Comparative Pharmacology
Head-to-head clinical analysis: LISINOPRIL versus ZESTORETIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LISINOPRIL versus ZESTORETIC.
LISINOPRIL vs ZESTORETIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. It inhibits ACE, which converts angiotensin I to angiotensin II, a potent vasoconstrictor. This results in decreased plasma angiotensin II, leading to decreased vasoconstriction, reduced aldosterone secretion, decreased sodium and water retention, and lower blood pressure.
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: 5-10 mg orally once daily. Maintenance: 10-40 mg orally once daily. Max: 80 mg/day.
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
moderateLisinopril + Etacrynic acid
"The risk or severity of adverse effects can be increased when Lisinopril is combined with Etacrynic acid."
Clinical Note
moderateLisinopril + Bumetanide
"The risk or severity of adverse effects can be increased when Lisinopril is combined with Bumetanide."
Clinical Note
moderateLisinopril + Benzydamine
"The risk or severity of adverse effects can be increased when Lisinopril is combined with Benzydamine."
Clinical Note
moderateLisinopril + Estrone sulfate
Terminal half-life approximately 12 hours (range 11–13 hours); clinical context: once-daily dosing for hypertension and heart failure; accumulation occurs with renal impairment.
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).
Renal: 100% unchanged via glomerular filtration and tubular secretion; negligible biliary/fecal elimination.
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 serum concentration of Estrone sulfate can be decreased when it is combined with Lisinopril."