Comparative Pharmacology
Head-to-head clinical analysis: CAPTOPRIL versus ZESTORETIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CAPTOPRIL versus ZESTORETIC.
CAPTOPRIL vs ZESTORETIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Competitive inhibitor of angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion.
Combination of lisinopril (ACE inhibitor) and hydrochlorothiazide (thiazide diuretic). Lisinopril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, decreasing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in distal convoluted tubule, increasing diuresis and reducing plasma volume.
Initial: 25 mg PO 2-3 times daily; target dose: 50 mg PO 2-3 times daily; maximum: 450 mg/day. For heart failure: start 6.25-12.5 mg PO 3 times daily, titrate to 25-50 mg PO 3 times daily.
Zestoretic (lisinopril/hydrochlorothiazide) is available in fixed-dose combinations. Typical adult dose: 10 mg/12.5 mg, 20 mg/12.5 mg, or 20 mg/25 mg orally once daily. Maximum dose: lisinopril 80 mg/day, hydrochlorothiazide 50 mg/day.
None Documented
None Documented
Clinical Note
moderateCaptopril + Benzydamine
"The risk or severity of adverse effects can be increased when Captopril is combined with Benzydamine."
Clinical Note
moderateCaptopril + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Captopril."
Clinical Note
moderateCaptopril + Droxicam
"The risk or severity of adverse effects can be increased when Captopril is combined with Droxicam."
Clinical Note
moderateCaptopril + Loxoprofen
Terminal half-life 1.9 hours, prolonged to 3.5-32 hours in renal impairment; clinical context: requires adjusted dosing in renal failure
Lisinopril: terminal half-life approximately 12 hours (accumulation half-life 13.8 hours in patients with normal renal function). Hydrochlorothiazide: terminal half-life 5.6–14.8 hours (mean 9.6 hours).
Primarily renal (50-60% unchanged), with minor biliary/fecal elimination (<5%)
Lisinopril is excreted unchanged in urine; 100% renal elimination. Hydrochlorothiazide is excreted primarily by the kidney (≥95% as unchanged drug) via tubular secretion.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor + Diuretic
"The risk or severity of adverse effects can be increased when Captopril is combined with Loxoprofen."