Comparative Pharmacology
Head-to-head clinical analysis: AVALIDE versus OLMESARTAN MEDOXOMIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AVALIDE versus OLMESARTAN MEDOXOMIL.
AVALIDE vs OLMESARTAN MEDOXOMIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Avalide is a combination of an angiotensin II receptor blocker (irbesartan) and a thiazide diuretic (hydrochlorothiazide). Irbesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively antagonizing the AT1 receptor. Hydrochlorothiazide increases sodium and water excretion by inhibiting the Na+/Cl- symporter in the distal convoluted tubule.
Olmesartan medoxomil is a prodrug that is hydrolyzed to olmesartan, a selective angiotensin II receptor type 1 (AT1) antagonist. It blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II, leading to decreased peripheral vascular resistance and reduced blood pressure.
AVALIDE (irbesartan/hydrochlorothiazide) is available as tablets containing 150/12.5 mg, 300/12.5 mg, or 300/25 mg. The typical starting dose is 150/12.5 mg once daily, titrated to 300/12.5 mg once daily as needed. Maximum dose is 300/25 mg once daily.
20 mg orally once daily, titrate as needed to 40 mg once daily; maximum 40 mg daily.
None Documented
None Documented
Irbesartan: 11-15 h (terminal), HCTZ: 6-15 h (terminal). Clinical context: Steady state reached in 3-5 days; allows once-daily dosing.
Terminal elimination half-life: 10-15 hours; reaches steady-state after 3-5 days; clinically allows once-daily dosing.
Renal: HCTZ ~70% unchanged; Irbesartan ~20% unchanged, remainder as metabolites via biliary (60%) and renal (20%). Combined: Renal ~50%, biliary/fecal ~50%.
Renal: 35-50% as unchanged drug; biliary/fecal: 50-65% via bile into feces, primarily as parent drug.
Category C
Category D/X
ARB and Thiazide Diuretic Combination
ARB