Renal Dose Adjustment (Based on CrCl)
- <30 mL/min: Use not recommended
Hepatic Dose Adjustment
- Hepatic impairment: Use with caution, dose adjustments not defined
- Benazepril/hydrochlorothiazide cause fetal/neonatal morbidity/mortality when administered to a pregnant woman[US Black Box Warning]
- Anaphylactoid reactions including head, neck or intestinal angioedema have been reported in patients receiving ACE inhibitors. Angioedema involving tongue, glottis or larynx can lead to airway obstruction and can be fatal. Discontinue therapy and immediately provide emergency treatment including administration of subcutaneous epinephrine injection 1:1000 (0.3-0.5 mL)
- Life-threatening anaphylactoid reactions have occurred in patients undergoing desensitizing therapy with hymenoptera venom while receiving ACE inhibitors. Patients dialyzed with high-flux membranes and concomitantly treated with an ACE inhibitor and patients undergoing low-density lipoprotein apheresis with dextran sulfate absorption are prone to anaphylactoid reactions
- Symptomatic hypotension can occur with benazepril/hydrochlorothiazide therapy especially who are volume-and/or salt-depleted or receiving high doses of diuretics, correct the volume depletion prior to administration of benazepril/hydrochlorothiazide, if excessive hypotension occurs place the patient in a supine position and, if necessary, given an intravenous infusion of normal saline
- Severe hypotension associated with oliguria, azotemia, and rarely with acute renal failure and death has been reported in patients with congestive heart failure, with or without associated renal insufficiency, receiving ACE inhibitor therapy. Initiate benazepril/hydrochlorothiazide therapy in these patients, under close medical supervision for the first 2 weeks of treatment and whenever the dose of benazepril or diuretic is increased
- Hypertensive patients with renal artery stenosis may experience increase in blood urea nitrogen and serum creatinine with benazepril therapy, these increases were reversible upon discontinuation of benazepril therapy, concomitant diuretic therapy, or both. Monitor renal function in these patients during the first few weeks of therapy
- Agranulocytosis and bone marrow depression has been reported with ACE inhibitor therapy, in patients with renal impairment, especially those who also have collagen-vascular diseases such as systemic lupus erythematosus or scleroderma. Monitor WBC counts in patients with collagen-vascular disease, especially if the disease is associated with impaired renal function
- Cholestatic jaundice progressing to fulminant hepatic necrosis and sometimes death have occurred with ACE inhibitors; discontinue therapy and provide appropriate medical treatment
- Use benazepril/hydrochlorothiazide cautiously in patients with impaired hepatic function or progressive liver disease as minor alterations of fluid and electrolyte balance may precipitate hepatic coma
- Thiazide diuretics exacerbates or activates systemic lupus erythematosus
- Benazepril monotherapy causes hyperkalemia and conversely treatment with thiazide diuretics has been associated with hypokalemia. The opposite effects of benazepril and hydrochlorothiazide on serum potassium balance each other in some patients and one or the other effect may be dominant in some, monitor serum electrolytes to detect possible electrolyte imbalance periodically
- As thiazide diuretics tend to reduce glucose tolerance and raise serum levels of cholesterol, triglycerides, and uric acid, it can precipitate gout or diabetes in susceptible patients
- ACE inhibitors causes nonproductive cough, due to the inhibition of the degradation of endogenous bradykinin, which resolves on discontinuation of therapy
- Prolong use of thiazide can cause hypercalcemia, hypophosphatemia, and hypomagnesemia
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Renal artery stenosis
- Volume depletion
- Congestive heart failure
- Severe CAD
- Diabetes mellitus
- Hypotension
- Hypertrophic cardiomyopathy
- Postsympathectomy
- Collagen vascular disease
- Hyponatremia
- Black patients
- Antigen desensitization treatment
- Surgery/Anesthesia
- SLE
- History of gout
- Low-density lipoprotein apheresis with dextran sulfate
- Geriatrics
Pregnancy Category:D
Breastfeeding: As low level of benazepril is excreted in breastmilk, amount ingested by the infant is small and would not be expected to cause any adverse effects in breastfed infants. During lactation hydrochlorothiazide at a dose of 50 mg daily or less is acceptable. Intense diuresis with large doses may decrease breastmilk production. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 21 February 2011). As per manufacturer's data minimal amount of benazepril and benazeprilat are excreted into the breast milk and thiazides are definitely excreted into breast milk. Because of the potential for serious adverse reactions from hydrochlorothiazide and the unknown effects of benazepril in nursing infants, a decision should be made whether to discontinue nursing or to discontinue benazepril/hydrochlorothiazide taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
benazepril/hydrochlorothiazide (generic)
- TABS
- 5 mg/6.25 mg
- 10 mg/12.5 mg
- 20 mg/12.5 mg
- 20 mg/25 mg
Lotensin HCT (benazepril/hydrochlorothiazide)
- TABS:
- 5 mg/6.25 mg
- 10 mg/12.5 mg
- 20 mg/12.5 mg
- 20 mg/25 mg
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Lotensin HCT 10-12.5 MG TABS [Bottle] (NOVARTIS)
30 mg = $62.99
90 mg = $175.98 - Lotensin HCT 20-25 MG TABS [Bottle] (NOVARTIS)
30 mg = $65.99
90 mg = $179.97 - Lotensin HCT 20-12.5 MG TABS [Bottle] (NOVARTIS)
30 mg = $63.99
90 mg = $168.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
