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acebutolol + HCTZ (Sectral Plus / Secadrex / acebutolol + HCTZ)

✓ Approved

Sanofi S.A · ADRB1 · Small Molecule

What is acebutolol + HCTZ?

acebutolol + HCTZ is a small molecule developed by Sanofi S.A. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesSectral Plus, Secadrex, acebutolol + HCTZ
CompanySanofi S.A
Drug ClassSmall Molecule
Molecular TargetADRB1, SLC12A3
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Sanofi S.A

Mechanism of Action

Molecular Targets

acebutolol + HCTZ acts on 2 molecular targets:

ADRB1adrenoceptor beta 1 (B1AR, RHR)
SLC12A3solute carrier family 12 member 3 (NCCT, NCC)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

acebutolol + HCTZ is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedArchives of toxicology2026-10-16

N-nitroso-hydrochlorothiazide: in vivo mutagenicity evaluation in a transgenic rodent model.

Ott Gregory R GR, Griffin Troy T, Bebb Kate K, Marinkovic Marina M et al.

N-nitrosamine drug substance related impurities (NDSRIs) are considered to be within the "cohort of concern" (CoC) due to their potential mutagenic carcinogenicity. However, increasing evidence indicates variability in mutagenic potency across this class. N-nitroso-hydrochlorothiazide (N-nitroso-HCTZ), an impurity associated with hydrochlorothiazide, has shown positive results in bacterial mutagenicity (Ames) assays, although mechanistic studies suggest these findings are likely driven by reactive degradation products rather than the parent compound. To further characterize mutagenic potential in vivo, a transgenic rodent (TGR) gene mutation assay was conducted in the Muta™Mouse test system. Male mice were administered N-nitroso-HCTZ by oral gavage at 0, 18.5, 55.7, 167, 500, or 750 mg/kg/day for 28 consecutive days. Mutant frequency (lacZ) was evaluated in liver and glandular stomach at 167, 500, and 750 mg/kg/day. Systemic exposure was confirmed in a toxicokinetic study following a single 750 mg/kg dose. N-nitroso-HCTZ was well tolerated, and no statistically significant increases in mutant frequency were observed in either tissue at any evaluated dose. All values were within historical control ranges, while the positive control demonstrated the anticipated response. Under the conditions of this study, N-nitroso-HCTZ did not induce gene mutations in vivo.

PMID 42881286
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PubMedOpen medicine (Warsaw, Poland)2026-10-13

Developing and evaluating per-protocol adherence definitions in a large pragmatic clinical trial: insights from the Diuretic Comparison Project.

Anand Sonia T ST, Hau Cynthia C, Davenport Michael J MJ, Ishani Areef A et al.

Pragmatic clinical trials leveraging real-world data, such as the Diuretic Comparison Project (DCP), present unique challenges in measuring treatment adherence compared to traditional randomized controlled trials. In DCP, medications were managed through routine VA care and monitored via pharmacy claims, requiring tailored methods to assess adherence beyond standard measures like medication possession ratio (MPR). To develop a data-driven approach to define protocol treatment adherence for pragmatic comparative effectiveness trials. Structured EHR pharmacy dispense records guided categorization of treatment changes for two diuretics - chlorthalidone (CTD) and hydrochlorothiazide (HCTZ). We examined fill intervals, total drug supply, filling patterns among others to identify prescribing characteristics informing medication adherence definitions and time censoring for per-protocol analysis. Nonadherence was defined as having a gap (>90-days pause in assigned treatment), switch (receiving the other study medication), or discontinuation (without CTD/HCTZ for >90-days). 5,476 patients met nonadherence criteria - 2,851 (52 %) in CTD and 2,625 (48 %) in HCTZ. Switching occurred earlier in CTD patients, gaps were more common in HCTZ, but discontinuation was similar between groups. Defining adherence requires complex decision-making hybrid framework entailing both clinical and statistical expertise. Pragmatic studies should allow flexibility to generate data-driven, clinically-sensitive measures that appropriately describe trial compliance.

PMID 42866310
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PubMedAmerican journal of hypertension2026-10-01

Effects of Anti-Hypertensive Agents on Orthostatic Changes: Secondary Analysis of the Treatment of Mild Hypertension Study (TOMHS).

Liu Esther Y EY, Lee Grace G, Khan Md Marufuzzaman MM, Petriceks Aldis A et al.

Orthostatic hypotension (OH) and orthostatic hypertension (OHT) are common among adults with hypertension and may complicate antihypertensive treatment selection.However, the impact of specific antihypertensive agents on orthostatic blood pressure (BP) responses and risk of OH or OHT remains incompletely characterized. We performed a secondary analysis of the Treatment of Mild Hypertension Study (TOMHS), a multicenter randomized clinical trial (1987-1993). A total of 902 adults aged 45-69 years with diastolic BP 90-99 mmHg were randomized to acebutolol, amlodipine, chlorthalidone, doxazosin, enalapril, or placebo. Orthostatic BP change (standing minus seated BP) was assessed at randomization, 1 month, and every 3 months up to 54 months. OH was defined as a systolic BP decrease ≥20 mmHg or diastolic BP decrease ≥10 mmHg; OHT was defined as a systolic BP increase ≥20 mmHg or diastolic BP increase ≥10 mmHg. Generalized estimating equations evaluated associations between agents and orthostatic BP changes overall, by baseline BP, and over time. Among 897 participants with orthostatic BP measurements (mean age 54.8 years; 38.5% female; 19.6% Black), doxazosin increased odds of OH (OR 1.45; 95% CI, 1.05-2.02) and reduced odds of OHT (OR 0.66; 95% CI, 0.51-0.86) versus placebo. Chlorthalidone reduced OHT among participants with baseline OHT (P=0.018). Amlodipine and doxazosin attenuated orthostatic systolic BP changes across baseline orthostatic BP change strata. Over time, amlodipine and chlorthalidone reduced odds of OH (P=0.001, 0.044). Specific antihypertensive agents demonstrated distinct effects on orthostatic BP regulation. Consideration of orthostatic effects during antihypertensive selection may help individualize therapy, improve hemodynamic stability, and optimize treatment for patients at risk of orthostatic dysregulation.

PMID 42820774
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PubMedThe Journal of pharmacy and pharmacology2026-09-27

Putative thiazide-like diuretic medicinal plants: an electrolyte fingerprint-based review of preclinical evidence.

Park Junkyu J, Shin Sujin S, Kim Youngmin Y, Yoo Jahyun J et al.

Thiazide and thiazide-like diuretics remain first-line antihypertensive agents, exerting their primary renal effect through inhibition of the Na+-Cl- cotransporter (NCC) in the distal convoluted tubule, producing natriuresis and saluresis with relative K+ and Ca2+ sparing. Although numerous medicinal plants possess diuretic properties, most preclinical studies assess only urine volume, preventing mechanistic classification and obscuring whether observed diuresis reflects NCC-mediated tubular activity. This focused review applied an electrolyte-based pharmacological framework to critically appraise medicinal plants with putative thiazide-like diuretic activity. Of nine studies assessed across seven plant species, Tagetes erecta most closely approximated the thiazide-like fingerprint-natriuresis with relative K+ sparing and a partial Ca2+-sparing effect under HCTZ-referenced conditions, with additive interaction with HCTZ. Remaining candidates showed broader saluretic profiles, HCTZ-comparable natriuresis through mechanistically distinct pathways, or mixed/loop-like electrolyte patterns, illustrating the pharmacological heterogeneity of herbal diuretics. Isoquercitrin and related flavonol scaffolds were identified as plausible candidates for NCC-targeted investigation. Genuinely thiazide-like electrolyte profiles are uncommon in the herbal diuretic literature, largely due to reliance on urine volume, inconsistent electrolyte profiling, and infrequent HCTZ comparison. Electrolyte-based classification frameworks would improve mechanistic interpretation and facilitate identification of pharmacologically selective candidates. T. erecta represents the priority candidate for future NCC-focused mechanistic investigation.

PMID 42800041
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PubMedLuminescence : the journal of biological and chemical luminescence2026-08-24

Micellar Enhanced Second Derivative Spectrofluorimetric Determination of Hydrochlorothiazide, Amlodipine, and Telmisartan in Fixed Dose Combination and Spiked Human Plasma.

Yenduri Suvarna S, H Shashank S, K Naga Prashant NP

A very sensitive and eco-friendly second-derivative spectrofluorimetric method was developed for simultaneous analysis of hydrochlorothiazide (HCTZ), amlodipine besylate (AML), and telmisartan (TEL) in pharmaceutical products and human plasma. Native fluorescence of HCTZ (λex267/λem295 nm), AML (λex362/λem415 nm), and TEL (λex292/λem369 nm) was used together with fluorescence enhancement achieved through sodium lauryl sulfate micelles at optimum excitation/emission wavelengths for all other analytes being analyzed. Overlap of spectroscopic data was able to be resolved through second-derivative spectrofluorimetry without prior separation. Method validation was performed according to ICH Q2(R1) guidelines; results showed excellent linearity (R2 > 0.999) across a concentration range of 3-18, 2-10, and 10-50 ng/mL for HCTZ, AML, and TEL, respectively. Accuracy, precision and robustness were demonstrated with %RSD values below two. Application of the method to pharmaceutical product and spiked plasma samples gave satisfactory recoveries with minimal matrix interference. Assessment of method greenness was conducted using AGREE Prep, MoGAPI, AGSA, SAMI, Ma Tool, CACI, and WECA metrics, all of which indicate superior environmental sustainability. The proposed method is simple, fast, low-cost, ultra-sensitive, and suitable for routine quality control and/or bioanalytical analysis.

PMID 42634090
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PubMedFrontiers in pharmacology2026-08-06

Drug-associated psoriasis: a pharmacovigilance study based on the FAERS database.

Yi Sha S, Liu Aimei A, Huoshen Wuda W, Xia Dengmei D et al.

Drug-induced psoriasis has been increasingly recognized, but the spectrum of potential triggering medications remains incompletely characterized. We aimed to identify the drugs potentially associated with psoriasis using a large-scale and real-world pharmacovigilance analysis. Firstly, disproportionality analyses were used to detect psoriasis-related drug signals. Furthermore, Multivariable logistic regression and Bayesian shrinkage models were applied to evaluate the consistency of the detected associations after adjustment for available demographic and reporting-related factors. Finally, stratified analyses by sex, age, and reporter type were conducted to assess signal robustness. A total of 30 drugs showed significant associations with psoriasis. These signals involved several pharmacological categories, including anti-infective agents (e.g., Abacavir, Fluconazole, Moxifloxacin, Sulfamethoxazole), anti-inflammatory and immunomodulatory drugs (e.g., Celecoxib, Tofacitinib), cardiovascular agents (e.g., Acebutolol, Telmisartan, Clonidine), neuropsychiatric drugs (e.g., Nortriptyline, Temazepam, Zopiclone, Wellbutrin), hormonal agents (e.g., Progesterone, Prometrium), and respiratory medications (e.g., Ventolin). Bayesian correction generally attenuated extreme effect estimates but confirmed the robustness of most signals. The stratified analysis also approve the above results. Our findings suggest that multiple drug classes are associated with psoriasis signals in pharmacovigilance data. These results highlight the importance of early recognition of drug-associated psoriasis and may assist clinicians in medication review and risk stratification in routine practice.

PMID 42558881
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