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.

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.

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.