<unk>  is the lysine-analog of enalapril. Unlike other ACE inhibitors, it is not a prodrug, is not metabolized by the liver, and is excreted unchanged in the urine. Mechanism of action<unk>  is an ACE inhibitor, meaning it blocks the actions of angiotensin-converting enzyme (ACE) in the renin–angiotensin–aldosterone system (RAAS), preventing angiotensin I from being converted to angiotensin II. Angiotensin II is a potent direct vasoconstrictor and a stimulator of aldosterone release. Reduction in the amount of angiotensin II results in relaxation of the arterioles. Reduction in the amount of angiotensin II also reduces the release of aldosterone from the adrenal cortex, which allows the kidney to excrete sodium along with water into the urine, and increases retention of potassium ions. Specifically, this process occurs in the peritubular capillaries of the kidneys in response to a change in Starling forces. The inhibition of the RAAS system causes an overall decrease in blood pressure. Pharmacokinetics Absorption<unk>  has a bioavailability of ~25% (reduced to 16% in people with New York Heart Association Functional Classification (NYHA) Class II–IV heart failure). Its time to peak concentration is 7 hours. The peak effect of<unk>  is about 4 to 8 hours after administration. Food does not affect its absorption. Distribution<unk>  does not bind to proteins in the blood. It does not distribute as well in people with NYHA Class II–IV heart failure. Metabolism<unk>  is the only water-soluble member of the ACE inhibitor class, with no metabolism by the liver. Elimination<unk>  leaves the body completely unchanged in the urine. The half-life of<unk>  is 12 hours, and is increased in people with kidney problems. While the plasma half-life of<unk>  has been estimated between 12 and 13 hours, the elimination half-life is much longer, at around 30 hours. The full duration of action is between 24 and 30 hours. Chemistry Pure<unk>  powder is white to off white in color.<unk>  is soluble in water (approximately 13 mg/L at room temperature), less soluble in methanol, and virtually insoluble in ethanol.
Lisinopril
Captopril
Azilsartan
Telmisartan
Losartan
Irbesartan
Valsartan
Nebivolol