Amlodipine and Benazepril
Pronunciation
(am LOE di peen & ben AY ze pril)
U.S. Brand Names
Lotrel®
Synonyms
Benazepril and Amlodipine
Generic Available
No
Use
Treatment of hypertension
Pregnancy Risk Factor
C/D (2nd and 3rd trimesters)
Pregnancy Implications
See individual agents.
Lactation
Amlodipine: Excretion in breast milk unknown
Benazepril: Enters breast milk
Contraindications
Hypersensitivity to amlodipine, benazepril, other ACE inhibitors, or any component of the formulation; pregnancy (2nd and 3rd trimesters)
Warnings/Precautions
Used as a replacement for separate dosing of components or combination when response to single agent is suboptimal; the fixed combination is not indicated for initial treatment of hypertension; see individual monographs for additional warnings/precautions
Adverse Reactions
See individual agents.
Drug Interactions
Amlodipine:
Substrate
of CYP3A4 (major);
Inhibits
CYP1A2 (moderate), 2A6 (weak), 2B6 (weak), 2C8/9 (weak), 2D6 (weak), 3A4 (weak)
Also see individual agents.
Mechanism of Action
The mechanism through which benazepril lowers blood pressure is believed to be primarily suppression of the renin-angiotensin-aldosterone system, benazepril has an antihypertensive effect even in patients with low-renin hypertension; amlodipine is a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle; amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure
Pharmacodynamics/Kinetics
See individual agents.
Dosage
Oral:
Adults: Dose is individualized, given once daily
Elderly: Initial dose: 2.5 mg based on amlodipine component
Dosage adjustment in renal impairment:
Clcr 
30 mL/minute: Use of combination product is not recommended.
Dosage adjustment in hepatic impairment:
Initial dose: 2.5 mg based on amlodipine component
Patient Education
See individual agents.
Pregnancy/breast-feeding precautions:
Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.
Dental Health: Effects on Dental Treatment
Fewer reports of gingival hyperplasia with amlodipine than with other CCBs (usually resolves upon discontinuation); consultation with physician is suggested.
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause drowsiness; rarely may produce insomnia and nervousness
Mental Health: Effects on Psychiatric Treatment
May decrease lithium clearance resulting in an increase in serum lithium levels and potential lithium toxicity; monitor serum lithium levels
Dosage Forms
Capsule:
Amlodipine 2.5 mg and benazepril hydrochloride 10 mg
Amlodipine 5 mg and benazepril hydrochloride 10 mg
Amlodipine 5 mg and benazepril hydrochloride 20 mg
Amlodipine 10 mg and benazepril hydrochloride 20 mg
References
Wynn RL, "An Update on Calcium Channel Blocker-Induced Gingival Hyperplasia,"
Gen Dent
, 1995, 43(3):218-22.
Wynn RL, "Calcium Channel Blockers and Gingival Hyperplasia,"
Gen Dent
, 1991, 39(4):240-3.
|
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's
accreditation program
is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s
editorial process
. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
|
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2007
A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
