Comparative Pharmacology
Head-to-head clinical analysis: QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE versus ZESTRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE versus ZESTRIL.
QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE vs ZESTRIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Quinapril is an ACE inhibitor that inhibits the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion; hydrochlorothiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal convoluted tubule, increasing excretion of sodium and water.
Lisinopril competes with angiotensin I for binding to angiotensin-converting enzyme (ACE), inhibiting its activity, thereby preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to decreased blood pressure, reduced aldosterone secretion, and decreased sodium and water retention.
Initial: 10/12.5 mg (quinapril/hydrochlorothiazide) orally once daily. Titrate based on response to a maximum of 40/25 mg once daily.
10 mg orally once daily initially; titrate to 20-40 mg orally once daily. Maximum 80 mg/day.
None Documented
None Documented
Quinaprilat terminal half-life ~25 hours (effective half-life ~12 hours); hydrochlorothiazide ~6-15 hours (increased in renal impairment).
Terminal elimination half-life is about 12 hours for lisinopril; in heart failure, half-life may be prolonged. Steady-state achieved in 2-3 days.
Renal excretion of quinaprilat (active metabolite) ~50-60% unchanged; hydrochlorothiazide ~70% unchanged. Biliary/fecal elimination accounts for <10% for both components.
Primarily renal (approximately 70% unchanged), with the remainder excreted as inactive metabolites via feces and urine.
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor