benazepril and hydrochlorothiazide, Lotensin HCT
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: benazepril and hydrochlorothiazide
BRAND NAME: Lotensin HCT
DRUG CLASS AND MECHANISM: Lotensin HCT is a combination of two drugs, benazepril and hydrochlorothiazide. Benazepril is an angiotensin converting enzyme (ACE) inhibitor that is used for treating high blood pressure. Other ACE inhibitors include enalapril (Vasotec), quinapril (Accupril), captopril (Capoten), fosinopril (Monopril), ramipril (Altace), moexipril (Univasc) and trandolapril (Mavik). ACE is an enzyme in the body which is important for the formation of angiotensin II. Angiotensin II causes constriction of arteries in the body, thereby elevating blood pressure. ACE inhibitors (for example, benazepril) lower blood pressure by inhibiting the formation of angiotensin II, thus relaxing the arteries. Relaxing the arteries not only lowers blood pressure, but the lower blood pressure also reduces the heart's work and improves the output of blood from the heart in patients with heart failure.
Hydrochlorothiazide (HCTZ) is a diuretic (water pill) used for treating high blood pressure (hypertension) and accumulation of fluid. It works by blocking salt and fluid reabsorption in the kidneys, causing increased output of salt and water in the urine (diuresis). The mechanism of its action in lowering high blood pressure is not well understood.
The combination of benazepril and HCTZ reduces blood pressure better than either drug alone. Lotensin was approved by the FDA in May 1992.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets (mg benazepril/mg HCTZ); 5/6.25, 10/12.5, 20/12.5, and 20/25.
STORAGE: Lotensin HCT should be stored at 59 F to 86 F (15 C to 30 C) and be protected from excessive light and humidity. It should be kept in a tight, light-resistant container.
PRESCRIBED FOR: Lotensin HCT is used for treatment of high blood pressure.
DOSING: The dose of Lotensin HCT is tailored to the patient's needs. The recommended dose when switching from benazepril or hydrochlorothiazide to Lotensin HCT is 10 mg/12.5 mg once daily. Dosage may be increased every 2 to 3 weeks, and the maximum dose is 20 mg /25 mg.
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.
Combining benazepril or other ACE inhibitors with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-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.
There have been reports that aspirin and other NSAIDs such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, and many others), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors.
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