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LOTENSIN HCT
Hypertension
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Drug Name:

LOTENSIN HCT Rx

Generic Name and Formulations:
Benazepril (as HCl), hydrochlorothiazide; 10mg/12.5mg, 20mg/12.5mg, 20mg/25mg; scored tabs.

Company:
Validus Pharmaceuticals

Therapeutic Use:

Indications for LOTENSIN HCT:

Hypertension (not for initial therapy).

Adult:

Switching from monotherapy with either component: initially 10/12.5mg once daily; may increase after 2–3 weeks as needed up to max 20/25mg daily. Or, substitute for individually titrated components.

Children:

Not established.

Contraindications:

History of ACEI-associated or other angioedema. Anuria. Sulfonamide allergy. Concomitant neprilysin inhibitors (eg, sacubitril); do not administer benazepril/HCT within 36hrs of switching to or from sacubitril/valsartan. Concomitant aliskiren in patients with diabetes.

Boxed Warning:

Fetal toxicity.

Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Discontinue if angioedema, laryngeal edema, jaundice or marked elevations of hepatic enzymes develop. Salt/volume depletion; correct prior to initiation. Severe CHF. Renal or hepatic impairment. Dialysis (esp. high-flux membrane). Renal artery stenosis. Monitor WBCs in renal or collagen vascular disease. Surgery. Postsympathectomy. SLE. Diabetes. Gout. Hypercalcemia; avoid. Acute myopia. Secondary angle-closure glaucoma. Monitor BP, electrolytes and renal function periodically. Black patients may have higher rate of angioedema than non-Black patients. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.

Pharmacological Class:

ACE inhibitor + diuretic (thiazide).

Interactions:

See Contraindications. Increased risk of angioedema with concomitant mTOR inhibitors (eg, temsirolimus, sirolimus, everolimus) or neprilysin inhibitors. Potassium or potassium-sparing diuretics may cause hyperkalemia. May increase lithium levels. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). 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). Potentiated by antihypertensives, anticholinergics. Potentiates skeletal muscle relaxants. Antagonizes norepinephrine. Orthostatic hypotension potentiated by alcohol, CNS depressants. Thiazide-induced hypokalemia or hypomagnesemia may predispose patients to digoxin toxicity. Adjust antidiabetic drugs. Renal excretion may be reduced and myelosuppression enhanced with antineoplastic agents. Antagonized by pro-kinetic drugs. Increased risk of hyperuricemia with cyclosporine. Anion exchange resins; administer at least 4hrs before or 4–6hrs after resin administration. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare. May interfere with parathyroid test.

Adverse Reactions:

Dizziness, fatigue, orthostatic hypotension, headache, cough, hypertonia, vertigo, nausea, impotence, somnolence, electrolyte imbalance; rare: hepatic failure.

Metabolism:

Hepatic. Approx. 96% protein bound.

Elimination:

Renal (primarily), biliary.

Generic Availability:

YES

How Supplied:

Tabs—100

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