Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
AZOR vs ALDORIL D30
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Amlodipine is a dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cells, causing vasodilation and reduced peripheral vascular resistance. Olmesartan is an angiotensin II receptor blocker (ARB) that selectively blocks AT1 receptors, inhibiting vasoconstriction and aldosterone secretion.
Aldoril D30 is a combination of methyldopa, a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow, and hydrochlorothiazide, a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, decreasing plasma volume and peripheral resistance.
Treatment of hypertension, alone or with other antihypertensive agents
Hypertension
AZOR is a combination of amlodipine and olmesartan. Typical adult dose: one tablet orally once daily. Available strengths: amlodipine/olmesartan 5mg/20mg, 5mg/40mg, 10mg/20mg, 10mg/40mg. Dose can be titrated based on blood pressure response.
Oral: 1 tablet (hydrochlorothiazide 30 mg / methyldopa 500 mg) twice daily; maximum dose: 2 tablets twice daily.
Amlodipine: 30-50 h (terminal); supports once-daily dosing. Olmesartan: 10-15 h (terminal); once-daily dosing effective
Terminal elimination half-life of hydrochlorothiazide is 6-15 hours; methyldopa half-life is 1.8 hours (normal renal function). In renal impairment, half-life of both components is prolonged.
Amlodipine is extensively metabolized in the liver via CYP3A4 to inactive metabolites. Olmesartan is metabolized by the liver to a minor extent; it undergoes glucuronidation and some oxidation by CYP2C9.
Methyldopa is metabolized by conjugation (catechol-O-methyltransferase) and hepatic sulfation; hydrochlorothiazide is not extensively metabolized and is excreted unchanged by the kidney.
Renal: 90% (amlodipine: 60% as metabolites, 10% as parent; olmesartan: 35-50% as parent via urine, rest in feces via bile). Fecal: 10%
Renal: approximately 50% as parent drug and metabolites; biliary/fecal: minimal, less than 5%.
Amlodipine: ~93% bound to plasma proteins. Olmesartan: >99% bound to albumin
Methyldopa: <10% bound to plasma proteins; hydrochlorothiazide: 40-68% bound to albumin.
Amlodipine: 21 L/kg (large, extensive tissue distribution). Olmesartan: 17-30 L (approximate, Vd not typically reported per kg); distribution into tissues
Methyldopa: Vd 0.2-0.3 L/kg (distributes into tissues, crosses placenta); hydrochlorothiazide: Vd 0.75-1.5 L/kg (extensively distributed, does not cross blood-brain barrier significantly).
Oral: amlodipine 64-90% (high, first-pass ~10%); olmesartan 26% (oral, complete absorption reduced by first-pass ester hydrolysis)
Oral bioavailability of methyldopa is approximately 25% (variable, influenced by gut metabolism); hydrochlorothiazide bioavailability is 65-75%.
No dose adjustment is required for mild to moderate renal impairment (Cr Cl ≥30 m L/min). For severe renal impairment (Cr Cl <30 m L/min), use with caution; maximum dose of olmesartan is 20 mg once daily. Monitor serum potassium and creatinine.
GFR 30-60 m L/min: reduce dose by 50%; GFR <30 m L/min: not recommended.
No dose adjustment for mild hepatic impairment (Child-Pugh A). For moderate to severe hepatic impairment (Child-Pugh B or C), amlodipine half-life is prolonged; initiate with amlodipine 2.5 mg and olmesartan 10 mg, and titrate slowly. Use caution; contraindicated in severe hepatic impairment with cholestasis? Not specifically contraindicated but not recommended.
Child-Pugh Class B or C: contraindicated; use not recommended.
Safety and efficacy in pediatric patients <18 years have not been established. Not recommended for use in children.
Not recommended for use in pediatric patients due to lack of safety and efficacy data.
In elderly patients (≥65 years), start with the lowest available dose (amlodipine/olmesartan 5/20 mg daily) and titrate slowly due to increased sensitivity and potential for hypotension. Monitor renal function and electrolytes closely in geriatric patients.
Start with lowest dose; monitor for hypotension, electrolyte imbalance, and CNS effects; consider reduced initial dose.
None
None
Fetal toxicity (detectable in second and third trimesters): drugs acting on the renin-angiotensin system can cause oligohydramnios, fetal renal dysfunction, and death,Avoid concomitant use with aliskiren in patients with diabetes,Hypotension in volume/depleted patients,Increased angina or myocardial infarction with calcium channel blockers, particularly with severe obstructive coronary artery disease,Peripheral edema is dose-dependent and more common with amlodipine,Hepatic impairment: lower starting dose,Renal artery stenosis,Electrolyte imbalances
May cause hemolytic anemia, liver disorders, positive Coombs test, sedation, depression, and hypersensitivity reactions. Hydrochlorothiazide may cause electrolyte imbalance, hyperuricemia, photosensitivity, and exacerbation of systemic lupus erythematosus. Use with caution in renal impairment, hepatic disease, and in patients with a history of drug-induced hemolytic anemia.
Hypersensitivity to any component,Do not use with aliskiren in patients with diabetes
Active hepatic disease, history of previous methyldopa therapy-associated liver disorders; anuria; hypersensitivity to methyldopa, hydrochlorothiazide, or sulfonamide-derived drugs.
Avoid grapefruit and grapefruit juice due to CYP3A4 inhibition increasing amlodipine levels. No other significant food interactions.
Food may decrease absorption of methyldopa. Avoid excessive intake of high-potassium foods (e.g., bananas, oranges) unless directed. Hydrochlorothiazide may cause potassium depletion; maintain adequate dietary potassium. Avoid natural licorice as it can worsen hypokalemia.
Pregnancy Category D. First trimester: Potential for fetal toxicity (oligohydramnios, fetal/neonatal renal dysfunction, skull hypoplasia) due to olmesartan action on renin-angiotensin system; avoid use. Second trimester: Continued risk of fetal renal impairment and oligohydramnios. Third trimester: High risk of fetal/neonatal renal failure, hypotension, hyperkalemia, and skull ossification defects; contraindicated.
First trimester: Limited data; no clear evidence of major malformations but methyldopa crosses placenta. Second and third trimesters: Associated with reduced placental perfusion; possible fetal bradycardia and neonatal hypotension. Hydrochlorothiazide may cause fetal/neonatal jaundice, thrombocytopenia, and electrolyte disturbances.
No human data on olmesartan or amlodipine excretion in breast milk. Amlodipine transfers into human milk with M/P ratio approximately 0.5-1.5; risk to infant unknown. Due to potential for adverse effects (hypotension, renal impairment), use is not recommended. Alternative antihypertensives with more safety data should be considered.
Methyldopa is excreted in breast milk in low concentrations; M/P ratio approximately 0.2. Hydrochlorothiazide is excreted in minimal amounts; may suppress lactation. Consider risks versus benefits.
Not applicable; use is contraindicated in pregnancy. No dose adjustment can mitigate fetal risk; alternative agents (e.g., labetalol, nifedipine) are preferred. If inadvertently used, discontinue as soon as pregnancy is detected.
Methyldopa: Pregnancy-induced plasma volume expansion may require dose titration; monitor blood pressure and adjust accordingly. Hydrochlorothiazide: Often avoided in pregnancy due to volume depletion risks; if used, monitor electrolytes and renal function, no pharmacokinetic data necessitate routine dose adjustment.
AZOR is a fixed-dose combination of amlodipine (calcium channel blocker) and olmesartan (angiotensin II receptor blocker). Monitor serum potassium and creatinine, especially in renal impairment or concomitant ACE inhibitor use. Avoid in pregnancy (use effective contraception). May cause dizziness or peripheral edema, often dose-related.
ALDORIL D30 combines methyldopa (central alpha-2 agonist) and hydrochlorothiazide (thiazide diuretic). Monitor for orthostatic hypotension, especially at initiation. Taper not needed for methyldopa but discontinue if fever or liver dysfunction occurs. Interferes with urinary catecholamine measurements (false elevation). Hydrochlorothiazide may cause hyponatremia, hypokalemia, and hyperglycemia; check electrolytes and glucose periodically.
Take exactly as prescribed, usually once daily, with or without food.,Avoid grapefruit or grapefruit juice as it can increase amlodipine levels.,Notify your doctor if you become pregnant or plan to become pregnant.,Do not stop taking suddenly; consult your doctor before discontinuing.,Report lightheadedness, fainting, or significant swelling in your ankles or feet.,Use caution when driving or operating machinery until you know how this medication affects you.
Take exactly as prescribed, preferably with food to reduce stomach upset.,Rise slowly from sitting or lying down to prevent dizziness.,This drug may make you drowsy; avoid driving or operating machinery until you know how it affects you.,Report fever, unexplained fatigue, jaundice, or dark urine immediately.,Weigh yourself daily and report rapid weight gain or swelling.,Limit alcohol intake as it can increase side effects.,Do not use salt substitutes containing potassium without consulting your doctor.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about AZOR vs ALDORIL D30, answered by our medical review team.
AZOR is a Antihypertensive Combination that works by Amlodipine is a dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cells, causing vasodilation and reduced peripheral vascular resistance. Olmesartan is an angiotensin II receptor blocker (ARB) that selectively blocks AT1 receptors, inhibiting vasoconstriction and aldosterone secretion.. ALDORIL D30 is a Antihypertensive Combination that works by Aldoril D30 is a combination of methyldopa, a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow, and hydrochlorothiazide, a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, decreasing plasma volume and peripheral resistance.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between AZOR and ALDORIL D30 depend on the specific clinical indication. These are both Antihypertensive Combination agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of AZOR is: AZOR is a combination of amlodipine and olmesartan. Typical adult dose: one tablet orally once daily. Available strengths: amlodipine/olmesartan 5mg/20mg, 5mg/40mg, 10mg/20mg, 10mg/40mg. Dose can be titrated based on blood pressure response.. The standard adult dose of ALDORIL D30 is: Oral: 1 tablet (hydrochlorothiazide 30 mg / methyldopa 500 mg) twice daily; maximum dose: 2 tablets twice daily.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between AZOR and ALDORIL D30 in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. AZOR is classified as Category C. Pregnancy Category D. First trimester: Potential for fetal toxicity (oligohydramnios, fetal/neonatal renal dysfunction, skull hypoplasia) due to olmesartan action on renin-angioten. ALDORIL D30 is classified as Category C. First trimester: Limited data; no clear evidence of major malformations but methyldopa crosses placenta. Second and third trimesters: Associated with reduced placental perfusion; p. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.