Spirapril hydrochloride is a new ACE inhibitor introduced in Finland for
the treatment of hypertension. Spirapril is orally active and rapidly absorbed and
converted to the active diacid spiraprilat which produces a reduction in blood pressure
similar to that seen with enalapril and captopril. Spirapril has been reported to be well
tolerated and exhibits an apparently lower incidence of cough compared with other ACE
inhibitors. The elimination of spirapril occurs via both renal and hepatic routes so that
no dosage adjustment is required for patients with renal impairment. In patients with
severe congestive heart failure, spirapril has demonstrated beneficial hemodynamic
effects with a duration of action >24 hours.
