Comparative Pharmacology
Head-to-head clinical analysis: LOPRESSOR HCT versus NADOLOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LOPRESSOR HCT versus NADOLOL.
LOPRESSOR HCT vs NADOLOL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
LOPRESSOR HCT is a combination of metoprolol tartrate (a beta-1 selective adrenergic receptor blocker) and hydrochlorothiazide (a thiazide diuretic). Metoprolol reduces heart rate, myocardial contractility, and blood pressure by blocking beta-1 receptors in the heart. Hydrochlorothiazide increases sodium and water excretion by inhibiting the Na+/Cl- symporter in the distal convoluted tubule of the kidney, reducing plasma volume.
Non-selective beta-adrenergic receptor antagonist (beta-blocker) that competitively blocks beta1 and beta2 receptors, reducing heart rate, myocardial contractility, and blood pressure.
1-2 tablets (each containing metoprolol tartrate 50 mg and hydrochlorothiazide 25 mg) orally once daily, maximum 4 tablets daily.
40 to 80 mg orally once daily, may be increased at 3-7 day intervals up to 240 mg once daily.
None Documented
None Documented
Clinical Note
moderateNadolol + Digitoxin
"Nadolol may increase the bradycardic activities of Digitoxin."
Clinical Note
moderateNadolol + Deslanoside
"Nadolol may increase the bradycardic activities of Deslanoside."
Clinical Note
moderateNadolol + Acetyldigitoxin
"Nadolol may increase the bradycardic activities of Acetyldigitoxin."
Clinical Note
moderateNadolol + Ouabain
"Nadolol may increase the bradycardic activities of Ouabain."
Metoprolol: 3-7 hours (terminal half-life); extensive metabolizers (CYP2D6) ~3-4 h, poor metabolizers ~7-8 h. Hydrochlorothiazide: 6-15 hours (terminal half-life).
Terminal elimination half-life: 14–24 hours (average 20 hours); prolonged in renal impairment (up to 45 hours) allowing once-daily dosing
Metoprolol: <5% unchanged in urine; rest metabolized in liver (CYP2D6) and excreted renally as metabolites. Hydrochlorothiazide: >95% excreted unchanged in urine within 24 hours via tubular secretion.
Renal (unchanged drug) 75-85%; fecal/biliary <5%
Category C
Category C
Beta-Blocker/Thiazide Diuretic Combination
Beta-Blocker