Spiraprilat

Spiraprilat

Spiraprilat is an angiotensin-converting enzyme inhibitor (ACE inhibitor) used primarily in the treatment of hypertension (high blood pressure) and congestive heart failure. It is the active metabolite of the prodrug spirapril, which is converted to spiraprilat in the body.

Mechanism of Action

Spiraprilat works by inhibiting the angiotensin-converting enzyme (ACE), which is responsible for the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor that increases blood pressure by causing blood vessels to narrow. By inhibiting ACE, spiraprilat decreases the production of angiotensin II, leading to vasodilation and a subsequent reduction in blood pressure.

Pharmacokinetics

After oral administration of spirapril, it is rapidly absorbed and converted to spiraprilat in the liver. The bioavailability of spiraprilat is influenced by the presence of food, which can reduce its absorption. Spiraprilat is primarily excreted by the kidneys.

Clinical Uses

Spiraprilat is used in the management of:

• Hypertension
• Congestive heart failure

Side Effects

Common side effects of spiraprilat include:

• Cough
• Hyperkalemia (elevated potassium levels)
• Hypotension (low blood pressure)
• Dizziness
• Renal impairment

Contraindications

Spiraprilat is contraindicated in patients with:

• Angioedema related to previous ACE inhibitor therapy
• Pregnancy
• Severe renal artery stenosis

Drug Interactions

Spiraprilat may interact with:

• Diuretics
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Potassium supplements or potassium-sparing diuretics
• Lithium

Monitoring

Patients on spiraprilat should be monitored for:

• Blood pressure
• Serum potassium levels
• Renal function

See Also

• ACE inhibitors
• Hypertension
• Congestive heart failure

References

Common ACE inhibitors include the following:

• Benazepril
• Captopril
• Enalapril
• Fosinopril
• Lisinopril
• Moexipril
• Perindopril
• Quinapril
• Ramipril
• Trandolapril