Amlodipine Besylate-Benazepril

( Lotrel )

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Mar 28, 2023

Warnings


Amlodipine-Benazepril (Lotrel) Risks, Warnings, and Complications


Amlodipine and benazepril can cause serious health problems in some people. Talk to your doctor or pharmacist about other treatment options for high blood pressure if you are at increased risk of complications from this medication combination. Some of the risks of taking amlodipine and benazepril include:

  • RISK DURING PREGNANCY: The combination of amlodipine and benazepril can be harmful to an unborn baby and may cause birth defects. Do not take amlodipine-benazepril if you're pregnant or planning a pregnancy. Your doctor can offer another blood pressure medicine.

  • COUGH: Some people develop a cough or minor throat irritation when taking ACE inhibitors. This can happen at any time while on amlodipine-benazepril because benazepril is an ACE inhibitor. Talk to your doctor about other options to treat hypertension if you have a history of ACE inhibitor induced cough or you develop a bothersome cough after starting this combination of medicines. 

  • SWELLING: Taking amlodipine and benazepril can put you at risk of developing angioedema (swelling in the face, eyes, lips, tongue, and throat, or other organs). This can happen at any time after starting the medicine. African-Americans are at greater risk of this occurring. Stop amlodipine-benazepril and call your doctor without delay or seek emergency medical help if you develop swelling in the head and neck.

  • HIGH POTASSIUM: Taking amlodipine and benazepril can increase potassium levels in the body, which can cause problems with your heart. Your doctor may order frequent blood tests to check your potassium levels while you are on this medication combination. Risk factors for this happening include pre-existing kidney disease, taking potassium supplements or salt substitutes, and taking other medications that can also raise potassium levels.

  • CARDIAC COMPLICATIONS: Very rarely, a small number of people can develop severe chest pain or heart attack when starting amlodipine and benazepril or after dose adjustments. The risk is greater in people who have severe coronary artery disease (heart disease). Talk to your doctor about other treatment options if you are at risk of this complication.

  • KIDNEY PROBLEMS: Amlodipine and benazepril can damage your kidneys and cause them to stop working properly. Your doctor may order blood tests to check kidney function before starting amlodipine-benazepril and then every year. The risk is greater in people with pre-existing kidney problems.

  • LIVER PROBLEMS: Rarely, amlodipine and benazepril can also cause severe liver problems. Tell your doctor right away if you develop symptoms of liver problems, such as yellowing of your skin, nausea, vomiting, or dark or brown urine while on this medicine.

  • LOW BLOOD PRESSURE: Amlodipine and benazepril can lower your blood pressure and cause dizziness, lightheadedness, and fainting. Risk factors include having diarrhea or vomiting for a long time, not enough fluid and low salt levels in your body, taking high doses of diuretic medications and history of narrow heart valves, such as aortic stenosis. If your blood pressure drops severely and you feel dizzy, sit down slowly and let your doctor know.


Precautions Before Starting Amlodipine-Benazepril (Lotrel)

Tell your doctor if you have ever had an allergic reaction to amlodipine (Norvasc, in Caduet, others), benazepril (Lotensin), any of the active or inactive ingredients in amlodipine-benazepril capsules, other calcium channel blockers (diltiazem, felodipine, others), other ACE inhibitors (lisinopril, enalapril, captopril, fosinopril, perindopril, moexipril, ramipril, quinapril, or trandolapril), or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, non-prescription medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between Lotrel (amlodipine and benazepril) and your other medicines. Specifically, tell your doctor if you have taken a heart medicine called sacubitril-valsartan (Entresto) within the last 36 hours. You should not take amlodipine and benazepril if you are on sacubitril and valsartan. Also tell your doctor if you have diabetes and are on a medication called aliskiren.

Give your doctor a complete medical history. Amlodipine-benazepril may not be right for people with certain medical conditions such as recent diarrhea or vomiting, diabetes, lupus, scleroderma, congestive heart failure, heart disease, liver problems, or kidney disease.

Tell your doctor if you are pregnant, could be pregnant, planning a pregnancy, or breast feeding. If you are a woman of childbearing age, talk to your healthcare provider about appropriate birth control during Lotrel therapy.

Precautions During Use of Amlodipine-Benazepril (Lotrel)

Keep all your healthcare appointments during Lotrel (amlodipine and benazepril) treatment. Your doctor may want to check your response to the medication and adjust the dose based on your blood pressure readings. They may order frequent blood tests to check kidney function and potassium levels while you are on amlodipine-benazepril.

Call your doctor if you become pregnant while on amlodipine and benazepril. 

Tell all your doctors you are on amlodipine-benazepril before any surgical procedure, including dental procedures.

Amlodipine-Benazepril (Lotrel) Drug Interactions

Certain other drugs can affect how amlodipine and benazepril work. Possible interactions between amlodipine-benazepril and other medicines can increase the risk of severe adverse effects. Some of the medications that can have interactions with this combination of blood pressure medicines include:

  • Sacubitril-valsartan
  • Aliskiren
  • Diuretics or water pills
  • Potassium supplements
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
  • Lithium (Lithobid)

The above list may not contain all the possible interactions of amlodipine-benazepril. Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.