Comparative Pharmacology
Head-to-head clinical analysis: ATENOLOL AND CHLORTHALIDONE versus ZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ATENOLOL AND CHLORTHALIDONE versus ZIDE.
ATENOLOL AND CHLORTHALIDONE vs ZIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Atenolol is a cardioselective beta-1 adrenergic receptor antagonist that reduces heart rate, myocardial contractility, and blood pressure. Chlorthalidone is a thiazide-like diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, reducing plasma volume and peripheral resistance.
Hydrochlorothiazide is a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule of the nephron, reducing reabsorption of sodium and chloride and increasing excretion of water, sodium, chloride, potassium, and bicarbonate.
1 tablet (atenolol 50 mg/chlorthalidone 25 mg) orally once daily. May be increased to 2 tablets once daily.
10 mg orally once daily.
None Documented
None Documented
Clinical Note
moderateBendroflumethiazide + Digoxin
"The risk or severity of adverse effects can be increased when Bendroflumethiazide is combined with Digoxin."
Clinical Note
moderateMethyclothiazide + Digoxin
"The risk or severity of adverse effects can be increased when Methyclothiazide is combined with Digoxin."
Clinical Note
moderateHydrochlorothiazide + Digoxin
"The risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Digoxin."
Clinical Note
moderateAtenolol: 6-7 hours (prolonged to 14-27 hours in severe renal impairment); Chlorthalidone: 40-60 hours (allows once-daily dosing).
6-8 hours in normal renal function; prolonged to 20-40 hours in severe renal impairment (eGFR <30 mL/min).
Atenolol: ~50% eliminated unchanged in urine; Chlorthalidone: ~50-70% eliminated unchanged in urine, remainder as metabolites via renal and biliary routes (<10% fecal).
Renal: 70% unchanged; Biliary/fecal: 30% (as metabolites and parent compound).
Category C
Category C
Thiazide Diuretic
Thiazide Diuretic
Hydroflumethiazide + Digoxin
"The risk or severity of adverse effects can be increased when Hydroflumethiazide is combined with Digoxin."