Comparative Pharmacology
Head-to-head clinical analysis: ACCURETIC versus MAXZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACCURETIC versus MAXZIDE.
ACCURETIC vs MAXZIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ACCURETIC is a combination of quinapril, an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide, a thiazide diuretic. Quinapril inhibits ACE, preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in the distal convoluted tubule, increasing diuresis and lowering blood pressure.
Maxzide is a combination of triamterene, a potassium-sparing diuretic that inhibits sodium reabsorption in the distal renal tubule, and hydrochlorothiazide, a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule. The combination reduces electrolyte disturbances.
One tablet orally once daily. Initial dose is 20 mg quinapril/12.5 mg hydrochlorothiazide, titrated to maximum 20 mg quinapril/25 mg hydrochlorothiazide.
Hydrochlorothiazide 25 mg / triamterene 37.5 mg orally once daily; may increase to twice daily if needed. Max dose: hydrochlorothiazide 50 mg / triamterene 75 mg daily.
None Documented
None Documented
Quinapril: 0.8 hours; Quinaprilat (active): 2 hours in young healthy adults, prolonged to 3-4 hours in elderly or renal impairment.
Triamterene: terminal half-life is approximately 4-6 hours in healthy individuals, but may be prolonged in renal impairment. Hydrochlorothiazide: terminal half-life is approximately 6-15 hours, and it accumulates in renal dysfunction. The combination product's effective half-life is influenced by both components.
Renal: approximately 90% (60% unchanged, 30% as metabolites). Fecal/biliary: <10%.
Renal: triamterene and hydrochlorothiazide are primarily excreted by the kidneys. Triamterene is extensively metabolized; about 20-30% of the dose is excreted unchanged in urine, with additional metabolites. Hydrochlorothiazide is excreted unchanged in urine (at least 61% of an oral dose within 24 hours).
Category C
Category C
ACE Inhibitor/Diuretic Combination
Diuretic Combination