benazepril and hydrochlorothiazide, Lotensin HCT

  • Pharmacy Author:
    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: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is the dosage for benazepril and hydrochlorothiazide?

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.

Which drugs or supplements interact with benazepril and hydrochlorothiazide?

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.

When taken with lithium (Eskalith, Lithobid), benazepril can increase lithium to toxic levels in the blood.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting, and hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including benazepril. Hydrochlorothiazide reduces the elimination of lithium (Lithobid, Eskalith) by the kidneys and can lead to lithium toxicity. Nonsteroidal anti-inflammatory drugs, for example, ibuprofen, may reduce the blood pressure lowering effects of hydrochlorothiazide. Blood sugar levels can be elevated by HCTZ necessitating adjustments in the doses of medications that are used for treating diabetes.

Combining HCTZ with corticosteroids may increase the risk for low levels of blood potassium and other electrolytes. Low blood potassium can increase the toxicity of digoxin (Lanoxin). Cholestyramine (Questran, Questran Light) and colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by 43% to 85%.

Medically Reviewed by a Doctor on 7/21/2015

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