Drug-induced nutrient depletion

Benazepril, Hydrochlorothiazide & Nutrient Depletion

Also searched as Lotensin HCT. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.

7Nutrient associations
Major DepletionHighest rating
The bottom line

Benazepril, Hydrochlorothiazide has been associated with depletion of POTASSIUM, VITAMIN C, MAGNESIUM and THIAMINE and 3 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Benazepril, Hydrochlorothiazide long-term, worth raising with your pharmacist or healthcare provider.

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Take more than one medication? Open the checker with Benazepril, Hydrochlorothiazide pre-loaded and add the rest to see overlapping nutrient signals.

The evidence

Reported nutrient depletions with Benazepril, Hydrochlorothiazide

Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.

POTASSIUM

Major Depletion

DIURETIC DRUGS

Some diuretic drugs increase urinary potassium excretion. Loop and thiazide diuretics increase the risk of hypokalemia due to increased urinary potassium excretion. However, potassium-sparing diuretics, such as amiloride, triamterene, or spironolactone, can counteract the potassium losses seen with loop diuretics and thiazides. Monitor serum potassium levels and give potassium supplements when necessary. For information on foods that are rich in potassium, see our chart.
Taking Benazepril, Hydrochlorothiazide? A supplement is needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and the hydrochlorothiazide in this combination pill is the real concern here. Thiazide diuretics make your kidneys push out extra potassium in the urine, which over time can drop your levels into a range that causes real problems like muscle cramps, weakness, or irregular heartbeat. This is rated a major depletion, meaning low potassium is a genuine, common issue for long-term users, not just a theoretical one. Ask your doctor or pharmacist about getting your potassium levels checked and whether a supplement or dietary changes make sense for you.

What Potassium does & food sources

Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally.

Common food sources:

  • Bananas and citrus fruits
  • Potatoes and sweet potatoes
  • Beans and lentils
  • Tomatoes and leafy greens

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Potassium is routinely checked with basic blood work. If you take a medication associated with potassium loss (like some diuretics), ask your provider how often your electrolytes should be monitored.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Do not start potassium supplements on your own. Both low and high potassium can affect heart rhythm, and several common medications (ACE inhibitors, ARBs, potassium-sparing diuretics) raise potassium.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Potassium supplementation can be dangerous in kidney disease or alongside potassium-raising medications — this is a decision for your prescriber, guided by lab results.

Learn more about this nutrient: Potassium — uses, safety & interactions

References (3)
  1. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  2. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  3. Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.

VITAMIN C

Insignificant Depletion

DIURETIC DRUGS

Diuretics might reduce levels of vitamin C.

In people with chronic renal failure, a 20 mg intravenous dose of furosemide (Lasix) increases urinary losses of vitamin C, probably due to increased water excretion. Significant vitamin C depletion hasn't been reported with long-term oral use of furosemide or other diuretics.
Taking Benazepril, Hydrochlorothiazide? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Vitamin C is something your immune system, skin, and blood vessels all depend on, so it makes sense to wonder about it. The hydrochlorothiazide portion of this combination is a diuretic, meaning it makes your kidneys produce more urine, and there is some thinking that extra urine output could carry a little more vitamin C out of the body. That said, meaningful vitamin C depletion has not actually been reported with regular oral use of diuretics like this one. For most people taking this medication, no special action is needed, but if you have questions about your diet or vitamins, your pharmacist or doctor is a good person to ask.

What Vitamin C does & food sources

Vitamin C is an antioxidant that supports the immune system, collagen formation, and iron absorption.

Common food sources:

  • Citrus fruits
  • Bell peppers
  • Strawberries and kiwi
  • Broccoli and Brussels sprouts

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Frank vitamin C deficiency is uncommon with a varied diet. If your diet is limited and you take an associated medication, ask your provider whether your intake is adequate.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Vitamin C is water-soluble and generally low-risk at food-level intakes; very high supplemental doses can cause stomach upset and may not add benefit.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Learn more about this nutrient: Vitamin C — uses, safety & interactions

References (1)
  1. Mydlik M, Derzsiova K, Zemberova E. Influence of water and sodium diuresis and furosemide on urinary excretion of vitamin B6, oxalic acid and vitamin C in chronic renal failure. Miner Electrolyte Metab 1999;25:352-6..

MAGNESIUM

Moderate Depletion

DIURETIC DRUGS

Some diuretics increase the amount of magnesium excreted in the urine.

Loop diuretics and, to a lesser extent thiazide diuretics, interfere with magnesium reabsorption in the kidneys, increasing urinary losses and reducing serum magnesium levels. Potassium-sparing diuretics, such as amiloride, triamterene, or spironolactone, are also magnesium-sparing, and can therefore counteract the magnesium losses seen with loop diuretics and thiazides. For information on foods that are rich in magnesium, see our chart.
Taking Benazepril, Hydrochlorothiazide? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Magnesium helps your muscles, heart rhythm, and nerves work properly, so keeping levels in a healthy range really does matter. The hydrochlorothiazide in this combination is a thiazide diuretic, and thiazides can cause your kidneys to flush out more magnesium than usual through the urine rather than holding onto it. This is a moderate concern, meaning some long-term users do end up with lower magnesium levels worth addressing. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether checking your magnesium level or taking a supplement makes sense for you.

What Magnesium does & food sources

Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.

Common food sources:

  • Nuts and seeds (almonds, pumpkin seeds)
  • Whole grains
  • Leafy green vegetables
  • Beans and legumes

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.

Learn more about this nutrient: Magnesium — uses, safety & interactions

References (4)
  1. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  2. Ryan MP. Diuretics and potassium/magnesium depletion. Directions for treatment. Am J Med 1987;82:38-47.. PubMed
  3. Hollifield JW. Magnesium depletion, diuretics, and arrhythmias. Am J Med 1987;82:30-7.. PubMed
  4. Heidenreich O. Mode of action of conventional and potassium-sparing diuretics--aspects with relevance to Mg-sparing effects. Magnesium 1984;3:248-56..

THIAMINE

Moderate Depletion

DIURETIC DRUGS

High doses of diuretics can increase thiamine excretion and increase the risk of deficiency.
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Taking Benazepril, Hydrochlorothiazide? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. The hydrochlorothiazide in this combination is a diuretic, and diuretics can cause the kidneys to flush thiamine out in the urine faster than normal. This is rated a moderate concern, meaning it is not a guaranteed problem for everyone, but long-term users, older adults, or anyone not eating well may be at higher risk. Worth a conversation with your pharmacist or doctor, especially if you have been on this medication for several months.

What Vitamin B1 (thiamine) does & food sources

Thiamine helps convert food into energy and is essential for nerve and heart function.

Common food sources:

  • Whole grains and fortified cereals
  • Pork
  • Beans and lentils
  • Nuts and seeds

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask about thiamine if you take an associated medication (for example, a long-term loop diuretic in heart failure) and have symptoms like fatigue or worsening heart failure control — this is an area your care team can weigh.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Thiamine is water-soluble and generally low-risk, but supplementing to treat a suspected problem should still be clinician-guided so the real cause is not missed.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Learn more about this nutrient: Thiamine — uses, safety & interactions

References (9)
  1. Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
  2. Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
  3. Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
  4. Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
  5. Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
  6. Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
  7. Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
  8. Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
  9. Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.

COENZYME Q10

Insufficient Evidence

ANTIHYPERTENSIVE DRUGS

Some antihypertensive drugs can modestly decrease endogenous levels of coenzyme Q10.

Some antihypertensive drugs, including beta blockers, diazoxide, hydralazine, and others, appear to inhibit coenzyme Q10 enzyme activity and may decrease endogenous levels of coenzyme Q10. However, it is not clear if this reduction is clinically significant. There is no reliable evidence that coenzyme Q10 depletion contributes to antihypertensive drug side effects.
Taking Benazepril, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Coenzyme Q10 is a compound your cells use to produce energy, and it also acts as an antioxidant. Some antihypertensive medications have been associated with mildly lower CoQ10 levels, possibly by interfering with the enzymes your body uses to make it naturally. That said, the evidence for this combination is genuinely thin, and it is not known whether any reduction is meaningful in practice. Most people taking this medication do not need to act on this, but if you are curious about your CoQ10 status, it is worth a quick chat with your pharmacist or doctor.

What Coenzyme Q10 (CoQ10) does & food sources

CoQ10 helps cells produce energy and acts as an antioxidant; heart and muscle tissue use it heavily.

Common food sources:

  • Organ meats and fatty fish
  • Whole grains
  • Nuts and seeds

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

There is no routine blood test for CoQ10 in everyday practice. If you have new, unexplained muscle symptoms on a medication linked to CoQ10 (statins are the best-known example), talk to your prescriber before changing anything — symptoms have many possible causes and your prescriber has several options.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

CoQ10 is generally well tolerated, but evidence for supplementing (for example, for statin muscle symptoms) is mixed. It may also modestly affect warfarin — check with your pharmacist before combining.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Do not stop a prescribed medication because of this association — discuss any symptoms with your prescriber first.

Learn more about this nutrient: Coenzyme Q10 — uses, safety & interactions

References (1)
  1. Kishi T, Kishi H, Watanabe T, et al. Bioenergetics in clinical medicine. XI. Studies on coenzyme Q and diabetes mellitus. J Med 1976;7:307-21.

FOLIC ACID

Insufficient Evidence

DIURETIC DRUGS

Diuretics might increase folate excretion; however, the clinical significance of this is unclear.

Limited data suggests diuretics may increase excretion of folic acid. Reduced red blood cell folate levels, possibly contributing to increased homocysteine levels, were found in one group of people taking diuretics for six months or longer. The need for folic acid supplementation during diuretic therapy hasn't been adequately studied. Advise patients to maintain a good dietary intake of folic acid. For information on foods that are rich in folate, see our chart.
Taking Benazepril, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Folic acid is a B vitamin your body uses to build healthy red blood cells and keep homocysteine levels in check. The hydrochlorothiazide portion of this combination is a diuretic, meaning it makes your kidneys produce more urine, and there is some early evidence that this process may carry a little extra folate out of the body along the way. That said, the research is quite limited, and right now there simply is not enough data to know whether this matters clinically. For most people on this medication, eating folate-rich foods like leafy greens and beans is a sensible, low-key step, and if you have concerns about your levels, your doctor or pharmacist can help you decide whether anything else is worth looking into.

What Folic acid (folate) does & food sources

Folate is needed for cell division, red blood cell formation, and healthy fetal development.

Common food sources:

  • Leafy green vegetables
  • Beans, lentils, and peas
  • Fortified grains and cereals
  • Citrus fruits

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.

Learn more about this nutrient: Folic Acid — uses, safety & interactions

References (1)
  1. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866-70. PubMed

SODIUM

Insufficient Evidence

DIURETIC DRUGS

Theoretically, taking diuretic drugs might increase the risk of hyponatremia.
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Taking Benazepril, Hydrochlorothiazide? Insufficient evidence to rate; clinical significance is not known.
Dr. Brian Staiger, Pharm.D explains

Sodium is the mineral your body uses to balance fluids and keep your muscles and nerves firing properly. The hydrochlorothiazide part of this combination works in the kidneys to push sodium out through urine, which is actually part of how it lowers blood pressure. In rare cases, that same action can drop sodium levels too far, a condition called hyponatremia. The evidence here is still insufficient to say how often this is a real concern, so if you notice symptoms like unusual fatigue, nausea, or confusion while taking this medication, let your pharmacist or doctor know right away.

What Sodium does & food sources

Sodium maintains fluid balance, blood pressure, and nerve/muscle function.

Common food sources:

  • Table salt and most processed foods — dietary shortage is rare; medication-related loss is about balance, not intake

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Sodium is part of routine blood work. If you take an associated medication (like certain diuretics or antidepressants), ask how often your electrolytes should be checked — especially if you feel confused, weak, or unusually tired.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Low sodium from a medication is managed by your care team (often by adjusting the medication or fluids) — not by eating more salt on your own.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Significant symptoms of low sodium (confusion, severe weakness) warrant prompt medical attention.

Learn more about this nutrient: Sodium — uses, safety & interactions

References (2)
  1. Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
  2. Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.
Important

This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.

Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.

© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
Understand the basics

What drug-induced nutrient depletion means

Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.

Association is not deficiency

An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.

Evidence varies by pair

Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.

When to ask about labs

If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.

Don't self-supplement blindly

Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.

Never stop a medication over this

These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.

Food first, usually

For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.

Common questions

Benazepril, Hydrochlorothiazide & nutrients: FAQs

Does Benazepril, Hydrochlorothiazide deplete POTASSIUM?
Benazepril, Hydrochlorothiazide has been associated with lower POTASSIUM levels in the clinical literature — see the evidence rating and details above. An association is not a guarantee: dose, duration, diet, and your own health all matter. If you take Benazepril, Hydrochlorothiazide long-term, ask your healthcare provider whether checking your POTASSIUM status is appropriate.
Should I take a supplement because I take Benazepril, Hydrochlorothiazide?
Not automatically. The right first step is usually a conversation with your pharmacist or provider — they can weigh your dose and duration, decide whether testing makes sense, and recommend food-first strategies or a supplement if genuinely needed. Some supplements can interact with medications, so do not add one without checking.
Should I stop taking Benazepril, Hydrochlorothiazide?
No — never stop a prescribed medication because of a nutrient association. Benazepril, Hydrochlorothiazide is prescribed for good reasons, and nutrient considerations are usually manageable with monitoring or diet. Any change to your medication belongs in a conversation with your prescriber.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English context is written and reviewed by licensed HelloPharmacist pharmacists.

Questions about Benazepril, Hydrochlorothiazide and your nutrition?

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Sources

Sources & How We Checked

Nutrient depletion records for Benazepril, Hydrochlorothiazide are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.