Comparative Pharmacology
Head-to-head clinical analysis: CAPTOPRIL AND HYDROCHLOROTHIAZIDE versus ZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CAPTOPRIL AND HYDROCHLOROTHIAZIDE versus ZIDE.
CAPTOPRIL AND HYDROCHLOROTHIAZIDE vs ZIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Captopril is an angiotensin-converting enzyme (ACE) inhibitor that inhibits the conversion of angiotensin I to angiotensin II, resulting in vasodilation and decreased aldosterone secretion. Hydrochlorothiazide is a thiazide diuretic that inhibits the Na+/Cl- cotransporter in the distal convoluted tubule, increasing excretion of sodium and water.
Hydrochlorothiazide is a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule of the nephron, reducing reabsorption of sodium and chloride and increasing excretion of water, sodium, chloride, potassium, and bicarbonate.
1 tablet (captopril 25 mg / hydrochlorothiazide 15 mg) orally once daily, titrated up to a maximum of 1 tablet (captopril 50 mg / hydrochlorothiazide 25 mg) twice daily.
10 mg orally once daily.
None Documented
None Documented
Clinical Note
moderateBendroflumethiazide + Digoxin
"The risk or severity of adverse effects can be increased when Bendroflumethiazide is combined with Digoxin."
Clinical Note
moderateMethyclothiazide + Digoxin
"The risk or severity of adverse effects can be increased when Methyclothiazide is combined with Digoxin."
Clinical Note
moderateHydrochlorothiazide + Digoxin
"The risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Digoxin."
Clinical Note
moderateCaptopril: ~2 hours (prolonged to 6-8 hours in heart failure or renal impairment). Hydrochlorothiazide: 5.6-14.8 hours (mean ~9.6 hours; prolonged in renal impairment).
6-8 hours in normal renal function; prolonged to 20-40 hours in severe renal impairment (eGFR <30 mL/min).
Captopril: renal (95%), primarily as unchanged drug and disulfide metabolites. Hydrochlorothiazide: renal (≥95%) as unchanged drug via tubular secretion.
Renal: 70% unchanged; Biliary/fecal: 30% (as metabolites and parent compound).
Category A/B
Category C
Thiazide Diuretic
Thiazide Diuretic
Hydroflumethiazide + Digoxin
"The risk or severity of adverse effects can be increased when Hydroflumethiazide is combined with Digoxin."