Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
LOTREL vs ALDOCLOR-250
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-250 is a combination of methyldopa and chlorothiazide. Methyldopa is a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow from the brain, decreasing peripheral vascular resistance and blood pressure. Chlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, increasing urinary output and reducing plasma volume.
Treatment of hypertension,Off-label: chronic kidney disease, heart failure, diabetic nephropathy (as part of combination therapy)
Hypertension (first-line or adjunctive therapy),Off-label: Management of hypertensive crisis (as part of combination therapy)
Oral: 1 capsule (amlodipine 2.5 mg/benazepril 10 mg) once daily, titrate to maximum 10 mg/40 mg once daily.
250 mg orally twice 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.
1.5-3 hours; prolonged in renal impairment (up to 20 hours with Cr Cl <10 m L/min).
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: Primarily hepatic metabolism via catecholamine pathways; conjugated to sulfate and other metabolites. Chlorothiazide: Not extensively metabolized; excreted unchanged in urine.
Amlodipine: 60% renal, 20-25% fecal. Benazeprilat: 85% renal (as benazeprilat and conjugated metabolites), 15% biliary/fecal.
Renal (70-80% unchanged), biliary/fecal (15-25% as metabolites); total clearance ~250 m L/min.
Amlodipine: ~93% (plasma proteins). Benazepril: ~96.7%; benazeprilat: ~95.3% (primarily albumin).
25-40% bound primarily to albumin and alpha-1-acid glycoprotein.
Amlodipine: 21 L/kg (large Vd indicates extensive tissue distribution). Benazeprilat: 0.11-0.13 L/kg (limited extravascular distribution).
0.6-1.0 L/kg; indicates distribution into total body water and some tissue binding.
Amlodipine: 64-90% (oral). Benazepril: >30% (oral; rapidly converted to active benazeprilat).
70-90% (oral); 100% (IV).
GFR ≥30 m L/min: No adjustment. GFR <30 m L/min: Not recommended. Hemodialysis: Avoid.
Cr Cl >50 m L/min: no adjustment; Cr Cl 10-50 m L/min: 250 mg once daily; Cr Cl <10 m L/min: 250 mg every 48 hours
Child-Pugh A: No dose adjustment. Child-Pugh B: Reduce dose or avoid. Child-Pugh C: Contraindicated.
Child-Pugh A: no adjustment; Child-Pugh B: use with caution, reduce dose by 50%; Child-Pugh C: avoid use
Not established in pediatric patients (safety and efficacy not evaluated).
Not recommended for use in pediatric patients due to lack of safety and efficacy data
Initiate with amlodipine 2.5 mg/benazepril 10 mg daily; titrate slowly due to increased risk of hypotension and renal impairment.
Start at lower end of dosing range; monitor renal function closely; adjust dose based on Cr Cl
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 explicitly listed. However, methyldopa carries a warning for hepatotoxicity and hemolytic anemia; chlorothiazide carries a warning for electrolyte disturbances and hypersensitivity reactions.
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
Hepatotoxicity (methyldopa), hemolytic anemia, positive direct Coombs test, sedation, depression, bradycardia, orthostatic hypotension, electrolyte imbalance (hypokalemia, hyponatremia, hypomagnesemia), hyperuricemia, hyperglycemia, photosensitivity, lupus-like syndrome, and hypersensitivity reactions.
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)
Active hepatic disease, history of previous methyldopa-induced liver dysfunction, hemolytic anemia associated with methyldopa, anuria, hypersensitivity to methyldopa, chlorothiazide, or sulfonamide-derived drugs, severe renal impairment (Cr Cl <30 m L/min), and concomitant therapy with MAO inhibitors.
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 high-potassium foods (bananas, oranges, spinach) unless specifically advised; chlorothiazide may cause potassium loss, but methyldopa can cause potassium retention. Avoid excessive alcohol intake as it may potentiate hypotension. Take with food to reduce gastrointestinal upset. May decrease glucose tolerance; monitor in diabetic patients.
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.
FDA Pregnancy Category D. First trimester: Associated with cardiovascular defects (e.g., VSD), neural tube defects, and oral clefts. Second and third trimesters: Fetal nephrotoxicity (oligohydramnios, renal failure), premature closure of ductus arteriosus, pulmonary hypertension, and intracranial hemorrhage. Avoid in third trimester.
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.
Chlorothiazide is excreted in breast milk; M/P ratio unknown. Can suppress lactation. Use only if maternal benefit outweighs potential infant risks (e.g., electrolyte disturbances, thrombocytopenia).
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.
Increased volume of distribution and GFR in pregnancy may necessitate higher doses for equivalent effect. Start at lowest effective dose; titrate based on BP response. Monitor for hypokalemia and metabolic alkalosis.
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-250 is a combination of methyldopa (250mg) and chlorothiazide. Methyldopa can cause a positive direct Coombs test (10-20% of patients) which may interfere with blood cross-matching; obtain a hematocrit and Coombs test before therapy and at 6 and 12 months. Chlorothiazide may cause hypokalemia; monitor potassium and consider potassium supplementation. Onset of methyldopa is 3-6 hours; delay full effect for 48-72 hours. Avoid use in patients with active liver disease or history of previous methyldopa-induced liver dysfunction.
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 exactly as prescribed; do not skip doses or stop suddenly.,May cause drowsiness or dizziness; avoid driving or operating machinery until you know how it affects you.,Rise slowly from sitting or lying to prevent lightheadedness.,Report any unexplained fever, jaundice, or dark urine immediately.,Use sun protection; this drug may increase sensitivity to sunlight.,Do not use potassium supplements or salt substitutes without consulting your doctor.,If you miss a dose, take it as soon as you remember unless it's near the next dose; do not double.
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-250, 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-250 is a Antihypertensive Combination (Central Alpha Agonist and Thiazide Diuretic) that works by Aldoclor-250 is a combination of methyldopa and chlorothiazide. Methyldopa is a centrally acting alpha-2 adrenergic agonist that reduces sympathetic outflow from the brain, decreasing peripheral vascular resistance and blood pressure. Chlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, increasing urinary output and reducing plasma volume.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between LOTREL and ALDOCLOR-250 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-250 is: 250 mg orally twice 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-250 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-250 is classified as Category C. FDA Pregnancy Category D. First trimester: Associated with cardiovascular defects (e.g., VSD), neural tube defects, and oral clefts. Second and third trimesters: Fetal nephrotoxici. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.