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Amlodipine/ Benazepril (Lotrel) description: Rx List: "Lotrel is a combination of amlodipine besylate and benazepril hydrochloride. The capsules are formulated for oral administration with a combination of amlodipine besylate equivalent to 2.5 mg or 5 mg of amlodipine and 10 mg or 20 mg of benazepril hydrochloride. The inactive ingredients of the capsules are calcium phosphate, cellulose compounds, colloidal silicon dioxide, crospovidone, gelatin, hydrogenated castor oil, iron oxides, lactose, magnesium stearate, polysorbate 80, silicon dioxide, sodium lauryl sulfate, sodium starch glycolate, starch, talc, and titanium dioxide."
http://www.rxlist.com/cgi/generic3/amlobenaz.htm

Amlodipine/ benazepril special precautions: Safe medication: "tell your doctor and pharmacist if you are allergic to amlodipine, benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik), or any other drugs.tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially diuretics (''''water pills''''), fentanyl (Duragesic), lithium (Eskalith, Lithobid), other medications for high blood pressure, potassium supplements, and vitamins.tell your doctor if you have or have ever had heart, liver, or kidney disease or diabetes.if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking amlodipine and benazepril.
http://www.safemedication.com/displaydrug.cfm?id=807

Amlodipine/benazepril side effects : Health Square: "Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lotrel.If you develop swelling of your face, around the lips, tongue, or throat; swelling of arms and legs; or difficulty swallowing, you should contact your doctor immediately. You may need emergency treatment. More common side effects may include: Cough Less common side effects may include: Abdominal pain, anxiety, back pain, bloating and gas, constipation, cramps, decreased sex drive, diarrhea, dizziness, dry mouth, excessive urination, fluid retention and swelling, flushing, headache, hot flashes, impotence, insomnia, muscle and bone pain, muscle cramps, nausea, nervousness, rash, skin disorders, sore throat, tremor, weakness and fatigue Rare side effects may include: Anemia, blisters that leave dark spots on the skin, heart attack, pancreatitis (inflammation of the pancreas), worsening of angina pectoris (crushing chest pain)
http://www.healthsquare.com/rx/lotrel.htm

How Lotrel (Amlodipine/benazepril) works: virtual drugstore: "Lotrel is a combination of an angiotensin converting enzyme (ACE) inhibitor - benazepril - and a calcium channel blocker - amlodipine. It is used for blood pressure control. The combination product is able to increase compliance and, because lower doses are needed, is an ideal combination for geriatric people, small frail individuals, and people with liver insufficiency. Containing two ingredients, Lotrel works in two different ways. The benazepril inhibits an enzyme, ACE, which is involved in the angiotensin-renin system. This system plays an integral role in blood pressure control, and with ACE inhibition blood pressure is lowered. Blood vessels have calcium channels or "pathways" in their walls. Calcium moves along these channels being involved in blood vessel constriction. The calcium channel blocker, amlodipine, affects how calcium moves along these channels resulting in relaxed blood vessel walls and reduced blood pressure."
http://www.virtualdrugstore.com/hbp/amlodipine.html

Action/ kinetics of Amlodipine/ benazepril: Nurses PDR: "Action/Kinetics: The incidence of edema is significantly reduced with this combination product. Peak plasma levels, benazepril: 0.5-2 hr (1.5-4 hr for benazeprilat, the active metabolite). Peak plasma levels, amlodipine: 6-12 hr. Elimination t1/2, benazeprilat: 10-11 hr; elimination t1/2, amlodipine: 2 days. Contraindications: Initial treatment of hypertension. Hypersensitivity to amlodipine or benazepril. Lactation. Special Concerns: Discontinue ACE inhibitors as soon as pregnancy is determined. The addition of benazepril to amlodipine should not be expected to provide additional antihypertensive effects in African-Americans, although there will be less edema. Use with caution in those with severe renal disease, in CHF, and in severe hepatic impairment. Safety and efficacy have not been determined in children."
http://www.nursespdr.com/members/database/archives/amlodipineandbenazeprilhydrochloride.html

Amlodipine/ benazepril drug interactions and precautions: Personal MD: "Tell your doctor if you have any pre-existing kidney disease, heart disease, liver disease, diabetes, blood disorders or if you have any allergies. Limit intake of alcohol which enhances dizziness. Because this medication may make you dizzy or lightheaded, use caution operating machinery or engaging in activities requiring alertness. Rise slowly from a lying or seated position to minimize dizziness. This medication is not recommended for use during pregnancy. Consult your doctor before using this drug. It is not known if this medication appears in breast milk. Consult your doctor before breast-feeding. Tell your doctor of any over-the-counter or prescription medication you may take including any heart medications, potassium supplements, salt substitutes or any product for cough, cold or allergies. Avoid grapefruit juice while using this medication, unless your doctor instructs you otherwise. Do not start or stop any medicine without doctor or pharmacist approval."
http://www.personalmd.com/drgdb/3075.htm

Precautions while using Amlodipine/ benazepril: nlm.nih.gov: "It is very important that your doctor check your progress at regular visits. This will allow your doctor to make sure the medicine is working properly, to check for unwanted effects, and to change the dosage if needed. If you think that you may have become pregnant, check with your doctor immediately. Use of this medicine, especially during the second and third trimesters (after the first 3 months) of pregnancy, may cause serious injury or even death to the unborn child. Do not take any other medicines, especially potassium supplements, or salt substitutes that contain potassium unless approved or prescribed by your doctor. Dizziness, lightheadedness, or fainting may occur after the first dose, especially if you have been taking a diuretic (water pill). Make sure you know how you react to the medicine before you drive, use machines, or do other things that could be dangerous if you experience these effects. Check with your doctor if you notice any signs of fever, sore throat, or chills. These could be symptoms of an infection resulting from low white blood cell counts. Check with your doctor if you notice difficult breathing or swelling of the face, arms, or legs. These could be symptoms of a serious allergic reaction. Check with your doctor if you become sick while taking this medicine, especially with severe or continuing vomiting or diarrhea. These conditions may cause you to lose too much water, possibly resulting in low blood pressure. Dizziness, lightheadedness, or fainting may also occur if you exercise or if the weather is hot. Heavy sweating can cause loss of too much water and result in low blood pressure. Use extra care during exercise or hot weather. In some patients, tenderness, swelling, or bleeding of the gums may appear soon after treatment with this medicine is started. Brushing and flossing your teeth carefully and regularly and massaging your gums may help prevent this. See your dentist regularly to have your teeth cleaned. Check with your medical doctor or dentist if you have any questions about how to take care of your teeth and gums, or if you notice any tenderness, swelling, or bleeding of your gums. Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine."
http://www.nlm.nih.gov/medlineplus/druginfo/amlodipineandbenazeprilsystemi203634.html

Amlodipine/ benazepril health contraindications and special considerations: A healthy me: "Who should not take amlodipine and benazepril? Before taking this medication, tell your doctor if you have liver disease; have kidney disease; have diabetes; have a collagen vascular disorder; have other diseases of the heart or blood vessels such as heart failure, aortic stenosis, or low blood pressure; or are taking salt substitutes, potassium supplements (e.g., K-Dur, Klor-Con), or a potassium-sparing diuretic such as amiloride (Midamor), triamterene (Dyrenium, Dyazide, Maxzide), or spironolactone (Aldactone). You may not be able to take amlodipine and benazepril, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above. Amlodipine and benazepril is in the FDA pregnancy category D. This means that amlodipine and benazepril will harm an unborn baby. When used during the second and third trimesters of pregnancy, ACE inhibitors (benazepril) can cause injury and even death of the developing fetus. Do not take this medication without first talking to your doctor if you are pregnant or planning a pregnancy. It is also not known whether amlodipine and benazepril passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby."
http://www.ahealthyme.com/topic/topic100588449

Amlodipine/ benazepril drug interactions: Web MD: "Before taking this medication, tell your doctor if you are taking any of the following drugs: a potassium supplement such as K-Dur, Klor-Con, and others; salt substitutes that contain potassium; any of the diuretics (water pills) triamterene (Dyrenium, Maxzide, Dyazide), spironolactone (Aldactone), and amiloride (Midamor); any other diuretic (water pill) such as hydrochlorothiazide (HCTZ, Hydrodiuril, others), furosemide (Lasix), bumetanide (Bumex), indapamide (Lozol), and others; or lithium (Lithobid, Eskalith, others). You may not be able to take amlodipine and benazepril, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above. Drugs other than those listed here may also interact with amlodipine and benazepril or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines."
http://my.webmd.com/content/article/4046.1409

Children and Adolescents taking Amlodipine/ benazepril: Mayo clinic: "Children and Adolescents Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of amlodipine and benazepril combination in children with use in other age groups. Older Adults- This medicine has been tested in patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, blood levels of amlodipine may be increased in the elderly and elderly people may be more sensitive to the effects of this medicine. Racial differences- Black patients may be less sensitive to the blood pressure-lowering effects of this medicine. In addition, the risk of a serious allergic reaction involving swelling of the face, mouth, hands, or feet may be increased."
http://www.mayoclinic.com/findinformation/druginformation/druginvoke.cfm?objectId=000C70B8-8A45-1B79-AB8080AEBC2F0839#Children-and-Adolescents

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• ER:"Media products under your influence, particularly the NBC/Warner drama "ER," are harming the profession of 2.7 million American nurses by giving the public an inaccurate and inadequate account of what nurses really do to save and improve lives. Research suggests that "ER" strongly and negatively influences the way children view nursing. These products contribute to the nursing shortage, a public health crisis that threatens millions worldwide."

• NBC's "Passions":"NBC's "Passions" solves nursing shortage: monkeys can do the job! Starting in March 2003 and at least as recently as late August, NBC's campy, supernatural daytime soap opera "Passions" has featured an orangutan named Precious in the role of the private duty nurse of one of its characters--a bold step backwards in the already slow...evolution...of the media's treatment of nurses. more..."

• "Scrubs" defines nursing:""Scrubs" defines nursing: it's all about shutting up and following physician "orders. " November 20, 2003 -- Tonight's episode of NBC's "Scrubs," which purports to teach nurse Carla Espinosa that nursing is all about doing what physicians tell you, is one of the most virulently anti-nurse prime time television episodes the Center has ever seen. more..."
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Surprised? eBay Has Nursing Supplies, scrubs, uniforms, stethescopes, etc.:"You can find nursing supplies right here! With over 5 million items for sale every day, you'll find the nursing supplies you're looking for at the world's online marketplace - eBay!"
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Nurses' Station:"The idea for the Nurses' Station Catalog was conceived in 1989. After searching the marketplace in response to customer inquiries, it became obvious that there were no catalogs of this type serving the nursing profession. To be sure, there were several catalogs offering nurse's uniforms and a smattering of professional items. But there weren't any catalogs at the time offering a range of gifts, clothing, professional items, name badges, shoes and scrubs for nurses. It took two years of hard work to gather samples and put a together a catalog of the most unique and high-quality items for nurses."
Nurses Station P.O. Box 388 Centerbrook, CT 06409-03881
http://www.nursefriendly.com/station/

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Last updated by Andrew Lopez, RN on September 6, 2006