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Lotrel Generic Name & Formulations
Legal Class
Rx
General Description
Amlodipine (as besylate), benazepril (as HCl); 2.5mg/10mg, 5mg/10mg, 5mg/20mg, 5mg/40mg, 10mg/20mg, 10mg/40mg; caps.
Pharmacological Class
Calcium channel blocker (CCB) (dihydropyridine) + ACE inhibitor.
How Supplied
Caps—100
Manufacturer
Generic Availability
YES
Lotrel Indications
Indications
Hypertension (not for initial therapy).
Lotrel Dosage and Administration
Adult
For patients not adequately controlled with amlodipine or benazepril monotherapy or in those who show inability to achieve BP control with amlodipine without developing edema: initially 2.5mg/10mg once daily; may titrate up to 10mg/40mg once daily if BP remains uncontrolled. Replacement therapy: may be substituted for titrated components. CrCl ≤30mL/min: not recommended. Hepatic impairment, elderly: consider lower doses.
Children
Not established.
Lotrel Contraindications
Contraindications
History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not administer amlodipine/benazepril within 36hrs of switching to or from sacubitril/valsartan.
Lotrel Boxed Warnings
Boxed Warning
Fetal toxicity.
Lotrel Warnings/Precautions
Warnings/Precautions
Fetal toxicity may develop; discontinue if pregnancy is detected. Correct salt/volume depletion prior to initiation. Renal or hepatic impairment. Dialysis (esp. high-flux membrane). Renal artery stenosis. CHF. Severe obstructive coronary artery disease. Severe aortic or mitral stenosis. Obstructive hypertrophic cardiomyopathy. Diabetes. Surgery. Discontinue and treat if angioedema, laryngeal edema, jaundice or marked elevation of liver enzymes develop. Monitor BP, electrolytes and renal function. Black patients may have higher rate of angioedema than non-black patients. Elderly. Neonates. Pregnancy: monitor. Nursing mothers.
Lotrel Pharmacokinetics
See Literature
Lotrel Interactions
Interactions
See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus, sirolimus, everolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely, in general, avoid combined use of RAS inhibitors. Avoid aliskiren in renal impairment (CrCl <60mL/min). Hyperkalemia with K+supplements, K+ -sparing diuretics, or salt substitutes. May increase lithium levels; monitor. Potentiates simvastatin (max 20mg daily). Potentiated by diuretics, CYP3A4 inhibitors. Nitritoid reactions with concomitant injectable gold (sodium aurothiomalate); rare. 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). Hypoglycemia with insulin and oral antidiabetics; rare.
Lotrel Adverse Reactions
Adverse Reactions
Cough, edema, fatigue, dizziness, GI upset, angioedema, hypotension, hyperkalemia, palpitations, flushing, anaphylactoid reactions; rare: hepatic failure.
Lotrel Clinical Trials
See Literature
Lotrel Note
Not Applicable
Lotrel Patient Counseling
See Literature
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