Generic Name and Formulations:
Amlodipine (as besylate), benazepril (as HCl); 2.5mg/10mg, 5mg/10mg, 5mg/20mg, 5mg/40mg, 10mg/20mg, 10mg/40mg; caps.
Novartis Pharmaceuticals Corp
Indications for LOTREL:
Hypertension (not for initial therapy).
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.
History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36hrs of switching to or from sacubitril/valsartan.
Fetal toxicity may develop; discontinue if pregnancy is detected. Salt/volume depletion. 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 if angioedema, laryngeal edema, jaundice or marked elevation in liver enzymes occurs. Monitor BP, electrolytes and renal function. Black patients may have higher risk of angioedema than non-black patients. Neonates. Elderly. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.
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.
Calcium channel blocker (CCB) (dihydropyridine) + ACE inhibitor.
Cough, edema, fatigue, dizziness, GI upset, angioedema, hypotension, hyperkalemia, palpitations, flushing, anaphylactoid reactions; rare: hepatic failure.
Clinical Pain Advisor Articles
- Deaths After Nonfatal Opioid Overdose: Causes and Risk Factors
- Treatment for Opioid Use Disorder Associated With Reduced Risk for Opioid-Related Deaths
- Opioid-Free Analgesia Use for Postsurgical Pain Limited
- Clonidine May Not Improve Post-Cesarean Delivery Analgesia
- No Added Value With Liposomal Bupivacaine Following TKA With Peripheral Nerve Block
- Recommendations for Perioperative Pain Management in Patients With Opioid Tolerance
- Vertebroplasty Comparable With Placebo for Acute Vertebral Compression Fractures
- Capsaicin 8% Patch May Be Effective in Neuropathic Pain
- Detox vs Medication-Assisted Treatment for Opioid Use Disorder in Pregnancy: Expert Roundtable
- Prior Authorization Policy May Help Reduce Long-Acting Opioid Use
- Opioid-Related Deaths Represent Significant Public Health Burden
- Addressing Confidentiality Concerns With Electronic Access to Pediatric Medical Records
- Opioid-Related Adverse Events Common After Invasive Procedures
- Diagnosis and Treatment of Migraine in Children Should Consider Atopy
- Led by AG Sessions, DOJ Declines to Defend ACA Against Federal Lawsuit