Delapril

Delapril is an angiotensin-converting enzyme inhibitor (ACE inhibitor) used primarily in the treatment of hypertension and congestive heart failure. Like other ACE inhibitors, delapril works by causing relaxation of blood vessels and a decrease in blood volume, which leads to lower blood pressure and decreased oxygen demand from the heart.

Mechanism of Action

Delapril inhibits the angiotensin-converting enzyme, which is responsible for the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor that increases blood pressure and stimulates the release of aldosterone from the adrenal glands. By inhibiting the production of angiotensin II, delapril decreases blood pressure and reduces the workload on the heart. Additionally, this medication increases levels of bradykinin, a peptide that promotes vasodilation, further contributing to its antihypertensive effects.

Pharmacokinetics

Delapril is administered orally. It is metabolized in the liver to its active metabolite, delaprilat, which is responsible for most of the drug's ACE inhibition activity. The onset of action for delapril is within one hour of oral administration, with peak effects occurring in about four to six hours. The duration of action typically lasts for 24 hours, allowing for once or twice daily dosing. Delapril and its metabolites are primarily excreted through the kidneys.

Clinical Uses

Delapril is used in the management of:

• Hypertension - to lower blood pressure and reduce the risk of cardiovascular events, such as heart attack and stroke.
• Congestive Heart Failure - to improve symptoms, reduce hospitalization, and increase survival in patients with heart failure.

Side Effects

Common side effects of delapril include:

• Cough
• Dizziness
• Headache
• Fatigue
• Nausea

Serious side effects may include:

• Angioedema
• Hyperkalemia
• Renal impairment

Patients with a history of angioedema related to previous ACE inhibitor therapy should not take delapril. It is also contraindicated in pregnancy due to the risk of birth defects.

Drug Interactions

Delapril can interact with several other medications, including:

• Diuretics - may increase the risk of hypotension.
• Potassium supplements and potassium-sparing diuretics - may increase the risk of hyperkalemia.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) - may reduce the antihypertensive effects of delapril.

Conclusion

Delapril is an effective medication for the management of hypertension and congestive heart failure. Its mechanism of action involves the inhibition of the angiotensin-converting enzyme, leading to vasodilation and decreased blood volume. While generally well-tolerated, it is important for patients to be aware of potential side effects and drug interactions.