Lotrel
Generic Name
Amlodipine + Benazepril
Manufacturer
Novartis (original brand)
Country
USA (originally marketed), Switzerland (Novartis HQ)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lotrel 05 suspension | ৳ 175.00 | N/A |
Description
Overview of the medicine
Lotrel is a combination medication containing Amlodipine (a calcium channel blocker) and Benazepril (an ACE inhibitor). It is used to treat high blood pressure (hypertension) by relaxing blood vessels and making it easier for the heart to pump blood.
Uses & Indications
Dosage
Adults
Typically, 1 capsule once daily. Dosage may be adjusted based on individual patient response and tolerability, starting from lower strengths and titrating upwards. Max dose: 10mg Amlodipine/40mg Benazepril daily.
Elderly
Lower initial doses and careful titration are recommended due to potential for decreased renal function and increased sensitivity.
Renal_impairment
For patients with creatinine clearance <30 mL/min, the recommended initial dose is 2.5mg Amlodipine/10mg Benazepril. Max dose 5mg Amlodipine/20mg Benazepril daily.
How to Take
Take orally once daily, with or without food. Swallow the capsule whole.
Mechanism of Action
Amlodipine blocks calcium channels, causing vasodilation and reduced peripheral resistance. Benazepril inhibits Angiotensin-Converting Enzyme (ACE), reducing the formation of angiotensin II (a vasoconstrictor) and aldosterone secretion, leading to vasodilation, decreased sodium/water retention, and reduced blood pressure.
Pharmacokinetics
Onset
Amlodipine: Gradual onset (6-12 hours for peak effect). Benazepril: Onset within 1 hour.
Excretion
Amlodipine is excreted via urine (60-80% as metabolites, 10% unchanged). Benazeprilat is excreted equally by renal (50%) and biliary (50%) routes.
Half life
Amlodipine: 30-50 hours. Benazeprilat: 10-11 hours.
Absorption
Amlodipine is well absorbed orally, bioavailability 64-90%. Benazepril is rapidly absorbed, converted to active benazeprilat, bioavailability of benazeprilat about 37%.
Metabolism
Amlodipine is extensively metabolized in the liver to inactive metabolites. Benazepril is largely metabolized in the liver to its active metabolite benazeprilat.
Side Effects
Contraindications
- Hypersensitivity to amlodipine, benazepril, or any other ACE inhibitor.
- History of angioedema related to previous ACE inhibitor treatment.
- Hereditary or idiopathic angioedema.
- Concomitant use with aliskiren in patients with diabetes mellitus.
- Pregnancy (especially 2nd and 3rd trimesters).
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity.
Diuretics
Increased risk of symptomatic hypotension.
Simvastatin
Limit simvastatin dose to 20 mg daily with amlodipine.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of benazepril and worsen renal function.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
CYP3A4 inducers (e.g., rifampicin, St. John's wort)
May decrease amlodipine exposure.
CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir)
May increase amlodipine exposure.
Storage
Store at room temperature (20-25°C or 68-77°F), away from moisture, heat, and direct light. Keep out of reach of children.
Overdose
Symptoms of overdose may include marked hypotension (low blood pressure), bradycardia (slow heart rate), and electrolyte disturbances. Treatment is symptomatic and supportive, including gastric lavage, activated charcoal, and intravenous fluids to correct hypotension.
Pregnancy & Lactation
Lotrel is contraindicated in pregnancy, especially during the second and third trimesters, due to the risk of fetal injury or death from the ACE inhibitor component. Discontinue if pregnancy is detected. Both amlodipine and benazepril/benazeprilat are present in breast milk. Caution should be exercised, or breastfeeding should be avoided.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies
Approval Status
FDA approved
Patent Status
Generic versions available, patent expired
Clinical Trials
Clinical trials have demonstrated the efficacy and safety of Lotrel in reducing blood pressure in patients with hypertension. Studies showed it provides greater blood pressure reduction than either component alone.
Lab Monitoring
- Blood pressure monitoring
- Renal function (serum creatinine, BUN)
- Electrolytes (especially potassium)
- Liver function tests (periodically)
Doctor Notes
- Regularly monitor patient's blood pressure, renal function, and serum potassium levels.
- Counsel patients on the risk of angioedema and to seek immediate medical attention if symptoms occur.
- Avoid use in pregnant patients, and switch to alternative antihypertensive therapy if pregnancy is confirmed.
Patient Guidelines
- Take Lotrel exactly as prescribed by your doctor.
- Do not stop taking Lotrel without consulting your doctor, even if you feel well.
- Report any signs of angioedema (swelling of the face, lips, tongue, or throat) immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Lotrel may cause dizziness, lightheadedness, or fatigue, especially when you first start taking it or when the dose is increased. Avoid driving or operating machinery until you know how this medication affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and limit alcohol consumption.
- Manage stress effectively.
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Global Brand Names
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