ACE Inhibitors Initial Dosage Regimens 

Updated: Apr 18, 2019
Author: Abimbola Farinde, PharmD, PhD;

Initial Dosage Regimens for Angiotensin-Converting Enzyme Inhibitors

ACE (angiotensin converting enzyme) inhibitors inhibit the activity of the enzyme ACE that decreases the production of angiotensin II.[1, 2, 3]

Benazepril (dose adjustment required in renal impairment)

  • Hypertension (with diuretic): 5 mg PO once daily

  • Hypertension (without diuretic): 10 mg PO once daily

Captopril (dose adjustment required in renal impairment)

  • Hypertension (with or without diuretic): 25 mg PO BID/TID

  • Congestive heart failure (CHF) (with diuretic and digitalis): 6.25-12.5 mg PO TID

  • Diabetic nephropathy: 25 mg PO TID

Enalapril (dose adjustment required in renal impairment)

  • Hypertension (with diuretic): 2.5 mg PO once daily

  • Hypertension (without diuretic): 5 mg PO once daily

  • CHF: 2.5 mg PO once daily or q12hr

Fosinopril

  • Hypertension (with or without diuretic): 10 mg PO once daily

  • CHF: 10 mg PO once daily

Lisinopril (dose adjustment required in renal impairment)

  • Hypertension (with diuretic): 5 mg PO once daily

  • Hypertension (without diuretic): 10 mg PO once daily

  • CHF: 2.5-5 mg PO once daily

Moexipril (dose adjustment required in renal impairment)

  • Hypertension (with diuretic): 3.75 mg PO once daily

  • Hypertension (without diuretic): 7.5 mg PO once daily

Perindopril (dose adjustment required in renal impairment)

  • Hypertension (without diuretic): 4 mg PO once daily; consider dose reduction if coadministered with diuretic

Quinapril (dose adjustment required in renal impairment)

  • Hypertension (with diuretic): 5 mg PO once daily

  • Hypertension (without diuretics): 10-20 mg PO once daily

  • CHF: 5 mg PO BID

Ramipril (dose adjustment required in renal impairment)

  • Hypertension (with diuretic): 1.25 mg PO once daily

  • Hypertension (without diuretic): 2.5 mg PO once daily

  • CHF after MI: 2.5 mg PO BID

Trandolapril (dose adjustment required in renal impairment and hepatic cirrhosis)

  • Hypertension (with diuretic): 0.5 mg PO once daily

  • Hypertension (without diuretic): 1 mg PO once daily (nonblack), 2 mg PO once daily (black)

Possible side effects

  • Cough  
  • Weakness
  • Increased potassium levels  
  • Rash  
  • Kidney failure (rare)