Comparative Pharmacology
Head-to-head clinical analysis: AVALIDE versus TEVETEN HCT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AVALIDE versus TEVETEN HCT.
AVALIDE vs TEVETEN HCT
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.
TEVETEN HCT combines eprosartan mesylate, an angiotensin II receptor antagonist, and hydrochlorothiazide, a thiazide diuretic. Eprosartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively antagonizing the AT1 receptor. Hydrochlorothiazide inhibits the sodium-chloride symporter in the distal convoluted tubule, increasing excretion of sodium, chloride, and water, thereby reducing plasma volume.
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.
One tablet orally once daily, containing eprosartan 600 mg and hydrochlorothiazide 12.5 mg or 25 mg, with or without food. Maximum dose: eprosartan 600 mg/hydrochlorothiazide 25 mg per day.
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.
Eprosartan: 5-9 hours; Hydrochlorothiazide: 6-15 hours; 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%.
Eprosartan: renal (70% unchanged, 10% as metabolite), biliary/fecal (20%); Hydrochlorothiazide: renal (≥95% unchanged).
Category C
Category C
ARB and Thiazide Diuretic Combination
ARB + Thiazide Diuretic Combination