amlodipine and benazepril, Lotrel
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: amlodipine and benazepril
BRAND NAME: Lotrel
DRUG CLASS AND MECHANISM: Lotrel is a combination drug, containing benazepril (Lotensin) and amlodipine (Norvasc) and is used for treating high blood pressure. Benazepril is an angiotensin converting enzyme (ACE) inhibitor. ACE is an enzyme in the body that is important for the formation of angiotensin II. Angiotensin II causes constriction of the muscles surrounding arteries in the body, thereby narrowing the arteries and elevating blood pressure. ACE inhibitors such as benazepril lower blood pressure by inhibiting the formation of angiotensin II, thus relaxing the muscles and dilating the arteries. Relaxing the arteries not only lowers blood pressure, but also improves the pumping efficiency of a failing heart and improves the pumping of blood by the heart in patients with heart failure. Amlodipine belongs to a class of medications called calcium channel blockers. These medications block the transport of calcium into the smooth muscle cells lining the coronary arteries and other arteries of the body. Since calcium is important in muscle contraction, blocking calcium transport relaxes artery muscles and dilates coronary arteries and other arteries of the body. Relaxing muscles of arteries lowers blood pressure. The FDA approved Lotrel in March 1995.
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules (mg amlodipine/mg benazepril): 2.5/10; 5/10;5/20; 5/40; 10/20; and 10/40 STORAGE: Lotrel should be stored at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Lotrel is used for treating high blood pressure (hypertension) when blood pressure is not adequately controlled with either of its constituent drugs alone.
DOSING: The dose of Lotrel is tailored to the patient's needs. The dose is one capsule once daily.
DRUG INTERACTIONS: Combining benazepril with potassium supplements, potassium containing salt substitutes, and potassium conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium.
There have been reports of increased lithium (Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The reason for this interaction is not known, but the increased levels may lead to toxicity from lithium.
There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors. Combining ACE inhibitors with NSAIDs in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.
Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure or hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors.
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