Efficacy of eprosartan in combination with HCTZ
in patients with essential hypertension.
Most fixed-dose combinations that include a diuretic use a too-low dosage of HCTZ
The data demonstrated that long-term treatment with the triple combination therapy, OM/AML + HCTZ
was effective and well-tolerated regardless of diabetes or BMI status, as well as race, and confirm that the blood pressure reductions seen at Week 12 of the double-blind portion of the study were maintained at Week 52.
He cited several studies favoring chlorthalidone, including a recent blinded, randomized, head-to-head comparison (Hypertension 2006;47:352-8) that showed a greater reduction in 24-hour mean systolic blood pressure at 8 weeks in patients receiving chlorthalidone 25 mg/day, compared with those receiving HCTZ
50 mg/day (-12,4 mm Hg vs.
This phase 3, 12-week, randomized, double-blind study evaluated clinic SBP reductions of the fixed-dose combination of azilsartan medoxomil plus CLD and a fixed-dose combination of olmesartan medoxomil and HCTZ
in 1,071 patients with hypertension.
Study 1+ HCTZ
Losartan Lisinopril Cough 25% 17% 69% Study 2++ Placebo Losartan Lisinopril Cough 35% 29% 62% + Demographics = (89% caucasian, 64% female) ++ Demographics = (90% caucasian, 51% female)
In other studies, the fixed-dose combination of azilsartan medoxomil plus CLD was compared to azilsartan medoxomil coadministered with hydrochlorothiazide (HCTZ
), another diuretic, and with a fixed-dose combination of olmesartan medoxomil and HCTZ
The second, a supportive trial, compared Avalide with irbesartan and HCTZ
monotherapies in patients with moderate hypertension.
Important considerations due to the HCTZ
component: Uptitrate HCTZ
slowly in patients with renal disease, as thiazides may precipitate azotemia.
The 53% whose blood pressure wasn't adequately controlled on 300 mg/day received add-on HCTZ
Aliskiren Blunts Renin Activity Renin Concentration Renin Activity Treatment (change from baseline) (change from baseline) Aliskiren (300 mg/day) +348% -58% HCTZ
(25 mg/day) +108% +72% Aliskiren plus HCTZ
+1211% -62% (300 mg/25 mg per day) Placebo +30% 1% Note: All plasma renin measurements in 2,776 patients were made after 8 weeks of treatment.
And in the study, with more than 1,600 patients, concurrent treatment with the popular diuretic hydrochlorothiazide (HCTZ
) plus valsartan appeared to blunt the CRP reduction, raising questions about possible adverse, pleiotropic effects of HCTZ
After 1 week, the dosage received by all patients was doubled, to 300 mg of irbesartan plus 25 mg HCTZ
or to 300 mg of irbesartan alone.
If additional lowering is necessary, may substitute with Cozaar 100 mg and HCTZ
The FDA approval of Tekturna HCT as initial therapy was based on clinical trial data involving more than 2,700 patients, which showed that treatment with the combination of Tekturna and HCTZ
offered greater blood pressure reductions than either drug alone.