Renal Dose Adjustment (Based on Crcl)
- CrCl
30 mL/min: Not recommended - CrCl > 30 mL/min: No dose adjustments
Hepatic Dose Adjustment
- Hepatic Impairment: Use low doses
See Supplemental Patient Information
- Anaphylactoid reactions including head, neck or intestinal angioedema have occurred. angioedema associated with laryngeal edema may be fatal. Discontinue therapy and immediately treat laryngeal stridor or angioedema of the face, tongue, or glottis. Administer subcutaneous epinephrine injection 1:1000 (0.3-0.5 mL) when involvement of the tongue, glottis, or larynx appears likely to cause airway obstruction
- 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 may occur; volume or salt depleted patients, patients with congestive heart failure with or without associated renal insufficiency, patients with severe aortic stenosis are more prone. Initiate therapy with close medical supervision in patients with CHF; closely monitor for first 2 wks of treatment and whenever the dosage of the benazepril component is increased or on addition of diuretic or its dosage is increased
- Exacerbation of angina and acute MI may develop after starting or increasing the dose of amlodipine, especially in patients with severe obstructive coronary artery disease. Use cautiously in patients with aortic or mitral stenosis, or obstructive hypertrophic cardiomyopathy
- Injury and death have occurred in developing fetus due to drugs that act directly on the renin-angiotensin system. Immediately discontinue therapy on detection of pregnancy [US Black Box Warning]
- Cholestatic jaundice progressing to fulminant hepatic necrosis and sometimes death have occurred; discontinue therapy and receive appropriate medical treatment
- Oliguria, progressive azotemia, rare occasions of acute renal failure and/or death have occurred in patients with severe heart failure whose renal function depends on the activity of the renin-angiotensin-aldosterone system
- Monitor BUN/Cr at baseline, then periodically, or more frequently if CHF, renal artery stenosis
- Hyperkalemia (serum potassium at least 0.5 mEq/L >ULN) has occurred; periodically monitor serum potassium
- Due to inhibition of the degradation of endogenous bradykinin persistent nonproductive cough has occurred
- Monitor WBC if collagen vascular disease, especially if renal impairment
Cautions: Use cautiously in
- Renal impairment
- Renal artery stenosis
- Dialysis with high-flux membranes
- Hepatic impairment
- Volume depletion
- CHF
- Severe CAD
- Diabetes mellitus
- Hypotension
- Hypertrophic cardiomyopathy
- LDL apheresis with dextran
- Cerebrovascular disease
- Collagen vascular disease
- Aortic stenosis
- Hyponatremia
- Black patients
- Antigen desensitization treatment
- Surgery/Anesthesia
- Concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes
- Geriatrics
Supplemental Patient Information
- Female patients of childbearing age should be warned about the effects of the drug on the fetus; discuss other treatment options with female patients planning to become pregnant
Pregnancy Category:D
Breastfeeding: Safety unknown; Prefer an alternative drug during breastfeeding as appropriate literature on the use of amlodipine is unavailable. As low levels of benazepril are excreted in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse reactions in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 9 December 2010). Small amounts of unchanged benazepril and benazeprilat are excreted into the breast milk of lactating women, so a newborn child ingesting breast milk would receive <0.1% of the maternal doses. Unknown whether the amlodipine is excreted in human milk. Manufacturer advises to discontinue nursing or therapy.
US Trade Name(s)
US Availability
amlodipine/benazepril (generic)
- CAPS:
- 2.5 mg/10 mg
- 5 mg/10 mg
- 5 mg/20 mg
- 5 mg/40 mg
- 10 mg/20 mg
- 10 mg/40 mg
Lotrel (amlodipine/benazepril)
- CAPS:
- 2.5 mg/10 mg
- 5 mg/10 mg
- 5 mg/20 mg
- 5 mg/40 mg
- 10 mg/20 mg
- 10 mg/40 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.
- Lotrel 10-20 MG CAPS [Bottle] (NOVARTIS)
30 mg = $158.99
90 mg = $461.99 - Lotrel 10-40 MG CAPS [Bottle] (NOVARTIS)
30 mg = $175
90 mg = $499.97 - Lotrel 2.5-10 MG CAPS [Bottle] (NOVARTIS)
30 mg = $123.99
90 mg = $345.98 - Lotrel 5-10 MG CAPS [Bottle] (NOVARTIS)
30 mg = $139.99
90 mg = $399.96 - Lotrel 5-10 MG CAPS [Bottle] (NOVARTIS)
30 mg = $127.99
90 mg = $350.96 - Lotrel 5-40 MG CAPS [Bottle] (NOVARTIS)
30 mg = $145.98
90 mg = $426.95
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.
