Benazepril and hydrochlorothiazide

Before taking benazepril and hydrochlorothiazide, tell your doctor about all of your medical conditions. Especially tell your doctor if:

• are allergic to benazepril, to any other ACE inhibitor, to hydrochlorothiazide, or to other sulfonamide-derived drugs
• kidneys are unable to produce urine (anuric)
• history of a type of swelling that affects deeper layers in your skin, often around your eyes and lips (angioedema)
• you have diabetes or low blood sugar, especially if you are also using aliskiren (Tekturna)
• you are about to have major surgery
• you are pregnant or plan to become pregnant
• you are breastfeeding or plan to breastfeed

Tell you doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. 

• Take benazepril and hydrochlorothiazide exactly as prescribed. 
• Benazepril and hydrochlorothiazide comes in a tablet form and is taken by mouth once daily with or without food. 

Benazepril and hydrochlorothiazide is a combination of medicines that is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

Benazepril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking a substance in the body that causes blood vessels to tighten. As a result, benazepril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine which helps lower the blood pressure.

benazepril and hydrochlorothiazide is available only with your doctor's prescription.

• It is used to treat high blood pressure.
• It may be given to you for other reasons. Talk with the doctor.

• If you have an allergy to benazepril, hydrochlorothiazide, or any other part of this medicine.
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• If you have ever had a very bad or life-threatening reaction called angioedema. Signs may be swelling of the hands, face, lips, eyes, tongue, or throat; trouble breathing; trouble swallowing; unusual hoarseness.
• If you have high calcium levels.
• If you are not able to pass urine.
• If you are taking a drug that has aliskiren in it and you also have high blood sugar (diabetes) or kidney problems. Check with your doctor or pharmacist if you are not sure if a drug you take has aliskiren in it.
• If you are taking dofetilide.
• If you have taken a drug that has sacubitril in it in the last 36 hours.
• If you are breast-feeding or plan to breast-feed.

This is not a list of all drugs or health problems that interact with benazepril and hydrochlorothiazide.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

Use benazepril and hydrochlorothiazide as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take this medicine at the same time of day.
• To gain the most benefit, do not miss doses.
• Keep taking benazepril and hydrochlorothiazide as you have been told by your doctor or other health care provider, even if you feel well.
• This medicine may cause you to pass urine more often. To keep from having sleep problems, try to take before 6 pm.
• Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

In single-dose studies, benazepril lowered blood pressure within 1 hour, with peak reductions achieved 2 to 4 hours after dosing. The antihypertensive effect of a single dose persisted for 24 hours. In multiple-dose studies, once-daily doses of 20 to 80 mg decreased seated pressure (systolic/diastolic) 24 hours after dosing by about 6- 12/4- 7 mmHg. The reductions at trough are about 50% of those seen at peak.

Four dose-response studies of benazepril monotherapy using once-daily dosing were conducted in 470 mild-to-moderate hypertensive patients not using diuretics. The minimal effective once-daily dose of benazepril was 10 mg; further falls in blood pressure, especially at morning trough, were seen with higher doses in the studied dosing range (10 to 80 mg). In studies comparing the same daily dose of benazepril given as a single morning dose or as a twice-daily dose, blood pressure reductions at the time of morning trough blood levels were greater with the divided regimen.

The antihypertensive effects of benazepril were not appreciably different in patients receiving high- or low-sodium diets.

Benazepril-Hydrochlorothiazide

In 15 controlled clinical trials, 1453 healthy or hypertensive patients were exposed to Benazepril and Hydrochlorothiazide of which 459 were exposed for at least 6 months, 214 for at least 12 months and 25 for at least 24 months.

The combination of benazepril-hydrochlorothiazide resulted in mean placebo-adjusted decreases in sitting systolic and diastolic blood pressures of 10/6 mmHg with 5/6.25 mg and 10/12.5 mg doses, and 20/10 mmHg with 20/ 25 mg dose.

In clinical trials of benazepril/hydrochlorothiazide using benazepril doses of 5/20 mg and hydrochlorothiazide doses of 6.25/25 mg, the antihypertensive effects were sustained for at least 24 hours, and they increased with increasing dose of either component. Although benazepril monotherapy is somewhat less effective in blacks than in nonblacks, the efficacy of combination therapy appears to be independent of race.

(ben AY ze pril & hye droe klor oh THYE a zide)

Benazepril: Competitive inhibitor of angiotensin-converting enzyme (ACE); prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in lower levels of angiotensin II which causes an increase in plasma renin activity and a reduction in aldosterone secretion.

Hydrochlorothiazide: Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions.

When pregnancy is detected, discontinue benazepril/hydrochlorothiazide as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Mild to moderate renal dysfunction (CrCl 30 to 90 mL/min): No adjustment recommended.
Severe renal dysfunction (CrCl 30 mL/min or less): Data not available

Data not available