What class of drug is Lotensin HCT (benazepril and hydrochlorothiazide)?

Lotensin HCT Drug Classification

Lotensin HCT is a fixed-dose combination antihypertensive medication containing benazepril (an ACE inhibitor) and hydrochlorothiazide (a thiazide diuretic). 1

Drug Class Components

ACE Inhibitor Component:

• Benazepril is an angiotensin-converting enzyme (ACE) inhibitor that blocks the conversion of angiotensin I to angiotensin II, reducing blood pressure through vasodilation and decreased aldosterone secretion 2
• ACE inhibitors are considered first-line antihypertensive agents that have been proven to reduce cardiovascular morbidity and mortality in randomized controlled trials 1

Thiazide Diuretic Component:

• Hydrochlorothiazide is a thiazide-type diuretic that promotes sodium and water excretion, reducing blood volume and blood pressure 1
• Thiazide diuretics are recommended as first-line therapy for hypertension based on extensive clinical trial evidence showing cardiovascular event reduction 1

Available Formulations

Lotensin HCT is available in multiple fixed-dose combinations 1:

• 5 mg benazepril / 6.25 mg hydrochlorothiazide
• 10 mg benazepril / 12.5 mg hydrochlorothiazide
• 20 mg benazepril / 12.5 mg hydrochlorothiazide
• 20 mg benazepril / 25 mg hydrochlorothiazide

Clinical Positioning

Guideline-Recommended Combination:

• The combination of an ACE inhibitor with a thiazide diuretic represents a core drug combination strategy endorsed by major hypertension guidelines 1
• This combination is particularly effective because it addresses two complementary mechanisms of blood pressure control 3

Indication for Use:

• Lotensin HCT is indicated for the treatment of hypertension to lower blood pressure and reduce the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions 2
• It may be used when monotherapy with either component alone is insufficient to achieve blood pressure goals 2, 4

Important Clinical Considerations

Comparative Efficacy:

• While benazepril plus hydrochlorothiazide is effective, evidence suggests that benazepril plus amlodipine (a calcium channel blocker) may be superior for reducing cardiovascular events in high-risk patients 5
• However, ACE inhibitor-diuretic combinations remain guideline-recommended first-line therapy for most patients with hypertension 1

Metabolic Effects:

• Hydrochlorothiazide can cause hypokalemia, hyperuricemia, and may increase the risk of new-onset diabetes, though these metabolic effects are typically less pronounced than with chlorthalidone 1, 6
• Regular monitoring of electrolytes and renal function is recommended 1