Lotrel
Drug Information
This drug combines two primary active ingredients: amlodipine and benazepril.
Amlodipine is a calcium channel blocker used to treat angina and high blood pressure.
Benazepril is an angiotensin-converting enzyme (ACE) inhibitor drug used to treat high blood pressure.
Common brand names:
LotrelSummary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
- 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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Reduce Side Effects
- 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.
Support Medicine
none
Reduces Effectiveness
none
Potential Negative Interaction
- 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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence. - 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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence. 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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Explanation Required
- DHEA
Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.
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.
- 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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence. 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.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Last Review: 03-18-2015
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