Comparative Pharmacology
Head-to-head clinical analysis: BENICAR HCT versus CHLORTHALIDONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BENICAR HCT versus CHLORTHALIDONE.
BENICAR HCT vs CHLORTHALIDONE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Combination of an angiotensin II receptor blocker (ARB) and a thiazide diuretic. Olmesartan 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.
Thiazide-like diuretic; inhibits sodium-chloride cotransporter in distal convoluted tubule, increasing excretion of sodium, chloride, and water. Also lowers peripheral vascular resistance.
One tablet orally once daily. Available strengths: 40 mg olmesartan / 12.5 mg hydrochlorothiazide, 40 mg olmesartan / 25 mg hydrochlorothiazide. Dose may be titrated after 2-4 weeks based on response.
Oral: 25-100 mg once daily; initial dose 25 mg once daily; may increase to 50-100 mg once daily based on response.
None Documented
None Documented
Clinical Note
moderateChlorthalidone + Digoxin
"The risk or severity of adverse effects can be increased when Chlorthalidone is combined with Digoxin."
Clinical Note
moderateChlorthalidone + Digitoxin
"The risk or severity of adverse effects can be increased when Chlorthalidone is combined with Digitoxin."
Clinical Note
moderateChlorthalidone + Deslanoside
"The risk or severity of adverse effects can be increased when Chlorthalidone is combined with Deslanoside."
Clinical Note
moderateOlmesartan: Terminal elimination half-life is 10-15 hours, supporting once-daily dosing. Hydrochlorothiazide: Terminal half-life is 5.6-14.8 hours (mean ~10 hours), prolonged in renal impairment.
Terminal half-life 40-60 hours (range 35-70h); prolonged in renal impairment
Olmesartan: Approximately 50-65% of absorbed dose excreted in urine (10-20% as unchanged drug, remainder as metabolites), 35-50% in feces via biliary excretion. Hydrochlorothiazide: ≥95% excreted renally as unchanged drug.
Renal: 50-65% unchanged; biliary/fecal: minimal (<5%)
Category C
Category C
ARB + Thiazide Diuretic
Thiazide Diuretic
Chlorthalidone + Acetyldigitoxin
"The risk or severity of adverse effects can be increased when Chlorthalidone is combined with Acetyldigitoxin."