Related Experiment Videos
Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability
Barry L Carter1, Michael E Ernst, Jerome D Cohen
1Division of Clinical and Administrative Pharmacy, College of Pharmacy, Building S 532, University of Iowa, Iowa City, IA 52242, USA. barry-carter@uiowa.edu
Hypertension (Dallas, Tex. : 1979)
|November 26, 2003
Summary
Hydrochlorothiazide and chlorthalidone, common hypertension drugs, are not equipotent. Chlorthalidone is more potent and longer-acting than hydrochlorothiazide, but outcome differences remain unknown.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Nephrology
Background:
- Thiazide diuretics are a primary pharmacologic treatment for hypertension.
- Hydrochlorothiazide and chlorthalidone are frequently used thiazide diuretics in clinical trials.
- Current guidelines often consider these diuretics interchangeable and equipotent.
Purpose of the Study:
- To compare the pharmacokinetic and blood pressure-lowering effects of hydrochlorothiazide and chlorthalidone.
- To investigate potential differences between these two commonly prescribed diuretics.
Main Methods:
- A literature search was conducted from 1960 to 2003.
- Studies evaluating pharmacokinetic and blood pressure-lowering effects were identified and analyzed.
Main Results:
- Significant pharmacokinetic and pharmacodynamic differences exist between hydrochlorothiazide and chlorthalidone.
- Chlorthalidone is estimated to be 1.5 to 2.0 times more potent than hydrochlorothiazide.
- Chlorthalidone exhibits a considerably longer duration of action compared to hydrochlorothiazide.
Conclusions:
- Despite common clinical assumptions, hydrochlorothiazide and chlorthalidone possess distinct pharmacokinetic and pharmacodynamic profiles.
- The clinical implications of these differences on patient outcomes are currently unknown and warrant further investigation.