J Chromatogr B Analyt Technol
Biomed Life Sci. 2005 Jan 25;814(2):303-8.
Simultaneous determination of benazepril hydrochloride
and benazeprilat in plasma by high-performance liquid chromatography/electrospray-mass
spectrometry.
Xiao W, Chen B, Yao S, Cheng Z.
Key Laboratory of Chemical Biology and Traditional Chinese Medicine
Research (Hunan Normal University), Ministry of Education, Hunan Normal
University, Changsha 410081, PR China.
Myocardial infarction, stroke, heart failure and end-stage renal disease
have all been linked to inadequate control of blood pressure. Despite overwhelming
evidence that uncontrolled hypertension is responsible for a sizeable number
of adverse health-related outcomes, control of the disease remains considerably
suboptimal. Available data demonstrate that in order to achieve adequate
blood pressure control, a large number of patients require therapy with
more than one medication. Fixed dose combination antihypertensive therapy
has many advantages over other treatment options. Positive effects on blood
pressure control, rates of adherence, adverse effects and cost have been
identified. Amlodipine/benazepril (Lotrel), Novartis) is a fixed dose combination
product indicated for the treatment of hypertension. Although not currently
recommended as first-line therapy, studies confirm that this combination
of a long-acting calcium antagonist and an angiotensin-converting enzyme
(ACE) inhibitor possesses substantial blood pressure lowering capabilities.
Whereas adverse events tend to become more frequent with increasing doses
of antihypertensive monotherapy, the rate of adverse events attributed to
amlodipine/benazepril in clinical trials often correlates with rates ascribed
to placebo. Amlodipine/benazepril is capable of sustaining blood pressure
control over a 24 h period and appears to be minimally affected by an occasional
dose omission. Unlike the older calcium antagonists, amlodipine is unlikely
to cause alterations in myocardial contractility. Additionally, the amlodipine/benazepril
combination product costs less than the same therapy administered as the
individual components. It is, therefore, reasonable to consider therapy
with amlodipine/benazepril in appropriate patients after an adequate trial
of antihypertensive monotherapy. |
Expert Opin Pharmacother. 2001
Jan;2(1):165-78.
Amlodipine/benazepril: fixed dose
combination therapy for hypertension.
Faulkner
MA, Hilleman DE.
Creighton University School of Pharmacy and Allied Health Professions,
2500 California Plaza, Omaha, Nebraska 68178, USA.
Myocardial infarction, stroke, heart failure and end-stage renal disease
have all been linked to inadequate control of blood pressure. Despite overwhelming
evidence that uncontrolled hypertension is responsible for a sizeable number
of adverse health-related outcomes, control of the disease remains considerably
suboptimal. Available data demonstrate that in order to achieve adequate
blood pressure control, a large number of patients require therapy with
more than one medication. Fixed dose combination antihypertensive therapy
has many advantages over other treatment options. Positive effects on blood
pressure control, rates of adherence, adverse effects and cost have been
identified. Amlodipine/benazepril (Lotrel), Novartis) is a fixed dose combination
product indicated for the treatment of hypertension. Although not currently
recommended as first-line therapy, studies confirm that this combination
of a long-acting calcium antagonist and an angiotensin-converting enzyme
(ACE) inhibitor possesses substantial blood pressure lowering capabilities.
Whereas adverse events tend to become more frequent with increasing doses
of antihypertensive monotherapy, the rate of adverse events attributed to
amlodipine/benazepril in clinical trials often correlates with rates ascribed
to placebo. Amlodipine/benazepril is capable of sustaining blood pressure
control over a 24 h period and appears to be minimally affected by an occasional
dose omission. Unlike the older calcium antagonists, amlodipine is unlikely
to cause alterations in myocardial contractility. Additionally, the amlodipine/benazepril
combination product costs less than the same therapy administered as the
individual components. It is, therefore, reasonable to consider therapy
with amlodipine/benazepril in appropriate patients after an adequate trial
of antihypertensive monotherapy.
|
| GENERIC NAME: benazepril
BRAND NAME: Lotensin
DRUG CLASS AND MECHANISM: Benazepril is an ACE (angiotensin
converting enzyme) inhibitor. ACE is an enzyme in the body which is important
for the formation of angiotensin II. Angiotensin II causes constriction
of arteries in the body, thereby elevating blood pressure. ACE inhibitors
such as benazepril lower blood pressure by inhibiting the formation of
angiotensin II, thus relaxing the arteries. Relaxing the arteries not
only lowers blood pressure, but also improves the pumping efficiency of
a failing heart and improves cardiac output in patients with heart failure.
PREPARATIONS: tablets: 5 mg, 10 mg, 20 mg, 40 mg.
STORAGE: Tablets should be stored at room temperature
in a tightly closed container.
PRESCRIBED FOR: Benazepril can be used alone in treating
high blood pressure. Its blood pressure lowering effect can be further
enhanced by the addition of a diuretic medication. Lotensin HCT is an
example of a medication which combines the effect of benazepril with a
thiazide type diuretic (water pill) in treating hypertension. By reducing
resistance in the arteries, benazepril can be useful in the treatment
of congestive heart failure.
DOSING: May be taken on an empty or full stomach.
DRUG INTERACTIONS: Benazepril should not be taken by
people with a known allergy to ACE inhibitors. Swelling of the facial
tissues and even the upper airways has been reported with ACE inhibitors
on very rare occasions, and can lead to serious breathing difficulties.
Benazepril can interact with diuretics (water pills) and other blood pressure
medicines to cause an excessive drop in blood pressure, which can result
in symptoms of weakness, dizziness, and lightheadedness. Worsening of
kidney function has been reported with ACE inhibitors, especially in patients
with severe heart failure or pre-existing kidney disease. Combining benazepril
with potassium supplements, potassium containing salt substitutes, and
potassium conserving diuretics such as amiloride (Moduretic), spironolactone
(Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously
high blood levels of potassium. Indomethacin (Indocin) and possibly other
anti-inflammatory medications may decrease the blood pressure lowering
effect of benazepril.
In rare instances, low white blood cell counts have been reported with
the use of another ACE inhibitor. Low white blood cells increase the patient's
risk of infections. When taken with lithium, benazepril can increase lithium
to toxic levels in the blood. Safe use in children is not established.
It is not habit forming.
PREGNANCY: ACE inhibitors, including benazepril, can
be harmful to the fetus and should not be taken by pregnant women.
NURSING MOTHERS: It is also avoided in nursing mothers.
SIDE EFFECTS: Benazepril is generally well tolerated
and side effects are usually mild and transient. A dry, persistent cough
has been reported with the use of benazepril and other ACE inhibitors.
Coughing resolves after discontinuing the medication. Other side effects
are rare and include abdominal pain, constipation, diarrhea, dizziness,
fatigue, headache, loss of taste, loss of appetite, nausea and vomiting,
easy bruising or bleeding, chest pain, chills, difficulty breathing, severe
dizziness or fainting, fever, numbness or tingling in the hands or feet,
rash, and a sore or swollen throat. In rare instances, liver dysfunction
and skin yellowing (jaundice) have been reported with ACE inhibitors.
Caution! Before starting
to take this medicine, it is vital that you should consult your doctor!
Do not use it on your own initiative, without medical advice. |
