Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
LOTREL vs ALDOCLOR-150
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Lotrel is a combination of amlodipine (a calcium channel blocker) and benazepril (an ACE inhibitor). Amlodipine inhibits calcium ion influx across cardiac and vascular smooth muscle cells, causing vasodilation and reduced blood pressure. Benazepril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, leading to vasodilation and decreased aldosterone secretion.
Aldoclor-150 is a combination of methyldopa and chlorothiazide. Methyldopa is a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow, decreasing peripheral vascular resistance and blood pressure. Chlorothiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal convoluted tubule, leading to increased excretion of sodium and water, reducing plasma volume and blood pressure.
Treatment of hypertension,Off-label: chronic kidney disease, heart failure, diabetic nephropathy (as part of combination therapy)
Hypertension
Oral: 1 capsule (amlodipine 2.5 mg/benazepril 10 mg) once daily, titrate to maximum 10 mg/40 mg once daily.
ALDOCLOR-150 is a combination product containing 150 mcg of clonidine and 25 mg of chlorthalidone. The typical adult dose is one tablet orally once daily.
Amlodipine: 30-50 hours (terminal); steady state in 7-10 days. Benazeprilat: 10-11 hours (terminal); effective half-life 22-24 hours with once-daily dosing.
Terminal elimination half-life is approximately 6-8 hours in patients with normal renal function. In patients with creatinine clearance <30 m L/min, half-life may be prolonged to 15-20 hours, necessitating dose adjustment.
Amlodipine is extensively metabolized in the liver via CYP3A4 to inactive metabolites. Benazepril is hydrolyzed in the liver to its active metabolite, benazeprilat, primarily by hepatic esterases; further metabolism is minimal.
Methyldopa is metabolized primarily via conjugation and decarboxylation; chlorothiazide is not extensively metabolized and is excreted unchanged in urine.
Amlodipine: 60% renal, 20-25% fecal. Benazeprilat: 85% renal (as benazeprilat and conjugated metabolites), 15% biliary/fecal.
Renal excretion of unchanged drug accounts for approximately 50-60% of the administered dose; hepatic metabolism contributes the remainder, with metabolites excreted via bile and feces. Less than 2% is excreted unchanged in feces.
Amlodipine: ~93% (plasma proteins). Benazepril: ~96.7%; benazeprilat: ~95.3% (primarily albumin).
Approximately 70-80% bound to plasma proteins, primarily albumin.
Amlodipine: 21 L/kg (large Vd indicates extensive tissue distribution). Benazeprilat: 0.11-0.13 L/kg (limited extravascular distribution).
Vd is approximately 0.3-0.5 L/kg, indicating distribution primarily in extracellular fluid and limited tissue binding.
Amlodipine: 64-90% (oral). Benazepril: >30% (oral; rapidly converted to active benazeprilat).
Oral bioavailability is approximately 70-80%; food does not significantly alter absorption.
GFR ≥30 m L/min: No adjustment. GFR <30 m L/min: Not recommended. Hemodialysis: Avoid.
Contraindicated in patients with GFR <30 m L/min. For GFR 30-50 m L/min, reduce frequency to every other day. For GFR >50 m L/min, no adjustment necessary.
Child-Pugh A: No dose adjustment. Child-Pugh B: Reduce dose or avoid. Child-Pugh C: Contraindicated.
Child-Pugh Class A: No adjustment necessary. Child-Pugh Class B: Reduce dose by 50% or extend dosing interval. Child-Pugh Class C: Use is not recommended due to risk of hepatic encephalopathy and fluid retention.
Not established in pediatric patients (safety and efficacy not evaluated).
Not recommended for pediatric use due to lack of safety and efficacy data in patients under 18 years of age.
Initiate with amlodipine 2.5 mg/benazepril 10 mg daily; titrate slowly due to increased risk of hypotension and renal impairment.
Initiate at lower dose (e.g., half tablet) due to increased sensitivity to antihypertensive effects, risk of orthostatic hypotension, and impaired renal function. Monitor blood pressure and electrolytes closely.
Fetal toxicity: Drugs acting directly on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible when pregnancy is detected.
None.
Angioedema: Risk of head, neck, or intestinal angioedema,Hypotension: Symptomatic hypotension may occur, especially in volume- or salt-depleted patients,Hepatic impairment: Use with caution; may increase amlodipine exposure,Renal impairment: Monitor renal function; may increase serum creatinine,Hyperkalemia: Risk increases with renal impairment, diabetes, or concomitant potassium-sparing diuretics,Cough: Dry cough is common with ACE inhibitors,Cholestatic jaundice and hepatic failure: Rare but reported with ACE inhibitors
May cause sedation, dizziness, and orthostatic hypotension. Avoid abrupt discontinuation. Use with caution in patients with impaired renal function, liver disease, or history of depression. Monitor for electrolyte imbalance, especially hypokalemia, due to chlorothiazide component.,Methyldopa may cause positive direct Coombs test, hemolytic anemia, and liver disorders. Discontinue if jaundice or liver abnormalities occur.
Hypersensitivity to amlodipine, benazepril, or any component of the formulation,History of angioedema related to previous ACE inhibitor therapy,Hereditary or idiopathic angioedema,Concomitant use with aliskiren in patients with diabetes mellitus,Pregnancy (second and third trimesters)
Hypersensitivity to methyldopa, chlorothiazide, or sulfonamide-derived drugs.,Active liver disease or previous methyldopa-induced liver disorders.,Anuria or severe renal impairment (creatinine clearance <30 m L/min).
Avoid high-potassium foods (e.g., bananas, oranges, spinach, potatoes) in large amounts. No specific food restrictions beyond maintaining a balanced low-sodium diet. Grapefruit juice may increase amlodipine levels; limit or avoid consumption.
Avoid excessive potassium-rich foods (bananas, oranges, spinach) unless directed, as thiazide can cause potassium loss; however, monitor for hypokalemia. Limit sodium intake to enhance antihypertensive effect. Methyldopa absorption is not significantly affected by food.
First trimester: Animal studies suggest possible teratogenicity; human data limited. Second and third trimesters: Exposure to angiotensin II receptor antagonists (valsartan) and calcium channel blockers (amlodipine) is associated with oligohydramnios, fetal renal dysfunction, skull hypoplasia, and hypotension. Risk is highest during second and third trimesters. Contraindicated in pregnancy.
First trimester: Increased risk of neural tube defects (spina bifida) and other major congenital malformations (e.g., cardiovascular, orofacial clefts) due to folate antagonism. Second and third trimesters: Risk of intrauterine growth restriction (IUGR), oligohydramnios, and renal dysplasia. Neonatal: Folate deficiency, megaloblastic anemia, and potential for methotrexate-like toxicity if used near term.
No data on excretion in human milk. Amlodipine is excreted in animal milk; valsartan is excreted in animal milk. M/P ratio not determined. Potential for adverse effects in nursing infant includes hypotension, renal impairment. Caution advised; avoid use during breastfeeding.
Pyrimethamine (component of ALDOCLOR-150) is excreted into breast milk in small amounts; the M/P ratio is not well established. Sulfadoxine (component) is also excreted. Theoretical risk of kernicterus in jaundiced infants due to sulfonamide displacement of bilirubin. Use with caution, especially in preterm or G6PD-deficient infants. The benefits of breastfeeding should outweigh potential risks; alternative antimalarials are preferred.
Pharmacokinetic changes in pregnancy may alter drug levels but specific dose adjustments not established. Due to fetal risks, use is contraindicated in pregnancy; alternative therapy should be initiated.
No standard dose adjustment required, but consider increased folic acid supplementation (5 mg daily) to reduce teratogenic risk. Due to increased glomerular filtration rate (GFR) in pregnancy, renal clearance may be enhanced; however, ALDOCLOR-150 is typically used as a single dose and pharmacokinetic data do not support routine dose adjustment. Individualize based on clinical response and toxicity monitoring.
LOTREL is a fixed-dose combination of amlodipine (dihydropyridine calcium channel blocker) and benazepril (ACE inhibitor). Monitor serum potassium and renal function, especially in patients with renal impairment or on potassium-sparing diuretics. Avoid use in pregnancy; discontinue immediately if pregnancy is detected. May cause angioedema; higher risk in Black patients. Use with caution in patients with aortic stenosis or hypertrophic cardiomyopathy. Amlodipine may cause peripheral edema, which is dose-dependent and not relieved by diuretics.
ALDOCLOR-150 combines chlorothiazide (a thiazide diuretic) and methyldopa (a central alpha-2 agonist). Monitor for hypokalemia and hyponatremia due to thiazide; methyldopa may cause positive Coombs test (hemolytic anemia risk) and hepatotoxicity. Titrate methyldopa slowly to avoid sedation. Use with caution in renal impairment (Cr Cl <30 m L/min reduces thiazide efficacy).
Take exactly as prescribed, usually once daily. Do not stop without consulting your doctor.,Avoid potassium supplements or salt substitutes containing potassium unless directed by your doctor.,Report any swelling of face, lips, tongue, or difficulty breathing immediately (signs of angioedema).,If you become pregnant, stop the medication and contact your doctor right away.,May cause dizziness or lightheadedness; avoid driving until you know how the drug affects you.,Avoid alcohol, which can lower blood pressure further.
Take medication exactly as prescribed, usually once or twice daily.,May cause dizziness or drowsiness; avoid driving until effects are known.,Stand up slowly to prevent falls from low blood pressure.,Report unexplained fever, fatigue, or jaundice (signs of liver issues).,Avoid alcohol, which enhances sedative effects.,Do not stop abruptly (risk of rebound hypertension).
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about LOTREL vs ALDOCLOR-150, answered by our medical review team.
LOTREL is a Antihypertensive combination that works by Lotrel is a combination of amlodipine (a calcium channel blocker) and benazepril (an ACE inhibitor). Amlodipine inhibits calcium ion influx across cardiac and vascular smooth muscle cells, causing vasodilation and reduced blood pressure. Benazepril inhibits angiotensin-converting enzyme, reducing angiotensin II formation, leading to vasodilation and decreased aldosterone secretion.. ALDOCLOR-150 is a Antihypertensive Combination (Central Alpha Agonist and Thiazide Diuretic) that works by Aldoclor-150 is a combination of methyldopa and chlorothiazide. Methyldopa is a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow, decreasing peripheral vascular resistance and blood pressure. Chlorothiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal convoluted tubule, leading to increased excretion of sodium and water, reducing plasma volume and blood pressure.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between LOTREL and ALDOCLOR-150 depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of LOTREL is: Oral: 1 capsule (amlodipine 2.5 mg/benazepril 10 mg) once daily, titrate to maximum 10 mg/40 mg once daily.. The standard adult dose of ALDOCLOR-150 is: ALDOCLOR-150 is a combination product containing 150 mcg of clonidine and 25 mg of chlorthalidone. The typical adult dose is one tablet orally once daily.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between LOTREL and ALDOCLOR-150 in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. LOTREL is classified as Category C. First trimester: Animal studies suggest possible teratogenicity; human data limited. Second and third trimesters: Exposure to angiotensin II receptor antagonists (valsartan) and ca. ALDOCLOR-150 is classified as Category C. First trimester: Increased risk of neural tube defects (spina bifida) and other major congenital malformations (e.g., cardiovascular, orofacial clefts) due to folate antagonism. Se. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.