AWP, for AB-rated generic when available) for quantity listed. Source: Red Book Update, Vol. 25, No. 1, January 2006. AWP may not accurately represent the actual pharmacy cost because wide contractual variations exist among institutions.

ACE = angiotensin-converting enzyme; HCTZ = hydrochlorothiazide.

Table 11-8

*Table 11-8.* Antihypertensive drugs: ACE inhibitors and angiotensin II receptor blockers.
Drug	Proprietary Name	Initial Dosage	DosageRange	Cost per Unit	Cost of 30 Days Treatment (Average Dosage)¹		Adverse Effects	Comments
ACE INHIBITORS
Benazepril	Lotensin	10 mg once daily	5-40 mg in 1 or 2 doses	$1.05/20 mg	$31.50		Cough, hypotension, dizziness, renal dysfunction, hyperkalemia, angioedema; taste alteration and rash (may be more frequent with captopril); rarely, proteinuria, blood dyscrasia. Contraindicated in pregnancy.	More fosinopril is excreted by the liver in patients with renal dysfunction (dose reduction may or may not be necessary). Captopril and lisinopril are active without metabolism. Captopril, enalapril, lisinopril, and quinapril are approved for congestive heart failure.
Captopril	Capoten	25 mg twice daily	50-300 mg in 2 or 3 doses	$0.65/25 mg	$39.00
Enalapril	Vasotec	5 mg once daily	5-40 mg in 1 or 2 doses	$1.52/20 mg	$45.60
Fosinopril	Monopril	10 mg once daily	10-80 mg in 1 or 2 doses	$1.19/20 mg	$35.70
Lisinopril	Prinivil, Zestril	5-10 mg once daily	5-40 mg once daily	$1.06/20 mg	$31.80
Moexipril	Univasc	7.5 mg once daily	7.5-30 mg in 1 or 2 doses	$1.33/7.5 mg	$39.90
Perindopril	Aceon	4 mg once daily	4-16 mg in 1 or 2 doses	$2.07/8 mg	$62.10
Quinapril	Accupril	10 mg once daily	10-80 mg in 1 or 2 doses	$1.22/20 mg	$36.60
Ramipril	Altace	2.5 mg once daily	2.5-20 mg in 1 or 2 doses	$1.67/5 mg	$50.10
Trandolapril	Mavik	1 mg once daily	1-8 mg once daily	$1.20/4 mg	$36.00
ANGIOTENSIN II RECEPTOR BLOCKERS
Candesartan cilexitil	Atacand	16 mg once daily	8-32 mg once daily	$1.68/16 mg		$50.40	Hyperkalemia, renal dysfunction, rare angioedema. Combinations have additional side effects. Contraindicated in pregnancy.	Losartan has a very flat dose-response curve. Valsartan and irbesartan have wider dose-response ranges and longer durations of action. Addition of low-dose diuretic (separately or as combination pills) increases the response.
Candesartan cilexitil/HCTZ	Atacand HCT	16 mg/12.5 mg once daily	8-32 mg of candesartan once daily	$2.27/16 mg/12.5 mg		$68.10
Eprosartan	Teveten	600 mg once daily	400-800 mg in 1-2 doses	$1.51/600 mg		$45.30
Eprosartan/HCTZ	Teveten HCT	600 mg/12.5 mg once daily	600 mg/12.5 mg or 600 mg/25 mg once daily	$1.51/600 mg/12.5 mg		$45.30
Irbesartan	Avapro	150 mg once daily	150-300 mg once daily	$1.69/150 mg		$50.70
Irbesartan and hydrochlorothiazide	Avalide	150 mg/12.5 mg once daily	150-300 mg irbesartan daily	$2.09/150 mg		$62.70
Losartan	Cozaar	50 mg once daily	25-100 mg in 1 or 2 doses	$1.77/50 mg		$53.10
Losartan and hydrochlorothiazide	Hyzaar	50 mg/12.5 mg once daily	One or 2 tablets once daily	$1.77/50 mg/12.5 mg/tablet		$53.10	Hyperkalemia, renal dysfunction, rare angioedema. Combinations have additional side effects. Contraindicated in pregnancy.	Losartan has a very flat dose-response curve. Valsartan and irbesartan have wider dose-response ranges and longer durations of action. Addition of low-dose diuretic (separately or as combination pills) increases the response.
Olmesartan	Benicar	20 mg once daily	20-40 mg daily	$1.68/20 mg		$50.40
Olmesartan and HCTZ	Benicar HCT	20 mg/12.5 mg daily	20-40 mg olmesartan daily	$1.81/20 mg/12.5 mg		$54.30
Telmisartan	Micardis	40 mg once daily	20-80 mg once daily	$1.84/40 mg		$55.20
Telmisartan and HCTZ	Micardis HCT	40 mg/12.5 mg once daily	20-80 mg telmisartan daily	$1.97/40 mg/12.5 mg		$59.10
Valsartan	Diovan	80 mg once daily	80-320 mg once daily	$2.04/160 mg		$61.20
Valsartan and HCTZ	Diovan HCT	80 mg/12.5 mg once daily	80-320 mg valsartan daily	$2.22/160 mg/12.5 mg		$66.60

ACE = angiotensin-converting enzyme; HCTZ = hydrochlorothiazide.