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Lotensin 20mg Tablet
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Indications & Clinical Uses
- Lotensin 20 mg tablets contain benazepril hydrochloride, an angiotensin-converting enzyme (ACE) inhibitor.
- It is approved for the treatment of high blood pressure (hypertension), used alone or with other blood pressure medicines, to lower blood pressure and so reduce the risk of cardiovascular events, particularly strokes and heart attacks.
- It is also approved for children aged 6 years and over.
- Lotensin comes as 10 mg, 20 mg and 40 mg tablets.
- In adults not taking a diuretic, treatment usually starts at 10 mg once daily with a maintenance range of 20 mg to 40 mg a day, given once daily or split into two doses; adults already on a diuretic, and people with a glomerular filtration rate below 30 mL/min, start at 5 mg once daily.
- Lotensin is taken by the patient at home.
- The Lotensin brand is now marketed in the United States by Validus Pharmaceuticals, and generic benazepril tablets are widely available.
Side Effects
- Lotensin carries a BOXED WARNING on FETAL TOXICITY: when pregnancy is detected, Lotensin must be stopped as soon as possible, because medicines acting directly on the renin-angiotensin system can injure and kill the developing baby.
- The most common side effects are headache (about 6%), dizziness (about 4%), drowsiness and dizziness on standing (about 2% each).
- A dry, persistent cough is typical of ACE inhibitors and is the commonest reason people stop treatment.
- Serious reactions to recognise are angioedema - swelling of the face, lips, tongue, throat, limbs or bowel, which has occasionally been fatal and needs emergency treatment; severe low blood pressure with fainting; a high potassium level, which can disturb the heart rhythm; worsening kidney function; and, rarely, jaundice or liver failure.
- Get emergency help for swelling of the face or tongue, difficulty breathing or swallowing, or yellowing of the skin or eyes.
Precautions & Warnings
- Blood pressure should be checked regularly, and kidney function and serum potassium monitored periodically, especially in the first weeks and in people with kidney disease, diabetes, heart failure or dehydration from diuretics, vomiting or diarrhoea.
- Lotensin is CONTRAINDICATED if you have ever had angioedema, including angioedema after any ACE inhibitor, and in people allergic to benazepril or other ACE inhibitors.
- Do not take it with a neprilysin inhibitor such as sacubitril/valsartan, and allow a 36-hour gap when switching.
- Do not combine it with aliskiren if you have diabetes.
- Lotensin must NOT be used in pregnancy at any stage; tell your healthcare provider at once if you become pregnant or plan to.
- Dizziness is common when starting or after a dose increase, so take care when driving, standing up quickly or in hot weather.
- Lower starting doses are used in kidney impairment.
- Store the tablets below 30°C and protect them from moisture.
Avoid Interactions
- Medicines that INCREASE the risk of harm with Lotensin are potassium supplements, potassium-containing salt substitutes and potassium-sparing diuretics such as spironolactone, amiloride, triamterene and eplerenone, which raise potassium; other diuretics and alcohol, which deepen the drop in blood pressure; lithium, whose blood levels and toxicity rise; angiotensin receptor blockers or aliskiren, because dual blockade of the renin-angiotensin system increases low blood pressure, high potassium and kidney failure; mTOR inhibitors such as sirolimus and neprilysin inhibitors, which raise the risk of angioedema; and antidiabetic medicines including insulin, because low blood sugar becomes more likely.
- Injectable gold can cause nitritoid reactions.
- Non-steroidal anti-inflammatory drugs including ibuprofen and COX-2 inhibitors REDUCE the blood pressure-lowering effect and can impair kidney function, especially in older or dehydrated people.
- Tell your healthcare provider about every medicine, herbal product and supplement you take.
References
Frequently Asked Questions
Lotensin (benazepril) 20 mg tablets treat high blood pressure in adults and in children aged 6 years and over. Lowering blood pressure reduces the risk of strokes and heart attacks. It can be used alone or alongside other blood pressure medicines such as a diuretic.
Lotensin (benazepril) is usually started at 10 mg once daily, with a maintenance dose of 20 mg to 40 mg daily taken once a day or split into two doses. Take it with or without food at the same time each day. People on a diuretic start at 5 mg.
Common Lotensin (benazepril) side effects are headache in about 6%, dizziness in about 4%, drowsiness and dizziness on standing. A dry persistent cough is typical of ACE inhibitors. Get emergency help for angioedema - swelling of the face, lips, tongue or throat - which can be fatal.
No. Lotensin (benazepril) has a boxed warning for fetal toxicity: medicines acting on the renin-angiotensin system can injure and kill an unborn baby. Stop Lotensin as soon as pregnancy is detected and tell your healthcare provider immediately if you become pregnant or plan to.
Avoid potassium supplements, potassium-based salt substitutes and potassium-sparing diuretics with Lotensin (benazepril), as they raise potassium dangerously. Avoid ibuprofen and other NSAIDs, which reduce its effect and harm the kidneys. Never combine it with sacubitril/valsartan, or with aliskiren if you have diabetes.
While taking Lotensin (benazepril) your healthcare provider should check serum potassium and kidney function periodically, particularly in the first weeks and if you have kidney disease, diabetes or heart failure. Blood pressure is monitored closely for the first 2 weeks, when hypotension is most likely.
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