Meds and you

27 September 2013

The combination of hydrochlorothiazide and benazepril

The combination of hydrochlorothiazide and benazepril is a combination of an ACE inhibitor, a type of medication used to lower blood pressure, and a diuretic, a type of drug.

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The combination of hydrochlorothiazide and benazepril is the active ingredient of Cibadrex (Nappi Code: 800279-019).

General information
The combination of hydrochlorothiazide and benazepril is a combination of an ACE inhibitor, a type of medication used to lower blood pressure, and a diuretic, a type of drug that increases the production of urine, thereby expelling excess water from the body.

In South Africa this combination is registered for the treatment of mild to moderately high blood pressure.

It is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective you must take it regularly. High blood pressure declines slowly and it may take a few weeks for this combination to reach its full effect. Keep taking this medicine during this period, even if you are feeling better or fail to notice any improvement.

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advised to be resting when starting treatment and to lie down for 2 hours afterwards.

The use of benazepril is often associated with a dry and persistent cough. Should you notice an irritating cough while being treated with this drug it is advised to contact you doctor.

This combination should be avoided during pregnancy, especially the second and third trimester. Speak to your doctor about the use of this drug if you are planning to get pregnant, as it may cause harm to the unborn baby.

How does this combination work?
A diuretic such as hydrochlorothiazide reduces the overall fluid volume in the body, thereby reducing pressure within blood vessels. Benazepril prevents the conversion of Angiotensin I, a chemical in your blood, to a more powerful version, Angiotensin II. Angiotensin II has a narrowing effect on blood vessels, thereby increasing blood pressure. Angiotensin II furthermore stimulates the production aldosterone, a hormone which promotes salt (sodium) retention in the body, an action which increases blood pressure.

Fast facts

Drug schedule: schedule 3
Available as: the combination of hydrochlorothiazide and benazepril is available as tablets.
What does it do? this combination lowers blood pressure.
Overdose risk: medium
Dependence risk: low
Is this combination available as a generic? no
Is this combination available on prescription only? yes

User information

Onset of effect: within 2 hours
Stopping this medicine: use this combination as prescribed by your doctor, and do not discontinue treatment before speaking to your prescriber. Suddenly stopping the drug may case you blood pressure to increase dangerously. Dosage should be deceased gradually as directed by your doctor.
Prolonged use: Prolonged use may result in an electrolyte disturbance. Kidney function may also need to be evaluated periodically.

Special precautions
Consult your doctor before using this drug if:

 

  • you have kidney or liver disease
  • you have known low blood levels of potassium or high blood levels of calcium
  • you have gout
  • you have diabetes
  • you have Addison's disease
  • you have systemic Lupus Erythematosus
  • you are planning to become pregnant
  • you are taking other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
Infants and children: this medication is not intended for use in children.
The elderly: caution is advised in the elderly as adverse effects may be more likely.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness and light-headedness. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

 

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
muscle cramps or pain
 
X
 
X
palpitations
 
X
 
X
weakness
 
X
 
X
dizziness
 
X
X
 
thirst/dry mouth
X
 
X
 
headache
X
 
X
 
dry cough
X
 
 
X
nausea
 
X
X
 
diarrhoea
 
X
X
 
constipation
 
X
X
 
loss of appetite
 
X
X
 
altered sense of taste
X
 
X
 
erectile dysfunction
 
X
X
 
gout
 
X
X
 
increased blood sugar
 
X
X
 
skin rash/itch
 
X
 
X
swelling of mouth/difficulty breathing
 
X
 
X
swelling of arms and legs
 
X
 
X
difficulty swallowing
 
X
 
X
abdominal pain with/without nausea/vomiting
 
X
 
X
chest pain/palpitations
 
X
 
X
unusual bleeding/bruising
 
X
 
X

Interactions

Drug interactions

 

alcohol, barbiturates increased dizziness at start of treatment
allopurinol, tetracycline antibiotics increased risk of hydrochlorothiazide toxicity
cholestyramine reduced absorption of this diuretic
corticosteroids reduced diuretic effect/risk of potassium depletion
digoxin increased risk of toxicity in case of potassium depletion
terdenadine, sotalol, pimozide risk of heart rhythm disturbance
lithium risk of lithium toxicity
non-steroidal anti-inflammatory drugs effect on blood pressure is impaired
oral anti-diabetic drugs blood sugar lowering effect may be reduced
co-trimoxazole, trimethoprim reduced sodium levels in body
vitamin D increased risk of high calcium blood levels
rifampicin may increase blood pressure

Disease interactions
Consult your doctor before using this drug if you have kidney or liver disease, gout, diabetes, Addison’s disease or if you have systemic lupus erythematosus.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
See each individual agent.

 

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.
 
 

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