Comparative Pharmacology
Head-to-head clinical analysis: HYDROCHLOROTHIAZIDE versus INDERIDE 40 25.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HYDROCHLOROTHIAZIDE versus INDERIDE 40 25.
HYDROCHLOROTHIAZIDE vs INDERIDE-40/25
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Thiazide diuretic that inhibits the sodium-chloride symporter (NCC) in the distal convoluted tubule of the kidney, reducing reabsorption of sodium and chloride, leading to increased excretion of water and electrolytes.
Inderide-40/25 is a combination of propranolol (non-cardioselective beta-blocker) and hydrochlorothiazide (thiazide diuretic). Propranolol reduces heart rate, myocardial contractility, and renin secretion via beta-adrenergic receptor blockade. Hydrochlorothiazide inhibits Na+/Cl- cotransporter in distal convoluted tubule, increasing excretion of Na+, Cl-, and water; also reduces peripheral vascular resistance.
Oral: 25-100 mg daily in 1-2 divided doses. Maximum dose 200 mg/day.
One tablet (40 mg propranolol HCl/25 mg hydrochlorothiazide) orally twice daily; may increase to maximum of 160 mg propranolol/100 mg hydrochlorothiazide per day in divided doses.
None Documented
None Documented
Clinical Note
moderateHydrochlorothiazide + Digoxin
"The risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Digoxin."
Clinical Note
moderateHydrochlorothiazide + Digitoxin
"The risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Digitoxin."
Clinical Note
moderateHydrochlorothiazide + Deslanoside
"The risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Deslanoside."
Clinical Note
moderateTerminal elimination half-life is 5.6–14.8 hours (mean ~9 hours). In patients with renal impairment (CrCl <30 mL/min), half-life is prolonged up to 24–48 hours, necessitating dose adjustment.
Propranolol: 3-6 hours (terminal); clinical context: dosing 2-3 times daily due to short half-life; may accumulate in hepatic impairment. Hydrochlorothiazide: 6-15 hours (terminal); clinical context: longer in renal impairment.
Primarily renal (≥95%) via glomerular filtration and tubular secretion, with approximately 60% of the dose excreted unchanged in urine. Minor biliary/fecal excretion accounts for <5%.
Propranolol: extensively metabolized in liver via CYP2D6 and glucuronidation; <1% excreted unchanged in urine. Hydrochlorothiazide: ~70% excreted unchanged in urine via tubular secretion.
Category A/B
Category C
Thiazide Diuretic
Beta Blocker and Thiazide Diuretic
Hydrochlorothiazide + Acetyldigitoxin
"The risk or severity of adverse effects can be increased when Hydrochlorothiazide is combined with Acetyldigitoxin."