Comparative Pharmacology
Head-to-head clinical analysis: ALTACE versus QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALTACE versus QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE.
ALTACE vs QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Angiotensin-converting enzyme inhibitor; inhibits ACE, preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion.
Quinapril is an ACE inhibitor that inhibits the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion; hydrochlorothiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal convoluted tubule, increasing excretion of sodium and water.
2.5-5 mg orally once daily initially, titrated to 10-20 mg once daily; maximum 20 mg/day
Initial: 10/12.5 mg (quinapril/hydrochlorothiazide) orally once daily. Titrate based on response to a maximum of 40/25 mg once daily.
None Documented
None Documented
Ramiprilat: 13–17 hours (prolonged in renal impairment, up to 50 hours in severe renal insufficiency; multiple doses: 45–60 hours effective half-life due to tissue binding)
Quinaprilat terminal half-life ~25 hours (effective half-life ~12 hours); hydrochlorothiazide ~6-15 hours (increased in renal impairment).
Renal: 60% (30% as ramiprilat, 30% as metabolites); Fecal: 40% (unabsorbed drug and biliary metabolites)
Renal excretion of quinaprilat (active metabolite) ~50-60% unchanged; hydrochlorothiazide ~70% unchanged. Biliary/fecal elimination accounts for <10% for both components.
Category C
Category D/X
ACE Inhibitor
ACE Inhibitor