Comparative Pharmacology
Head-to-head clinical analysis: CAPOZIDE 25 25 versus RAMIPRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CAPOZIDE 25 25 versus RAMIPRIL.
CAPOZIDE 25/25 vs RAMIPRIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Captopril: angiotensin-converting enzyme (ACE) inhibitor that blocks conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide: thiazide diuretic that inhibits sodium-chloride symporter in distal convoluted tubule, increasing sodium, chloride, and water excretion.
Ramipril is a prodrug that is hydrolyzed in the liver to its active metabolite ramiprilat, which inhibits angiotensin-converting enzyme (ACE), thereby decreasing angiotensin II production, reducing vasoconstriction, aldosterone secretion, and sodium retention.
1 tablet (captopril 25 mg / hydrochlorothiazide 25 mg) orally once daily initially; may titrate up to 2 tablets per day as needed.
Initial: 2.5 mg orally once daily; Maintenance: 2.5-20 mg/day in 1-2 divided doses; Maximum: 20 mg/day.
None Documented
None Documented
Clinical Note
moderateRamipril + Torasemide
"The risk or severity of adverse effects can be increased when Ramipril is combined with Torasemide."
Clinical Note
moderateRamipril + Etacrynic acid
"The risk or severity of adverse effects can be increased when Ramipril is combined with Etacrynic acid."
Clinical Note
moderateRamipril + Furosemide
"The risk or severity of adverse effects can be increased when Ramipril is combined with Furosemide."
Clinical Note
moderateRamipril + Bumetanide
Captopril: ~2 hours (increased in renal impairment). Hydrochlorothiazide: 6-15 hours (prolonged in renal impairment). Clinical context: trough effect may diminish with once-daily dosing; twice-daily dosing often used.
Terminal half-life of ramiprilat is 13–17 hours (prolonged to 50 hours in renal impairment). Accumulation half-life is 110 hours after multiple doses.
Captopril: renal 95% (40-50% unchanged), biliary/fecal <5%. Hydrochlorothiazide: renal >95% (unchanged), biliary/fecal minimal.
Primarily renal (60% as unchanged drug and metabolites) and fecal (40% via biliary elimination).
Category C
Category D/X
ACE Inhibitor and Diuretic Combination
ACE Inhibitor
"The risk or severity of adverse effects can be increased when Ramipril is combined with Bumetanide."