Todd P A, Benfield P
ADIS Drug Information Services, Auckland, New Zealand.
Drugs. 1990 Jan;39(1):110-35. doi: 10.2165/00003495-199039010-00009.
Ramipril is a long acting angiotensin converting enzyme (ACE) inhibitor, which exhibits similar pharmacodynamic properties to captopril and enalapril. Like enalapril it is a prodrug, which is hydrolysed after absorption to form the active metabolite ramiprilat which has a long elimination half-life, permitting once daily administration. In hypertensive patients daily doses in the range 2.5 to 20 mg are usually effective in reducing high blood pressure and maintaining satisfactory control during long term treatment. Patients who do not respond adequately to monotherapy with ramipril usually respond with the addition of a diuretic such as hydrochlorothiazide or piretanide. Ramipril 5 to 10 mg once daily shows comparable antihypertensive efficacy to usual therapeutic dosages of captopril, enalapril and atenolol in patients with mild to moderate essential hypertension. Preliminary data indicate that ramipril may be effective in indications such as severe essential hypertension and renal hypertension. It has also displayed beneficial effects in patients with moderate to severe congestive heart failure. Ramipril has been well tolerated and exhibits an adverse effect profile typical of ACE inhibitors as a class. In conclusion, ramipril will likely represent a useful alternative ACE inhibitor for use in patients with hypertension or congestive heart failure.
雷米普利是一种长效血管紧张素转换酶（ACE）抑制剂，其药效学特性与卡托普利和依那普利相似。与依那普利一样，它是一种前体药物，吸收后被水解形成活性代谢产物雷米普利拉，其消除半衰期长，允许每日给药一次。在高血压患者中，2.5至20毫克的日剂量通常能有效降低高血压，并在长期治疗中维持满意的控制效果。对雷米普利单一疗法反应不佳的患者，通常加用利尿剂如氢氯噻嗪或吡咯他尼后会有反应。对于轻度至中度原发性高血压患者，雷米普利每日一次5至10毫克的降压疗效与卡托普利、依那普利和阿替洛尔的常用治疗剂量相当。初步数据表明，雷米普利可能对重度原发性高血压和肾性高血压等适应症有效。它在中度至重度充血性心力衰竭患者中也显示出有益效果。雷米普利耐受性良好，具有ACE抑制剂类药物典型的不良反应特征。总之，雷米普利可能是高血压或充血性心力衰竭患者有用的替代ACE抑制剂。
