No evidence of significant CYP-dependent metabolism. Occasional observations of tolerance. Two references stating (probable) non-porphyrinogenicity. Risk for gastrointestinal adverse event in the form of nausea motivates vigilance against insufficient intake of food, especially of carbohydrate.

Hydrolyzed to cilazaprilate, a long term ACE-inhibitor. Excreted (90%) in unchanged form by the kidneys.

A common side effect that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack is nausea. Other common side effects are headache and fatigue.

Andersson, patient report (n=2): tolerated.