Indications
Therapeutic Class
Pharmacology
Amlodipine is a dihydropyridine calcium antagonist which inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. It has greater effect on vascular smooth muscle cells than on cardiac muscle cells; Amlodipine is a peripheral arterial vasodilator that causes reduction in peripheral vascular resistance and reduction in blood pressure. Serum calcium concentration is not affected by Amlodipine.
Benazepril inhibits angiotensin-converting enzyme (ACE). ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. Inhibition of ACE results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and aldosterone secretion. Mechanism through which Benazepril lowers blood pressure is believed to be primarily suppression of the renin-angiotensin-aldosterone system, Benazepril has an antihypertensive effect even in patients with low-renin hypertension.
Dosage & Administration
Interaction
Diuretics: Patients on diuretics may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Amlodipine and Benazepril. Potassium-sparing diuretics (e.g. spironolactone) or potassium supplements can increase the risk of hyperkalemia.
Lithium: Increased serum lithium level and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors during therapy with lithium.
Contraindications
Side Effects
Pregnancy & Lactation
Pregnancy:Â Categories C (first trimester) and D (second and third trimesters).
Nursing Mothers: Minimal amounts of unchanged benazepril and of benazeprilat are excreted into the breast milk of lactating women treated with benazepril, so that a newborn child ingesting nothing but breast milk would receive less than 0.1% of the maternal doses of benazepril and benazeprilat. It is not known whether amlodipine is excreted in human milk. In the absence of this information, it is recommended that nursing be discontinued while this combination is administered.
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