Generic name: amlodipine besylate and benazepril hydrochloride
Dosage form: capsule
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2.1 General Considerations
The recommended initial dose of Lotrel is one capsule of amlodipine 2.5 mg/benazepril 10 mg orally once daily.
It is usually appropriate to begin therapy with Lotrel only after a patient has either (a) failed to achieve the desired antihypertensive effect with amlodipine or benazepril monotherapy, or (b) demonstrated inability to achieve adequate antihypertensive effect with amlodipine therapy without developing edema.
The antihypertensive effect of Lotrel is largely attained within 2 weeks. If blood pressure remains uncontrolled, the dose may be titrated up to amlodipine 10 mg/benazepril 40 mg once daily. The dosing should be individualized and adjusted according to the patient’s clinical response.
Amlodipine is an effective treatment of hypertension in once-daily doses of 2.5-10 mg while benazepril is effective in doses of 10-80 mg. In clinical trials of amlodipine/benazepril combination therapy using amlodipine doses of 2.5-10 mg and benazepril doses of 10-40 mg, the antihypertensive effects increased with increasing dose of amlodipine in all patient groups, and the effects increased with increasing dose of benazepril in nonblack groups.
2.2 Dosage adjustment in renal impairment
Renal Impairment: Lotrel is not recommended in patients with creatinine clearance ≤ 30 mL/min. No dose adjustment of Lotrel is required in patients with creatinine clearance > 30 mL/min/1.73m2 (serum creatinine roughly ≤3 mg/dL or 265 µmol/L) [see Warnings and Precautions (5.7), Use in Specific Populations (8.7) and Clinical Pharmacology (12.3)].