Introduction
Amocal BZ 10/20 is used to treat hypertension (high blood pressure). This is a combination of two medicines that controls blood pressure when a single medication is not effective. It helps to lower high blood pressure and thus reduces the chances of future heart attack and stroke.
You can take Amocal BZ 10/20 at any time of day, with or without food, but it is best to take it at the same time each day. Keep taking it for as long as advised by your doctor. Even if you feel well, do not stop this medicine on your own because high blood pressure often has no symptoms. If you stop taking it, your condition may get worse. Keeping active with regular exercise, reducing your weight and eating a healthy diet will also help control your blood pressure. Follow your doctor's advice while taking this medicine.
It may cause side effects like ankle swelling, headache, weakness, numbness of extremities, flushing (sense of warmth in the face, ears, neck, and trunk), and tiredness. It may also cause dizziness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. You may be asked for regular monitoring of blood pressure, kidney function, and electrolytes level while on the treatment.
Before taking it, let your doctor know if you have any liver or kidney problems. Pregnant or breastfeeding women should also consult their doctor for advice before taking this medicine. You also need to tell your doctor what other medicines you are taking especially those used to treat high blood pressure or heart conditions.
Uses of Amocal BZ 10/20
- Hypertension (high blood pressure)
Side effects of Amocal BZ 10/20
Common
- Ankle swelling
- Headache
- Tiredness
- Palpitations
- Increased potassium level in blood
- Sleepiness
- Cough
- Taste change
- Flushing (sense of warmth in the face, ears, neck and trunk)
- Decreased blood pressure
- Upset stomach
How to use Amocal BZ 10/20
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Amocal BZ 10/20 may be taken with or without food, but it is better to take it at a fixed time.
How Amocal BZ 10/20 works
Amocal BZ 10/20 is a combination of two medicines: Amlodipine and benazepril which lower blood pressure effectively. It works by relaxing blood vessels so that blood flows more smoothly and the heart can pump blood more efficiently.
Indication
Oral
Hypertension
Adult: Amlodipine component: 2.5-10 mg once daily; benazepril component: 10-40 mg once daily. Titrate dose gradually according to response.
Elderly: Initiate with 2.5 mg Amlodipine component once daily.
Hepatic impairment: Initiate with 2.5 mg Amlodipine component once daily. Titrate combination slowly in severe hepatic impairment.
Administration
Additive effect when used with catecholamine depleting drugs; monitor for hypotension and/or marked bradycardia. If used with clonidine, clonidine withdrawal should occur a few days after withdrawal of the beta-blocker to prevent rebound hypertension; if replacing clonidine by beta-blocker, beta-blocker should be introduced only after clonidine administration has stopped for several days. Concurrent use with prostaglandin synthase inhibiting drugs (e.g. indomethacin) may reduce the hypotensive effects of beta-blockers.
Adult Dose
Discontinue as soon as possible when pregnancy is detected; affects renin-angiotensin system, causing oligohydramnios, which may result in fetal injury and/or death. Caution in elderly, renal or hepatic impairment, congestive heart failure, severe aortic stenosis, unilateral or bilateral renal artery stenosis, use during surgery or anaesthesia. Amlodipine+Benazepril can cause symptomatic hypotension, especially in patients with salt/volume depletion. ACE inhibitors (ACEi) have been associated with cholestatic jaundice and fulminant hepatic necrosis; discontinue treatment if patient develops jaundice/marked elevation of liver enzymes.
Monitor renal function and serum potassium periodically. Angioedema of the face, extremities, lips, tongue, glottis, larynx and intestinal angioedema have been reported in ACEi-treated patients. As with all ACEi, may cause persistent dry cough.
Lactation: Minimal amounts of benazepril enters milk, but excretion of amlodipine is not known; not recommended
Renal Dose
Amlodipine is a dihydropyridine calcium antagonist. It lowers BP by relaxing the coronary vascular smooth muscles and producing coronary vasodilation; through inhibition of transmembrane Ca ion influx into vascular smooth muscle and cardiac muscle. It is also a peripheral vascular vasodilator. Benazepril and its active metabolite benazeprilat inhibit ACE, which results in decreased plasma angiotensin II and thus leading to decreased aldosterone secretion.
Contraindication
Safety and efficacy in paediatric patients have not been established.
Mode of Action
May be taken with or without food.
Side Effect
Renal impairment: Decrease dose if CrCl <30 mL/min, severe liver impairment, or coadministered with diuretic
Pregnancy Category Note
>10%
Amlodipine
Peripheral edema (2-15%),Pulmonary edema (7-15%)
1-10%
Amlodipine
Abdominal pain (1.6%),Dizziness (1.1-3.4%),Dyspepsia (1-2%),Fatigue (4.5%),Flushing (0.7-2.6%),Headache (7.3%),Male sexual dysfunction (1-2%),Muscle cramps (1-2%),Nausea (2.9%),Palpitation (0.7-4.5%),Rash (1-2%),Somnolence (1-2%),Weakness (1-2%)
Benazepril
ARF if renal artery stenosis
Cough (1-10%),Dizziness (4%),Fatigue (2%),Headache (6%),Nausea (1%),Postural dizziness (2%),Serum creatinine increased (2%),Somnolence (2%)
Potentially Fatal: Analphylactoid reactions, angioedema, Stevens-Johnson syndrome.
Interaction
Patients with history of angioedema; pregnancy, lactation.