Drug
Lotrel
Pronounced
"am-LOE-di-peen/ben-AZ-e-pril"
Drug Interactions
See also Precautions section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: aliskiren, certain drugs that weaken the immune system/increase the risk of infection (such as everolimus, sirolimus), lithium, drugs that may increase the level of potassium in the blood (such as ARBs including losartan/valsartan, birth control pills containing drospirenone), gold injections, sacubitril.
Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking benazepril. Make sure all your doctors know which medicines you are using.
Negative Interactions
4- Potential Negative Interaction
Amlodipine-Benazepril
Pleurisy Root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as calcium channel blockers.
Pleurisy RootAmlodipine-Benazepril- Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.
- Potential Negative Interaction
Benazepril
Potassium
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels. This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements, potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others), or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems. Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.
PotassiumBenazepril- Good CB, McDermott L, McCloskey B. Diet and serum potassium in patients on ACE inhibitors. JAMA 1995;274:538.
- Rush JE, Merrill DD. The Safety and tolerability of lisinopril in clinical trials. J Cardiovasc Pharmacol 1987;9(Suppl 3):S99-107.
- Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1965-8.
- Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation. A potential for hyperkalemia. Arch Intern Med 1984;144:2371-2.
- Burnakis TG. Captopril and increased serum potassium levels. JAMA 1984;252:1682-3 [letter].
- Ray K, Dorman S, Watson R. Severe hyperkalemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens 1999;13:717-20.
- Stoltz ML. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA 1990;264:2737-8 [letter].
- Potential Negative Interaction
Amlodipine-Benazepril
Potassium
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels. This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements, potassium-containing salt substitutes (No Salt, Morton Salt Substitute, and others), or large amounts of high-potassium foods (including noni juice) at the same time as ACE inhibitors could cause life-threatening problems. Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.
PotassiumAmlodipine-Benazepril- Good CB, McDermott L, McCloskey B. Diet and serum potassium in patients on ACE inhibitors. JAMA 1995;274:538.
- Rush JE, Merrill DD. The Safety and tolerability of lisinopril in clinical trials. J Cardiovasc Pharmacol 1987;9(Suppl 3):S99-107.
- Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1965-8.
- Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation. A potential for hyperkalemia. Arch Intern Med 1984;144:2371-2.
- Burnakis TG. Captopril and increased serum potassium levels. JAMA 1984;252:1682-3 [letter].
- Ray K, Dorman S, Watson R. Severe hyperkalemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens 1999;13:717-20.
- Stoltz ML. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA 1990;264:2737-8 [letter].
- Potential Negative Interaction
Benazepril
Salt Substitutes
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels. This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements, potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others), or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems. Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.
Salt SubstitutesBenazepril- Good CB, McDermott L, McCloskey B. Diet and serum potassium in patients on ACE inhibitors. JAMA 1995;274:538.
- Rush JE, Merrill DD. The Safety and tolerability of lisinopril in clinical trials. J Cardiovasc Pharmacol 1987;9(Suppl 3):S99-107.
- Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1965-8.
- Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation. A potential for hyperkalemia. Arch Intern Med 1984;144:2371-2.
- Burnakis TG. Captopril and increased serum potassium levels. JAMA 1984;252:1682-3 [letter].
- Ray K, Dorman S, Watson R. Severe hyperkalemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens 1999;13:717-20.
- Stoltz ML. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA 1990;264:2737-8 [letter].
Supportive Interactions
4- Replenish Depleted Nutrients
Benazepril
Zinc
In a study of 34 people with hypertension, six months of captopril or enalapril (ACE inhibitors related to benazepril) treatment led to decreased zinc levels in certain white blood cells, raising concerns about possible ACE inhibitor–induced zinc depletion.
While zinc depletion has not been reported with benazepril, until more is known, it makes sense for people taking benazepril long term to consider, as a precaution, taking a zinc supplement or a multimineral tablet containing zinc. (Such multiminerals usually contain no more than 99 mg of potassium, probably not enough to trigger the above-mentioned interaction.) Supplements containing zinc should also contain copper, to protect against a zinc-induced copper deficiency.
ZincBenazepril- Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on zinc metabolism in hypertensive patients. J Am Coll Nutr 1998;17:75-8.
- Replenish Depleted Nutrients
Amlodipine-Benazepril
Zinc
In a study of 34 people with hypertension, six months of captopril or enalapril (ACE inhibitors related to benazepril) treatment led to decreased zinc levels in certain white blood cells, raising concerns about possible ACE inhibitor–induced zinc depletion.
While zinc depletion has not been reported with benazepril, until more is known, it makes sense for people taking benazepril long term to consider, as a precaution, taking a zinc supplement or a multimineral tablet containing zinc. (Such multiminerals usually contain no more than 99 mg of potassium, probably not enough to trigger the above-mentioned interaction.) Supplements containing zinc should also contain copper, to protect against a zinc-induced copper deficiency.
ZincAmlodipine-Benazepril- Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on zinc metabolism in hypertensive patients. J Am Coll Nutr 1998;17:75-8.
- Reduce Side Effects
Benazepril
Iron
In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous sulfate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.
IronBenazepril- Lee SC, Park SW, Kim DK, et al. Iron supplementation inhibits cough associated with ACE inhibitors. Hypertension 2001;38:166-70.
- Reduce Side Effects
Amlodipine-Benazepril
Iron
In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous sulfate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.
IronAmlodipine-Benazepril- Lee SC, Park SW, Kim DK, et al. Iron supplementation inhibits cough associated with ACE inhibitors. Hypertension 2001;38:166-70.
Explanation Required
7- Needs Explanation
Amlodipine
DHEA
Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.
DHEAAmlodipine- Beer NA, Jakubowicz DJ, Beer RM, Nestler JE. The calcium channel blocker amlodipine raises serum dehydroepiandrosterone sulfate and androstenedione, but lowers serum cortisol, in insulin-resistant obese and hypertensive men. J Clin Endocrinol Metab 1993;76:1464-9.
- Needs Explanation
Amlodipine-Benazepril
DHEA
Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.
DHEAAmlodipine-Benazepril- Beer NA, Jakubowicz DJ, Beer RM, Nestler JE. The calcium channel blocker amlodipine raises serum dehydroepiandrosterone sulfate and androstenedione, but lowers serum cortisol, in insulin-resistant obese and hypertensive men. J Clin Endocrinol Metab 1993;76:1464-9.
- Needs Explanation
Amlodipine
Grapefruit
Ingestion of grapefruit juice has been shown to increase the absorption of felodipine (a drug similar in structure and action to that of amlodipine) and to increase the adverse effects of the medication in patients with hypertension. Until more is known, it seems that grapefruit juice should not be ingested by people taking amlodipine or similar drugs. The same effects might be seen from eating grapefruit as from drinking its juice.
GrapefruitAmlodipine- Bailey DG, Arnold MO, Strong HA, Munoz C, Spence JD, et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther 1993;54:589-94.
- Needs Explanation
Amlodipine-Benazepril
Grapefruit
Ingestion of grapefruit juice has been shown to increase the absorption of felodipine (a drug similar in structure and action to that of amlodipine) and to increase the adverse effects of the medication in patients with hypertension. Until more is known, it seems that grapefruit juice should not be ingested by people taking amlodipine or similar drugs. The same effects might be seen from eating grapefruit as from drinking its juice.
GrapefruitAmlodipine-Benazepril- Bailey DG, Arnold MO, Strong HA, Munoz C, Spence JD, et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther 1993;54:589-94.
- Needs Explanation
Amlodipine
Pleurisy Root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as calcium channel blockers.
Pleurisy RootAmlodipine- Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.
- Needs Explanation
Amlodipine
Pomegranate
Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice. The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with amlodipine in the same way that grapefruit juice does.
PomegranateAmlodipine- Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol 2006;98:705-6.
- Summers KM. Potential drug-food interactions with pomegranate juice. Ann Pharmacother 2006;40:1472-3.
- Needs Explanation
Amlodipine-Benazepril
Pomegranate
Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice. The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with lotrel in the same way that grapefruit juice does.
PomegranateAmlodipine-Benazepril- Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol 2006;98:705-6.
- Summers KM. Potential drug-food interactions with pomegranate juice. Ann Pharmacother 2006;40:1472-3.