Select therapeutic use:
Indications for LOTENSIN HCT:
Hypertension (not for initial therapy).
To switch from benazepril monotherapy: initially 10/12.5mg once daily. Or, titrate individual components.
History of ACEI-associated or other angioedema. Anuria. Sulfonamide allergy. Concomitant neprilysin inhibitors (eg, sacubitril); do not administer benazepril/HCT within 36hrs of switching to or from sacubitril/valsartan. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Salt/volume depletion; correct prior to initiation. Severe CHF. Renal or hepatic impairment. Dialysis (esp. high-flux membrane). Renal artery stenosis. Monitor WBCs in renal or collagen vascular disease. Surgery. Postsympathectomy. SLE. Diabetes. Gout. Hypercalcemia; avoid. Acute myopia. Secondary angle-closure glaucoma. Discontinue if angioedema, laryngeal edema, jaundice or marked elevations of hepatic enzymes develop. Monitor BP, electrolytes and renal function. Black patients may have higher rate of angioedema than non-Black patients. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers: not recommended.
See Contraindications. Potassium or potassium-sparing diuretics may cause hyperkalemia. May increase lithium levels. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). May be antagonized by, and renal toxicity potentiated by, NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume depleted). Potentiated by antihypertensives, anticholinergics. Potentiates skeletal muscle relaxants. Antagonizes norepinephrine. Orthostatic hypotension potentiated by alcohol, CNS depressants.Thiazide-induced hypokalemia or hypomagnesemia may predispose patients to digoxin toxicity. Adjust antidiabetic drugs. Renal excretion may be reduced and myelosuppression enhanced with antineoplastic agents. Antagonized by pro-kinetic drugs. Increased risk of hyperuricemia with cyclosporine. Anion exchange resins; administer at least 4hrs before or 4–6hrs after resin administration. May interfere with parathyroid test. Increased risk of angioedema with concomitant mTOR inhibitors (eg, temsirolimus, sirolimus, everolimus) or neprilysin inhibitors. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare.
ACE inhibitor + diuretic (thiazide).
Dizziness, fatigue, orthostatic hypotension, headache, cough, hypertonia, vertigo, nausea, impotence, somnolence, electrolyte imbalance; rare: hepatic failure.
Hepatic. Approx. 96% protein bound.
Renal (primarily), biliary.