Home Drug Guide Benazepril Hydrochloride; Hydrochlorothiazide

Drug Guide

Generic Name

Benazepril Hydrochloride; Hydrochlorothiazide

Brand Names Lotensin Hct, Benazepril Hydrochloride And Hydrochlorothiazide

Classification

Therapeutic: Antihypertensive, Diuretic

Pharmacological: ACE inhibitor and Thiazide diuretic

FDA Approved Indications

Hypertension

Mechanism of Action

Benazepril inhibits the angiotensin-converting enzyme (ACE), leading to vasodilation and reduced blood pressure. Hydrochlorothiazide inhibits sodium and chloride reabsorption in the distal tubules of the kidney, promoting diuresis and lowering blood pressure.

Dosage and Administration

Adult: Typically start with 10 mg benazepril once daily; dose may be titrated up as needed. Hydrochlorothiazide 12.5 mg may be added or increased depending on response.

Pediatric: Not commonly used in children for hypertension; consult specific pediatric guidelines.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Adjust dose based on renal function; contraindicated in certain severe renal impairments with electrolyte disturbances.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Benazepril is extensively bound to plasma proteins; hydrochlorothiazide has moderate protein binding.

Metabolism: Benazepril is metabolized in the liver to active benazeprilat; hydrochlorothiazide undergoes minimal hepatic metabolism.

Excretion: Renal excretion for both drugs; benazeprilat mainly via urine, hydrochlorothiazide primarily via urine.

Half Life: Benazepril: approximately 12 hours; hydrochlorothiazide: approximately 6-15 hours.

Contraindications

History of angioedema related to previous ACE inhibitor treatment, allergies to sulfonamides, anuria.

Precautions

Pregnancy (risk of fetal toxicity), renal impairment, electrolyte disturbances, combination therapy with other antihypertensives.

Adverse Reactions - Common

Cough (Common)
Dizziness (Common)
Hyperkalemia (Uncommon)

Adverse Reactions - Serious

Angioedema (Rare)
Hypotension (Rare)
Electrolyte imbalances (high potassium, low sodium) (Uncommon)

Drug-Drug Interactions

Potassium supplements, other antihypertensives, Lithium, NSAIDs

Drug-Food Interactions

Excess potassium intake may increase risk of hyperkalemia.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, electrolyte levels, renal function, signs of angioedema.

Diagnoses:

Risk for injury related to hypotension.
Electrolyte imbalance.

Implementation: Administer as prescribed, monitor response, educate patient about orthostatic hypotension.

Evaluation: Assess blood pressure response, electrolyte levels, and patient adherence.

Patient/Family Teaching

Take medication exactly as prescribed.
Rise slowly to prevent dizziness.
Report signs of angioedema, persistent cough, or hyperkalemia.
Maintain hydration and dietary potassium intake as advised.

Special Considerations

Black Box Warnings:

Fetal toxicity during pregnancy.

Genetic Factors: ACE inhibitors may cause angioedema more frequently in certain populations.

Lab Test Interference: May increase serum potassium, change renal function tests.

Overdose Management

Signs/Symptoms: Severe hypotension, electrolyte disturbances.

Treatment: Supportive care, monitor blood pressure and electrolytes, administer vasopressors if needed.

Storage and Handling

Storage: Store at room temperature, 20-25°C.

Stability: Stable when stored properly.