Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
DUTOPROL vs ALDORIL D30
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Combination of metoprolol tartrate (beta-1-selective adrenergic receptor blocker) and hydrochlorothiazide (thiazide diuretic inhibiting Na+/Cl- cotransporter in distal convoluted tubule).
Aldoril D30 is a combination of methyldopa, a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow, and hydrochlorothiazide, a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, decreasing plasma volume and peripheral resistance.
Hypertension,Off-label: heart failure (metoprolol component), edema
Hypertension
1 tablet (containing 12.5 mg hydrochlorothiazide and 50 mg losartan) orally once daily; may increase to 1 tablet (12.5 mg/100 mg) once daily if inadequate response.
Oral: 1 tablet (hydrochlorothiazide 30 mg / methyldopa 500 mg) twice daily; maximum dose: 2 tablets twice daily.
Bisoprolol: 10-12 hours, allowing once-daily dosing; Hydrochlorothiazide: 6-15 hours, prolonged in renal impairment.
Terminal elimination half-life of hydrochlorothiazide is 6-15 hours; methyldopa half-life is 1.8 hours (normal renal function). In renal impairment, half-life of both components is prolonged.
Metoprolol: primarily CYP2D6; Hydrochlorothiazide: not metabolized, excreted unchanged in urine.
Methyldopa is metabolized by conjugation (catechol-O-methyltransferase) and hepatic sulfation; hydrochlorothiazide is not extensively metabolized and is excreted unchanged by the kidney.
Renal: 40-50% as unchanged drug and metabolites (hydrochlorothiazide and bisoprolol); Fecal/Biliary: <15%.
Renal: approximately 50% as parent drug and metabolites; biliary/fecal: minimal, less than 5%.
Bisoprolol: 30% bound to albumin; Hydrochlorothiazide: 40-68% bound to plasma proteins (predominantly albumin).
Methyldopa: <10% bound to plasma proteins; hydrochlorothiazide: 40-68% bound to albumin.
Bisoprolol: 3.5 L/kg, reflecting extensive tissue distribution; Hydrochlorothiazide: 0.83 L/kg, indicating distribution in extracellular fluid.
Methyldopa: Vd 0.2-0.3 L/kg (distributes into tissues, crosses placenta); hydrochlorothiazide: Vd 0.75-1.5 L/kg (extensively distributed, does not cross blood-brain barrier significantly).
Oral: Bisoprolol 90% (high, first-pass negligible); Hydrochlorothiazide 65-75%.
Oral bioavailability of methyldopa is approximately 25% (variable, influenced by gut metabolism); hydrochlorothiazide bioavailability is 65-75%.
Contraindicated if GFR <30 m L/min/1.73 m². For GFR 30-60 m L/min/1.73 m²: no dose adjustment required, but monitor potassium and creatinine. For GFR <30 m L/min/1.73 m²: do not use.
GFR 30-60 m L/min: reduce dose by 50%; GFR <30 m L/min: not recommended.
Child-Pugh Class A or B: no dose adjustment; use with caution. Child-Pugh Class C: not recommended.
Child-Pugh Class B or C: contraindicated; use not recommended.
Not approved for use in pediatric patients (safety and efficacy not established).
Not recommended for use in pediatric patients due to lack of safety and efficacy data.
Start at lowest possible dose; monitor renal function and electrolytes. No specific dose adjustment required if renal function normal, but elderly more susceptible to hypotension and electrolyte imbalance.
Start with lowest dose; monitor for hypotension, electrolyte imbalance, and CNS effects; consider reduced initial dose.
None.
None
Exacerbation of ischemic heart disease upon abrupt withdrawal of beta-blocker.,Bronchospasm in patients with bronchospastic disease.,May mask signs of hyperthyroidism or hypoglycemia.,Electrolyte disturbances (hypokalemia, hyponatremia) due to thiazide.,May increase serum uric acid and precipitate gout.,May cause photosensitivity reaction.
May cause hemolytic anemia, liver disorders, positive Coombs test, sedation, depression, and hypersensitivity reactions. Hydrochlorothiazide may cause electrolyte imbalance, hyperuricemia, photosensitivity, and exacerbation of systemic lupus erythematosus. Use with caution in renal impairment, hepatic disease, and in patients with a history of drug-induced hemolytic anemia.
Sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure.,Bronchial asthma or significant COPD.,Anuria or hypersensitivity to sulfonamide-derived drugs (thiazides).
Active hepatic disease, history of previous methyldopa therapy-associated liver disorders; anuria; hypersensitivity to methyldopa, hydrochlorothiazide, or sulfonamide-derived drugs.
DUTOPROL should be taken 30 minutes after the same meal each day to reduce variability in absorption. Grapefruit juice inhibits CYP3A4 and can increase dutasteride levels; avoid concomitant consumption. High-fat meals may alter absorption, but consistent timing with a meal minimizes fluctuations. No other specific food interactions are known, but maintain a balanced diet and avoid excessive alcohol, which can worsen dizziness or hypotension.
Food may decrease absorption of methyldopa. Avoid excessive intake of high-potassium foods (e.g., bananas, oranges) unless directed. Hydrochlorothiazide may cause potassium depletion; maintain adequate dietary potassium. Avoid natural licorice as it can worsen hypokalemia.
Category D: First trimester exposure associated with fetal bradycardia, intrauterine growth restriction, and oligohydramnios; second and third trimester use may cause fetal hypotension, hypoglycemia, and decreased placental perfusion.
First trimester: Limited data; no clear evidence of major malformations but methyldopa crosses placenta. Second and third trimesters: Associated with reduced placental perfusion; possible fetal bradycardia and neonatal hypotension. Hydrochlorothiazide may cause fetal/neonatal jaundice, thrombocytopenia, and electrolyte disturbances.
Excreted in breast milk; M/P ratio not established. Use with caution, monitor infant for bradycardia and hypotension.
Methyldopa is excreted in breast milk in low concentrations; M/P ratio approximately 0.2. Hydrochlorothiazide is excreted in minimal amounts; may suppress lactation. Consider risks versus benefits.
Dose may need reduction due to increased plasma volume and clearance; individualize based on maternal blood pressure and fetal status.
Methyldopa: Pregnancy-induced plasma volume expansion may require dose titration; monitor blood pressure and adjust accordingly. Hydrochlorothiazide: Often avoided in pregnancy due to volume depletion risks; if used, monitor electrolytes and renal function, no pharmacokinetic data necessitate routine dose adjustment.
DUTOPROL is a fixed-dose combination of dutasteride (0.5 mg) and tamsulosin (0.4 mg) used for benign prostatic hyperplasia (BPH). Due to dutasteride's long half-life (~5 weeks), clinical effect on prostate volume may take 3–6 months. Tamsulosin, an alpha-1 blocker, can cause orthostatic hypotension, especially when initiated; titrate cautiously in elderly or those on antihypertensives. Avoid concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole) as they increase dutasteride exposure. Measure PSA before starting and periodically thereafter; dutasteride halves PSA levels after 6 months, so adjust interpretation. Do not use in women or children.
ALDORIL D30 combines methyldopa (central alpha-2 agonist) and hydrochlorothiazide (thiazide diuretic). Monitor for orthostatic hypotension, especially at initiation. Taper not needed for methyldopa but discontinue if fever or liver dysfunction occurs. Interferes with urinary catecholamine measurements (false elevation). Hydrochlorothiazide may cause hyponatremia, hypokalemia, and hyperglycemia; check electrolytes and glucose periodically.
Take this medication exactly as prescribed, usually once daily, 30 minutes after the same meal each day to maintain consistent absorption.,Do not crush, chew, or open the capsules; swallow them whole to avoid irritation.,This drug can cause dizziness, lightheadedness, or fainting, especially when first starting or if you take blood pressure medications. Get up slowly from sitting or lying down.,Avoid grapefruit juice and grapefruit products as they may affect how the drug works.,Inform your doctor if you experience any of the following: severe dizziness, difficulty urinating, chest pain, or signs of an allergic reaction (rash, itching, swelling).,Do not donate blood while taking this medication and for at least 6 months after stopping, as the drug can be present in blood and cause harm to a pregnant woman or her baby.,If you are having cataract surgery, tell your surgeon you are taking this drug, as it may increase the risk of intraoperative floppy iris syndrome (IFIS).,This medication may cause a decrease in sexual desire, difficulty with erections, or reduced semen volume. These side effects are generally reversible after stopping treatment.,Women who are pregnant or could become pregnant should avoid handling crushed or broken capsules due to risk of harm to the unborn baby.,Regular follow-ups with your healthcare provider for PSA testing and symptom monitoring are important to assess treatment response and adjust dose if needed.
Take exactly as prescribed, preferably with food to reduce stomach upset.,Rise slowly from sitting or lying down to prevent dizziness.,This drug may make you drowsy; avoid driving or operating machinery until you know how it affects you.,Report fever, unexplained fatigue, jaundice, or dark urine immediately.,Weigh yourself daily and report rapid weight gain or swelling.,Limit alcohol intake as it can increase side effects.,Do not use salt substitutes containing potassium without consulting your doctor.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about DUTOPROL vs ALDORIL D30, answered by our medical review team.
DUTOPROL is a Antihypertensive Combination that works by Combination of metoprolol tartrate (beta-1-selective adrenergic receptor blocker) and hydrochlorothiazide (thiazide diuretic inhibiting Na+/Cl- cotransporter in distal convoluted tubule).. ALDORIL D30 is a Antihypertensive Combination that works by Aldoril D30 is a combination of methyldopa, a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow, and hydrochlorothiazide, a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, decreasing plasma volume and peripheral resistance.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between DUTOPROL and ALDORIL D30 depend on the specific clinical indication. These are both Antihypertensive Combination agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of DUTOPROL is: 1 tablet (containing 12.5 mg hydrochlorothiazide and 50 mg losartan) orally once daily; may increase to 1 tablet (12.5 mg/100 mg) once daily if inadequate response.. The standard adult dose of ALDORIL D30 is: Oral: 1 tablet (hydrochlorothiazide 30 mg / methyldopa 500 mg) twice daily; maximum dose: 2 tablets twice daily.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between DUTOPROL and ALDORIL D30 in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. DUTOPROL is classified as Category C. Category D: First trimester exposure associated with fetal bradycardia, intrauterine growth restriction, and oligohydramnios; second and third trimester use may cause fetal hypoten. ALDORIL D30 is classified as Category C. First trimester: Limited data; no clear evidence of major malformations but methyldopa crosses placenta. Second and third trimesters: Associated with reduced placental perfusion; p. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.