Benazepril-hydroCHLOROthiazide

Benazepril-Hydrochlorothiazide is FDA-approved for the treatment of hypertension. It is often prescribed when a single medication is not sufficient to control blood pressure or when a combination approach is deemed appropriate by a healthcare provider.

Benazepril-Hydrochlorothiazide is contraindicated in patients with:

• A history of angioedema related to previous treatment with an ACE inhibitor.
• Known hypersensitivity to Benazepril, Hydrochlorothiazide, or any other component of the formulation.
• Anuria (inability to produce urine).
• Severe renal impairment.
• Use during pregnancy, especially in the second and third trimesters, due to the risk of fetal harm.
• Concurrent use with aliskiren in patients with diabetes.

Patients taking Benazepril-Hydrochlorothiazide should be advised to:

• Monitor their blood pressure regularly and report any significant changes to their healthcare provider.
• Avoid potassium supplements or salt substitutes containing potassium unless directed by a healthcare provider, as ACE inhibitors can increase potassium levels.
• Be cautious when standing up quickly from a sitting or lying position, as the medication may cause dizziness or lightheadedness, especially during the initial days of treatment.
• Drink plenty of fluids, but avoid excessive salt intake to help manage blood pressure and prevent dehydration due to the diuretic effect of Hydrochlorothiazide.
• Report any signs of angioedema (such as swelling of the face, lips, tongue, or throat) immediately, as this can be a serious side effect.

Common side effects of Benazepril-Hydrochlorothiazide may include:

• Dizziness or lightheadedness
• Cough (a common side effect of ACE inhibitors)
• Headache
• Fatigue
• Increased urination (due to the diuretic effect)

Serious side effects can include:

• Angioedema (swelling of the face, throat, or limbs)
• Hyperkalemia (high potassium levels)
• Hyponatremia (low sodium levels)
• Kidney dysfunction
• Severe hypotension (low blood pressure)

Patients should seek immediate medical attention if they experience symptoms of angioedema, severe dizziness, fainting, or unusual changes in their urine output.

• Angioedema: Benazepril can cause angioedema, a potentially life-threatening condition characterized by swelling of the deeper layers of the skin, often around the eyes and lips, and sometimes the throat. Patients with a history of angioedema are at higher risk.
• Hyperkalemia: Benazepril can increase blood potassium levels, particularly in patients with kidney disease, diabetes, or those taking potassium-sparing diuretics.
• Renal Function: The combination of Benazepril and Hydrochlorothiazide can affect kidney function, particularly in patients with pre-existing kidney conditions. Monitoring of renal function is advised, especially during the first few weeks of treatment.
• Hypotension: Severe hypotension can occur, particularly in patients who are volume-depleted or on diuretic therapy.
• Electrolyte Imbalances: Hydrochlorothiazide can cause imbalances in electrolytes, including low potassium, sodium, and magnesium levels, which require monitoring.

Benazepril-Hydrochlorothiazide may interact with other medications, including:

• Potassium-sparing diuretics and potassium supplements: Can increase the risk of hyperkalemia.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): May reduce the antihypertensive effects of Benazepril-Hydrochlorothiazide and increase the risk of kidney damage.
• Lithium: Co-administration with Benazepril-Hydrochlorothiazide can increase lithium levels and risk of lithium toxicity.
• Other blood pressure medications: Such as beta-blockers, calcium channel blockers, and diuretics, may have additive effects, leading to hypotension.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

Alternative treatments for hypertension include:

• Other ACE inhibitor/diuretic combinations: Such as Lisinopril-HCTZ or Enalapril-HCTZ.
• Angiotensin II receptor blockers (ARBs) with diuretics: Such as Losartan-HCTZ or Valsartan-HCTZ, which may be used in patients who cannot tolerate ACE inhibitors.
• Calcium channel blockers: Such as Amlodipine, often used in combination with other antihypertensive agents.
• Beta-blockers: Such as Metoprolol or Atenolol.
• Standalone diuretics: Such as Chlorthalidone.

The choice of treatment depends on the patient’s specific health condition, response to previous treatments, and any underlying medical conditions.