Following the increasing need for the use of combination therapy for better blood pressure control as recommended by most guidelines, Reals launched Alstoretic 20 which is a fixed dose combination of Lisinopril 20mg + Hydrochlorothiazide 12.5mg and Alstoretic (Lisinopril 5mg + Hydrochlorothiazide 12.5mg).
Following the increasing need for the use of combination therapy for better blood pressure control as recommended by most guidelines, Reals launched Alstoretic 20 which is a fixed dose combination of Lisinopril 20mg + Hydrochlorothiazide 12.5mg and Alstoretic (Lisinopril 5mg + Hydrochlorothiazide 12.5mg). Alstoretic is ideal once daily oral treatment for essential hypertension when combination treatment is indicated. In addition to its excellent pharmacokinetics which makes it well tolerated, Alstoretic is scored for easy dose titration. It is also calenderised and this aids patient’s compliance.
As a result of its diuretic effects, hydrochlorothiazide increases plasma rennin activity, increases aldosterone secretion, and decreases serum potassium.
Administration of lisinopril blocks the rennin-angiotensin-aldosterone axis and tends to reverse the potassium loss associated with the diuretic.
In clinical studies, the extent of blood pressure reduction seen with the combination of lisinopril and hydrochlorothiazide was approximately additive. The lisinopril and hydrochlorothiazide 10-12.5mg combination worked equally well in black and white patients. The lisinopril and hydrochlorothiazide 20-12.5mg and lisinopril and hydrochlorothiazide combinations appeared somewhat less effective in black patients, but relatively few black patients were studied. In most patients, the hypertensive effect of lisinopril and hydrochlorothiazide was sustained for at least 24 hours.
Lisinopril and hydrochlorothiazide are indicated for the treatment of hypertension. These fixed-dosed combinations are not indicated for initial therapy (see DOSAGE AND ADMINISTRATION).
In using lisinopril and hydrochlorothiazide, consideration should be given to the fact that an angiotensin converting enzyme inhibitor, captopril, has caused agranulocytosis, particularly in patients with renal impairment or collagen vascular disease, and that available data are insufficient to show that lisinopril does not have a similar risk.
In considering use of lisinopril and hydrochlorothiazide it should be noted that black patients receiving ACE inhibitors have been reported to have a higher incidence of angioedema compared to non-blacks.