Lotrel and peripheral Neuropathy

I had been diagnosed with neuropathy several years ago.  However, it has been so mild I hardly notice it anymore.  I began taking Lotrel in early March.  In May I noticed my feet starting to tingle again.  Gradually it has gotten severe and it is also burning.  As a test I went off Lotrel for two days and the tingling and burning disappeared.  When I went back on it, it flared up again.  Have you ever heard of ace inhibitors aggravating peripheral neuropathy?  I haven't told my doctor yet as I'm afraid he will tell me it's all in my head or that it isn't Lotrel.  Please help!

[Esteban Cheng-Ching, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Lotrel is a combination of Amlodipine (a calcium channel blocker) and Benazepril (an ACE inhibitor).
Neuropathy from these medications is not a common side effect. There is at least one sporadic case reported in the literature of neuropathy associated with an ACE inhibitor.  When reviewing side effects from these medications, paresthesias (abnormal sensation) is reported to be associated with ACE inhibitors in less than 1%. Patients on amlodipine on the other hand, sometimes report abnormal sensation in the legs but mostly associated with “swelling”, and not associated with neuropathy.
ACE inhibitors are widely used, specially in diabetic patients who usually have a higher prevalence of peripheral neuropathy, and worsening of neuropathy on patients caused by these medications is not common.
The fact that the side effect is not common does not mean that what you feel is not related to the medication. I cannot really say if the medication is causing you the problem or not. However if you feel that your neuropathy worsens with the medication, specially after doing the trial of going off the medication and seeing the symptoms improve, I think you should discuss this issue with your doctor, and consider changing the treatment.
I hope you find this information useful. Thank you for the opportunity to answer your questions, good luck.

[mof29212]

I have had right buttock pain for 2 years (recently this symptom is almost nonexistant), right leg pain, feet burn on bottom and sometimes some tinglingl Have had xrays and mri of hip and lumbar. This am dr. result on mri was for my age-69- nothing unusual-xrays done and do have arthritis in knees and know sometimes my knuckles swell. My eyes burn sometimes but we are in an area where allergies are bad. I am "disabled". The pain now is in upper thigh only with extensive walking and of course my knees (to be expected). and a little numb like feeling on outer leg below knee area.  I recently had a sed test and it was normal 15. Hardly ever had health issues-do I drop this  matter now or do I continue to 1. neurologist 2. rheumatologist. ***@**** please reply