Comparative Pharmacology
Head-to-head clinical analysis: CAPOZIDE 25 15 versus QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CAPOZIDE 25 15 versus QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE.
CAPOZIDE 25/15 vs QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Combination of captopril (ACE inhibitor) and hydrochlorothiazide (thiazide diuretic). Captopril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, decreasing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in the distal convoluted tubule, increasing diuresis and reducing plasma volume.
Quinapril is an ACE inhibitor that inhibits the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion; hydrochlorothiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal convoluted tubule, increasing excretion of sodium and water.
Oral: 1 tablet (captopril 25 mg / hydrochlorothiazide 15 mg) once daily initially; titrate to a maximum of 2 tablets twice daily based on blood pressure response.
Initial: 10/12.5 mg (quinapril/hydrochlorothiazide) orally once daily. Titrate based on response to a maximum of 40/25 mg once daily.
None Documented
None Documented
Captopril: ~2 hours (terminal) in normal renal function; increases to 20-60 hours in severe renal impairment. Hydrochlorothiazide: 6-15 hours (terminal), prolonged in renal impairment.
Quinaprilat terminal half-life ~25 hours (effective half-life ~12 hours); hydrochlorothiazide ~6-15 hours (increased in renal impairment).
Captopril: 95% renally excreted, primarily as unchanged drug and metabolites (disulfide dimers). Hydrochlorothiazide: at least 95% renally excreted as unchanged drug.
Renal excretion of quinaprilat (active metabolite) ~50-60% unchanged; hydrochlorothiazide ~70% unchanged. Biliary/fecal elimination accounts for <10% for both components.
Category C
Category D/X
ACE Inhibitor and Diuretic Combination
ACE Inhibitor