General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hypotensive effects magnified by natriuretic agents or sodium depletion. May cause hyperkalemia, metabolic acidosis. Acute renal dysfunction with bilateral or transplant renal artery stenosis, low renal perfusion pressure. Dry cough in 5-10% of patients.
Excreted Unchanged %
80-90
Half-Life (Normalesrd) Hours
40-50/>60
Plasma Protein Binding %
No data
Volume Of Distribution L/Kg
0.5-0.8
Dose For Normal Renal Function
1.25 mg q24h
Adjustment For Renal Failure Method
D, I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
75% q24h [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
50% q24-48h [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
10-25% q72h [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50,titrate, [D]
References
Deget F, Brogden RN. Cilazapril. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in cardiovascular disease. Drugs. 1991; 41: 799-820. [PMID: 1712710] / Kloke HJ, Ambros RJ, Van Hamersvelt HW, Wetzels JF, Koene RA, Huysmans FT. Pharmacokinetics and haemodynamic effects of the angiotensin converting enzyme inhibitor cilazapril in hypertensive patients with normal and impaired renal function. Br J Clin Pharmacol. 1996; 42: 615-20. [PMID: 8951193]
Toxicity Notes
Cilazaprilat is active moiety formed in liver.