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{{Benazepril}}
{{Benazepril}}
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==Drug Interactions==
==Drug Interactions==


<u>'''Diuretics'''</u>: Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Lotensin. The possibility of hypotensive effects with Lotensin can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Lotensin. If this is not possible, the starting dose should be reduced (see DOSAGE AND ADMINISTRATION).
<u>'''Diuretics'''</u>: Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of [[blood pressure]] after initiation of therapy with Lotensin. The possibility of hypotensive effects with Lotensin can be minimized by either discontinuing the [[diuretic]] or increasing the salt intake prior to initiation of treatment with Lotensin. If this is not possible, the starting dose should be reduced (see DOSAGE AND ADMINISTRATION).


<u>'''Potassium Supplements and Potassium-Sparing Diuretics'''</u>: Concomitant use with Lotensin may effect potassium levels. Monitor potassium periodically.
<u>'''Potassium Supplements and Potassium-Sparing Diuretics'''</u>: Concomitant use with Lotensin may effect [[potassium]] levels. Monitor potassium periodically.


<u>'''Oral Anticoagulants'''</u>: Interaction studies with warfarin and acenocoumarol failed to identify any clinically important effects on the serum concentrations or clinical effects of these anticoagulants.
<u>'''Oral Anticoagulants'''</u>: Interaction studies with [[warfarin]] and [[acenocoumarol]] failed to identify any clinically important effects on the serum concentrations or clinical effects of these anticoagulants.


<u>'''Lithium'''</u>: Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors (including benazepril) during therapy with lithium. Monitor lithium levels when used concomitantly with Lotensin.
<u>'''Lithium'''</u>: Increased serum lithium levels and symptoms of [[lithium toxicity]] have been reported in patients receiving ACE inhibitors (including benazepril) during therapy with [[lithium]]. Monitor lithium levels when used concomitantly with Lotensin.


<u>'''Gold'''</u>: Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy.
<u>'''Gold'''</u>: Nitritoid reactions (symptoms include [[facial flushing]], nausea, vomiting and [[hypotension]]) have been reported rarely in patients on therapy with injectable [[gold]] (sodium aurothiomalate) and concomitant [[ACE inhibitor]] therapy.


<u>'''Anti-diabetics'''</u>: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral anti-diabetics may develop hypoglycemia. Such patients should therefore be advised about the possibility of hypoglycemic reactions and should be monitored accordingly.
<u>'''Anti-diabetics'''</u>: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with [[insulin]] or [[oral anti-diabetics]] may develop [[hypoglycemia]]. Such patients should therefore be advised about the possibility of hypoglycemic reactions and should be monitored accordingly.


<u>'''Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors)'''</u>: In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including benazepril, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving benazepril and NSAID therapy.
<u>'''Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) including Selective [[Cyclooxygenase-2 Inhibitors]] (COX-2 Inhibitors)'''</u>: In patients who are elderly, volume-depleted (including those on [[diuretic]] therapy), or with compromised renal function, co-administration of [[NSAIDs]], including selective COX-2 inhibitors, with ACE inhibitors, including benazepril, may result in deterioration of renal function, including possible [[acute renal failure]]. These effects are usually reversible. Monitor renal function periodically in patients receiving benazepril and NSAID therapy.


The antihypertensive effect of ACE inhibitors, including benazepril, may be attenuated by NSAIDs.
The antihypertensive effect of ACE inhibitors, including benazepril, may be attenuated by NSAIDs.


<u>'''Other'''</u>: Lotensin has been used concomitantly with beta-adrenergic-blocking agents, calcium-channel-blocking agents, diuretics, digoxin, and hydralazine, without evidence of clinically important adverse interactions. Benazepril, like other ACE inhibitors, has had less than additive effects with beta-adrenergic blockers, presumably because both drugs lower blood pressure by inhibiting parts of the renin-angiotensin system.
<u>'''Other'''</u>: Lotensin has been used concomitantly with [[beta-adrenergic-blocking agents]], [[calcium-channel-blocking agents]], diuretics, [[digoxin]], and [[hydralazine]], without evidence of clinically important adverse interactions. Benazepril, like other ACE inhibitors, has had less than additive effects with beta-adrenergic blockers, presumably because both drugs lower blood pressure by inhibiting parts of the renin-angiotensin system.


The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine. Likewise the administration of benazepril does not substantially affect the pharmacokinetics of these medications (cimetidine kinetics were not studied).<ref name="dailymed.nlm.nih.gov">{{Cite web  | last =  | first =  | title = LOTENSIN (BENAZEPRIL HYDROCHLORIDE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=4d954024-a191-46e3-ba71-2a7d5b0c65d5#nlm34067-9 | publisher =  | date =  | accessdate = }}</ref>
The pharmacokinetics of benazepril are not affected by the following drugs: [[hydrochlorothiazide]], [[furosemide]], [[chlorthalidone]], digoxin, [[propranolol]], [[atenolol]], [[nifedipine]], [[amlodipine]], [[naproxen]], [[acetylsalicylic acid]], or [[cimetidine]]. Likewise the administration of benazepril does not substantially affect the pharmacokinetics of these medications (cimetidine kinetics were not studied).<ref name="dailymed.nlm.nih.gov">{{Cite web  | last =  | first =  | title = LOTENSIN (BENAZEPRIL HYDROCHLORIDE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=4d954024-a191-46e3-ba71-2a7d5b0c65d5#nlm34067-9 | publisher =  | date =  | accessdate = }}</ref>


==List of Drug Interactions==
==List of Drug Interactions==
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==Diuretics==
==Diuretics==


Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Benazepril hydrochloride tablets. The possibility of hypotensive effects with Benazepril hydrochloride tablets can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Benazepril hydrochloride tablets. If this is not possible, the starting dose should be reduced.
Patients on [[diuretics]], especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Benazepril hydrochloride tablets. The possibility of hypotensive effects with Benazepril hydrochloride tablets can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Benazepril hydrochloride tablets. If this is not possible, the starting dose should be reduced.


''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
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==Potassium Supplements and Potassium-Sparing Diuretics==
==Potassium Supplements and Potassium-Sparing Diuretics==


Benazepril hydrochloride tablets can attenuate potassium loss caused by thiazide diuretics. Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia. Therefore, if concomitant use of such agents is indicated, they should be given with caution, and the patient's serum potassium should be monitored frequently.
Benazepril hydrochloride tablets can attenuate [[potassium]] loss caused by thiazide diuretics. [[Potassium-sparing diuretics]] ([[spironolactone]], [[amiloride]], [[triamterene]], and others) or potassium supplements can increase the risk of [[hyperkalemia]]. Therefore, if concomitant use of such agents is indicated, they should be given with caution, and the patient's serum potassium should be monitored frequently.


''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
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==Oral Anticoagulants==
==Oral Anticoagulants==


Interaction studies with warfarin and acenocoumarol failed to identify any clinically important effects on the serum concentrations or clinical effects of these anticoagulants.
Interaction studies with [[warfarin]] and [[acenocoumarol]] failed to identify any clinically important effects on the serum concentrations or clinical effects of these anticoagulants.


''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
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==Lithium==
==Lithium==


Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors during therapy with lithium. These drugs should be coadministered with caution, and frequent monitoring of serum lithium levels is recommended. If a diuretic is also used, the risk of lithium toxicity may be increased.
Increased serum [[lithium]] levels and symptoms of [[lithium toxicity]] have been reported in patients receiving ACE inhibitors during therapy with lithium. These drugs should be coadministered with caution, and frequent monitoring of serum lithium levels is recommended. If a diuretic is also used, the risk of lithium toxicity may be increased.


''[[Benazepril drug interactions#List of drug interactions|Return to top]]''
''[[Benazepril drug interactions#List of drug interactions|Return to top]]''

Revision as of 20:22, 11 February 2014

Benazepril drug interactions
Black Box Warning
Adult Indications and Dosage
Pediatric Indications and Dosage
Contraindications
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Adverse Reactions
Drug Interactions
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]

Drug Interactions

Diuretics: Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Lotensin. The possibility of hypotensive effects with Lotensin can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Lotensin. If this is not possible, the starting dose should be reduced (see DOSAGE AND ADMINISTRATION).

Potassium Supplements and Potassium-Sparing Diuretics: Concomitant use with Lotensin may effect potassium levels. Monitor potassium periodically.

Oral Anticoagulants: Interaction studies with warfarin and acenocoumarol failed to identify any clinically important effects on the serum concentrations or clinical effects of these anticoagulants.

Lithium: Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors (including benazepril) during therapy with lithium. Monitor lithium levels when used concomitantly with Lotensin.

Gold: Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy.

Anti-diabetics: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral anti-diabetics may develop hypoglycemia. Such patients should therefore be advised about the possibility of hypoglycemic reactions and should be monitored accordingly.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including benazepril, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving benazepril and NSAID therapy.

The antihypertensive effect of ACE inhibitors, including benazepril, may be attenuated by NSAIDs.

Other: Lotensin has been used concomitantly with beta-adrenergic-blocking agents, calcium-channel-blocking agents, diuretics, digoxin, and hydralazine, without evidence of clinically important adverse interactions. Benazepril, like other ACE inhibitors, has had less than additive effects with beta-adrenergic blockers, presumably because both drugs lower blood pressure by inhibiting parts of the renin-angiotensin system.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine. Likewise the administration of benazepril does not substantially affect the pharmacokinetics of these medications (cimetidine kinetics were not studied).[1]

List of Drug Interactions


Diuretics

Potassium Supplements and Potassium-Sparing Diuretics

Oral Anticoagulants

Lithium

Other

Complete list of drug interactions

Major Interactions

Moderate Interactions

Minor Interactions




Diuretics

Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Benazepril hydrochloride tablets. The possibility of hypotensive effects with Benazepril hydrochloride tablets can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Benazepril hydrochloride tablets. If this is not possible, the starting dose should be reduced.

Return to top

Potassium Supplements and Potassium-Sparing Diuretics

Benazepril hydrochloride tablets can attenuate potassium loss caused by thiazide diuretics. Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia. Therefore, if concomitant use of such agents is indicated, they should be given with caution, and the patient's serum potassium should be monitored frequently.

Return to top

Oral Anticoagulants

Interaction studies with warfarin and acenocoumarol failed to identify any clinically important effects on the serum concentrations or clinical effects of these anticoagulants.

Return to top

Lithium

Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors during therapy with lithium. These drugs should be coadministered with caution, and frequent monitoring of serum lithium levels is recommended. If a diuretic is also used, the risk of lithium toxicity may be increased.

Return to top

Other

No clinically important pharmacokinetic interactions occurred when Benazepril hydrochloride tablets were administered concomitantly with hydrochlorothiazide, chlorthalidone, furosemide, digoxin, propranolol, atenolol, naproxen, or cimetidine.

Benazepril hydrochloride tablets have been used concomitantly with beta-adrenergic-blocking agents, calcium-channel-blocking agents, diuretics, digoxin, and hydralazine, without evidence of clinically important adverse interactions. Benazepril, like other ACE inhibitors, has had less than additive effects with beta-adrenergic blockers, presumably because both drugs lower blood pressure by inhibiting parts of the renin-angiotensin system.

Return to top

Complete list of drug interactions

Major Interactions

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Moderate Interactions

0-9

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A

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B

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C

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D

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E

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F

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G

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H

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I

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K

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L

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M

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N

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O

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P

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Q

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R

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S

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T

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U

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V

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W

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X

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Y

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Z

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Minor Interactions

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References

  1. ↑ "LOTENSIN (BENAZEPRIL HYDROCHLORIDE) TABLET [NOVARTIS PHARMACEUTICALS CORPORATION]".

Adapted from the FDA Package Insert.

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