Presystemic metabolism. To a large part not metabolised. No data pointing to CYP-interaction. Two references stating (probable) non-porphyrinogenicity.

Prodrug, hydrolyzed to trandoprilate, ACE-inhibitor. Low bioavailability (4-14%) due to incomplete absorption and presystemic metabolism. 36-95% of the absorbed dose is excreted in unchanged form by the kidneys.

Less common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are nausea, diarrhoea and obstipation.

Uneventful use reported in 3 patients with acute porphyria.