Which medications in the drug class Antihypertensive Combinations are used in the treatment of Hypertension?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Antihypertensive Combinations

Drug combinations using agents that act by different mechanisms have an additive effect. Most clinicians recommend initiating therapy with a single agent and advancing to the low-dose combination therapy. Some patients will require multiple medications to achieve their blood pressure targets and will benefit from drug combinations. Drug combination therapy may also help to improve patient compliance.

Drug combinations include—but are not limited to—the following:

- Amlodipine/benazepril (Lotrel)

- Amlodipine/olmesartan (Azor)

- Amlodipine/telmisartan (Twynsta)

- Amlodipine/valsartan (Exforge)

- Amlodipine/valsartan/hydrochlorothiazide (Exforge HCT)

- Amlodipine/aliskiren (Tekamlo)

- Amlodipine/aliskiren/hydrochlorothiazide (Amturnide)

- Olmesartan/amlodipine/hydrochlorothiazide (Tribenzor)

- Trandolapril/verapamil (Tarka)

- Benazepril/hydrochlorothiazide (Lotensin HCT)

- Captopril/hydrochlorothiazide (Capozide)

- Enalapril/hydrochlorothiazide (Vaseretic)

- Fosinopril/hydrochlorothiazide

- Lisinopril/hydrochlorothiazide (Prinzide, Zestoretic)

- Moexipril/hydrochlorothiazide (Uniretic)

- Quinapril/hydrochlorothiazide (Accuretic)

- Candesartan/hydrochlorothiazide (Atacand HCT)

- Eprosartan/hydrochlorothiazide (Teveten HCT)

- Irbesartan/hydrochlorothiazide (Avalide)

- Losartan/hydrochlorothiazide (Hyzaar)

- Olmesartan/hydrochlorothiazide (Benicar HCT)

- Telmisartan/hydrochlorothiazide (Micardis HCT)

- Valsartan/hydrochlorothiazide (Diovan HCT)

- Atenolol/chlorthalidone (Tenoretic)

- Bisoprolol/hydrochlorothiazide (Ziac)

- Metoprolol/hydrochlorothiazide (Lopressor HCT)

- Nadolol/bendroflumethiazide (Corzide)

- Propranolol/hydrochlorothiazide

- Aliskiren/hydrochlorothiazide (Tekturna HCT)

- Clonidine/chlorthalidone (Clorpres)

- Spironolactone/hydrochlorothiazide (Aldactazide)

- Triamterene/hydrochlorothiazide (Dyazide, Maxzide)

- Methyldopa/hydrochlorothiazide

- Amiloride/hydrochlorothiazide

Metoprolol/hydrochlorothiazide (Lopressor HCT)

Metoprolol/hydrochlorothiazide is a combination of metoprolol, a beta-blocker, and hydrochlorothiazide, a thiazide diuretic. Metoprolol is a beta1-selective blocker at low doses; at higher doses, it also inhibits beta2-adrenoreceptors. Hydrochlorothiazide inhibits sodium reabsorption in distal renal tubules, resulting in increased excretion of water, sodium, potassium, and hydrogen ions.

Triamterene/hydrochlorothiazide (Maxzide, Maxzide-25, Dyazide)

Triamterene/hydrochlorothiazide is a fixed-combination indicated for hypertension or edema in patients who are at risk of developing hypokalemia on hydrochlorothiazide alone. Triamterene exerts a diuretic effect on the distal renal tubule, inhibiting the reabsorption of sodium in exchange for potassium and hydrogen ions. Hydrochlorothiazide inhibits sodium and chloride reabsorption in distal renal tubules, resulting in increased excretion of water, sodium, potassium, and hydrogen ions.

Valsartan/hydrochlorothiazide (Diovan HCT)

Valsartan/hydrochlorothiazide is a combination of valsartan, an angiotensin receptor blocker, and hydrochlorothiazide, a diuretic. Valsartan is a prodrug that produces direct antagonism of angiotensin II receptors. It displaces angiotensin II from AT1 receptor and may lower blood pressure by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water intake, and hypertrophic responses. Hydrochlorothiazide inhibits sodium and chloride reabsorption in distal renal tubules, resulting in increased excretion of water, sodium, potassium, and hydrogen ions.

Valsartan/amlodipine/hydrochlorothiazide (Exforge HCT)

Valsartan/amlodipine/hydrochlorothiazide is a combination of amlodipine, a dihydropyridine calcium channel blocker, valsartan, an angiotensin receptor blocker, and hydrochlorothiazide, a diuretic. Amlodipine exhibits antianginal and antihypertensive effects by inhibiting the influx of calcium in cardiac and smooth muscle cells of the coronary and peripheral vasculature, resulting in dilatation of coronary and peripheral arteries. Valsartan is a prodrug that produces direct antagonism of angiotensin II receptors. It displaces angiotensin II from the AT1 receptor and may lower blood pressure by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water intake, and hypertrophic responses. Hydrochlorothiazide inhibits sodium and chloride reabsorption in distal renal tubules, resulting in increased excretion of water, sodium, potassium, and hydrogen ions.

Enalapril/hydrochlorothiazide (Vaseretic)

Enalapril/hydrochlorothiazide is a combination of enalapril, an ACE inhibitor, and hydrochlorothiazide, a diuretic. Hydrochlorothiazide inhibits sodium reabsorption in distal renal tubules, resulting in increased excretion of water, sodium, potassium, and hydrogen ions. Enalapril prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, resulting in increased levels of plasma renin and a reduction in aldosterone secretion. It helps control blood pressure and proteinuria.

Azilsartan/chlorthalidone (Edarbyclor)

This is an angiotensin II receptor blocker (ARB) and thiazide-like diuretic combination. It is indicated as initial hypertension therapy or for the treatment of hypertension in patients whose condition is not adequately controlled with monotherapy.


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