1 What is Lotrel?

Brand: Lotrel

Generic: Amlodipine And Benazepril

Lotrel is used to treat hypertension. Amlodipine is a dihydropyridine calcium channel blocker which relaxes peripheral and coronary vascular smooth muscle. 

It produces coronary vasodilation by inhibiting the entry of calcium ions into the voltage-sensitive channels of the vascular smooth muscle and myocardium during depolarization. 

It reduces peripheral vascular resistance and hence resulting in a reduction of blood pressure. Benazepril belongs to a class of medicines known as angiotensin converting enzyme (ACE) inhibitors. 

Benazepril and its active metabolite benazeprilat inhibit ACE, which results in decreased plasma angiotensin-II and thus leading to decreased aldosterone secretion. 

Finally, it relaxes the blood vessels and lowers blood pressure. This medicine is available in the market in capsule form. You can get such medications only with your doctor's prescription.

2 What to Know Before Using

Before using Lotrel, you must know all about the risks and complications associated with it.

If you are about to start a drug therapy, the risk and benefit ratio of taking the drug should be considered. This is a decision that your doctor will make with your active participation. 

There are some important factors such as drug interaction, metabolic impairment, hypersensitivity reaction, pregnancy, lactation etc. which may alter the drug action.

Sometimes presence of other health disorders affects the beneficial effects of this medicine and even may cause serious complications. Make sure you mention your doctor if you have any other medical problems. 

This combined antihypertensive preparation should not be used in patients with history of angioedema, pregnancy and lactation. 

Studies in animals or humans have demonstrated fatal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience. 

But potential benefits may warrant use of the drug in pregnant women despite potential risks.

Certain drugs should not be used concurrently with such medications. It is always recommended to consult with your doctor if you are in need of some drugs for another health problem in order to avoid unwanted serious complications.

3 Proper Usage

To use Lotrel properly, you must follow all instructions given by your doctor.

Medicines should be used following the directions given by a doctor. The dose of this medicine will vary according to patient’s condition or requirements. You should follow the doctor's directions and advices. 

The amount of medicine that you take should not exceed the maximum therapeutic dose. Also, the frequency of your daily drug administration and the duration of drug therapy depend on the particular medical problem for which you are taking the medicine. 

In order to treat high blood pressure, an adult should take combination capsules orally once in a day following the directions given by a doctor. Each capsule contains 2.5-10 mg amlodipine and 10-40 mg benazepril.

Always try to take your medicine in time. If you miss any dose of this medicine, you should take it as soon as possible. 

But if it is time for your next dose, then you should skip the missed dose and go back to your regular treatment schedule. You should store the medicine in a closed container at room temperature away from heat, moisture, and direct light. 

All kinds of medicines should be kept out of the reach of children. Outdated medicine must be disposed by an appropriate way.

4 Precautions to take

Before using Lotrel, there are some precautions you must take.

Regular visits are recommended to make sure this medicine is working properly or not while you are receiving a drug therapy. Some important measures should be taken if you feel any discomfort following this drug therapy. 

You should discontinue this combined antihypertensive preparation as soon as possible if pregnancy is detected. 

The use of such medications should be considered cautiously in elderly, renal or hepatic impairment, congestive heart failure, severe aortic stenosis, unilateral or bilateral renal artery stenosis, and during surgery or anesthesia. 

Both amlodipine and benazepril can cause symptomatic hypotension, especially in patients with salt or volume depletion. 

ACE inhibitors have been associated with cholestatic jaundice and fulminant hepatic necrosis. If any patient develops jaundice or marked elevation of liver enzymes, this treatment should be stopped. 

Periodical monitoring of renal function and serum potassium is recommended. Angioedema of the face, extremities, lips, tongue, glottis, larynx and intestinal angioedema have been reported in ACE inhibitors-treated patients. 

As with all ACE inhibitors, may cause persistent dry cough. Safety and efficacy in pediatric patients have not been established.

5 Potential Side Effects

Make sure you meet with your doctor in using Lotrel to avoid unwanted potential side effects.

There are some unwanted side-effects associated with each drug that usually do not need medical attention. These side-effects usually go away during the treatment episode as your body adjusts to the medicine. 

Additionally, your health care professional may advise you about the ways how to prevent or reduce those unwanted side-effects. Sometimes you may need to consult with the doctor if you feel any of toxic effects which are common to all members, but the relative propensity differs. 

Some adverse effects along with amlodipine are headache, dizziness, fatigue, somnolence, peripheral edema, flushing, palpitations, nausea, abdominal pain, rarely pruritus, rash, dyspnea, asthenia and muscle cramps.

On the contrary, benazepril is well tolerated by most of the patients but sometimes it may bring the following adverse effects:

  • An initial sharp fall in blood pressure occurs especially in diuretic treated and CHF patients. Persistent hypotension may be troublesome in MI patients.
  • Hyperkalemia is more likely to occur in patients with impaired renal function and in those taking potassium sparing diuretics, NSAIDs or beta-blockers.
  • A persistent brassy cough occurs in 4-16% patients within 1-8 weeks after starting this drug therapy which often requires discontinuation.
  • Rashes or hives may occur in 1-4% patients but do not usually warrant drug discontinuation.
  • Swelling of lips, mouth, nose and larynx i.e. angioedema may develop within hours to few days in 0.06-0.5% patients which may cause airway obstruction. This can be treated with adrenaline, antihistamines and corticosteroids according to need.
  • Reversible loss or alteration of taste sensation may occur rarely.
  • Headache, dizziness, nausea and bowel upset are reported in 1-4% patients.
  • Fetal growth retardation, hypoplasia of organs and even fetal death may occur if ACE inhibitors are given during later half of pregnancy.
  • Acute renal failure is precipitated by ACE inhibitors in patients with bilateral renal artery stenosis. ACE inhibitors are contraindicated in such patients.
  • Granulocytopenia and proteinuria are rare but warrant withdrawal. Renal disease predisposes to these adverse effects.