Benazepril / Hydrochlorothiazide Dosage
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Hypertension
Initial dose: 1 tablet of (benazepril-hydrochlorothiazide 5 mg-6.25 mg) orally once a day; dosage should be determined by individual titration
Maintenance dose: May increase up to 2 tablets of (benazepril-hydrochlorothiazide 20 mg-25 mg)/day in 1 to 2 divided doses
Renal Dose Adjustments
CrCl 30 mL/min or less: Not recommended.
Liver Dose Adjustments
The manufacturer recommends caution when administering this drug to patients with liver dysfunction or progressive liver disease.
The benazepril dosage may be titrated every 5 to 7 days. The hydrochlorothiazide dose should generally not be increased until 2 to 3 weeks have elapsed.
Angiotensin converting enzyme (ACE) inhibitors can cause fetal and neonatal morbidity and death when administered to pregnant women. Several dozen cases have been reported in the world literature. When pregnancy is detected, ACE inhibitors should be discontinued as soon as possible. If no alternative to ACE inhibitor therapy is available, patients should be made aware of the risks to their fetuses and the intra-amniotic environment should be evaluated by serial ultrasound examinations. If oligohydramnios develops, benazepril should be discontinued unless it is considered life-saving for the mother. Depending on the week of pregnancy, contraction stress testing, a non-stress test, or biophysical profiling may be appropriate.
To minimize dose-dependent side effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy.
Some patients may be at risk of excessive hypotension, particularly those having heart failure with systolic blood pressure below 100 mmHg, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. If symptomatic hypotension develops, a dose reduction or discontinuation of benazepril or concomitant diuretic may be necessary.
Benazepril and benazeprilat are substantially excreted by the kidney. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in this population, and it may be useful to monitor renal function.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Benazepril is slightly dialyzable by hemodialysis. Data not available for hydrochlorothiazide.
The fixed combination tablet is not indicated for the initial treatment of hypertension. A patient whose blood pressure is not adequately controlled with benazepril monotherapy may be switched to benazepril-hydrochlorothiazide 10 mg-12.5 mg or 20 mg-12.5 mg. Further increases of either or both components depend on clinical response.
Patients whose blood pressure is adequately controlled with hydrochlorothiazide at 25 mg daily, but who experience significant potassium loss with this regimen, may achieve similar blood pressure control without electrolyte disturbance if they are switched to benazepril-hydrochlorothiazide 5 mg-6.25 mg.
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