Comparative Pharmacology
Head-to-head clinical analysis: ACCURETIC versus ZESTRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACCURETIC versus ZESTRIL.
ACCURETIC vs ZESTRIL
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.
Lisinopril competes with angiotensin I for binding to angiotensin-converting enzyme (ACE), inhibiting its activity, thereby preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to decreased blood pressure, reduced aldosterone secretion, and decreased sodium and water retention.
One tablet orally once daily. Initial dose is 20 mg quinapril/12.5 mg hydrochlorothiazide, titrated to maximum 20 mg quinapril/25 mg hydrochlorothiazide.
10 mg orally once daily initially; titrate to 20-40 mg orally once daily. Maximum 80 mg/day.
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.
Terminal elimination half-life is about 12 hours for lisinopril; in heart failure, half-life may be prolonged. Steady-state achieved in 2-3 days.
Renal: approximately 90% (60% unchanged, 30% as metabolites). Fecal/biliary: <10%.
Primarily renal (approximately 70% unchanged), with the remainder excreted as inactive metabolites via feces and urine.
Category C
Category C
ACE Inhibitor/Diuretic Combination
ACE Inhibitor