benazepril, Lotensin

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GENERIC NAME: benazepril

BRAND NAME: Lotensin

DRUG CLASS AND MECHANISM: Benazepril is an ACE (angiotensin converting enzyme) inhibitor used for treating high blood pressure. Other ACE inhibitors include enalapril (Vasotec), quinapril (Accupril), captopril (Capoten), fosinopril (Monopril), ramipril (Altace), moexipril (Univasc) and trandolapril (Mavik). ACE is an enzyme in the body that causes the formation of angiotensin II. Angiotensin II causes contraction of the muscles surrounding arteries and constriction of arteries in the body, thereby elevating blood pressure. ACE inhibitors such as benazepril lower blood pressure by inhibiting the formation of angiotensin II, thus relaxing the arteries. Relaxing the arteries not only lowers blood pressure, but also improves the pumping efficiency of a failing heart and thereby benefits patients with heart failure. The FDA approved benazepril in June 1991.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 5, 10, 20, and 40 mg.

STORAGE: Tablets should be stored at room temperature at or below 30 C (86 F) and protected from moisture.

PRESCRIBED FOR: Benazepril can be used alone or in combination with hydrochlorothiazide for treating high blood pressure. Like other ACE inhibitors it also is used for treating heart failure or diabetic nephropathy (kidney disease) although these are not FDA approved uses for benazepril.

DOSING: The usual starting dose of benazepril is 10 mg daily. If patients are taking a diuretic (water pill) the starting dose is 5 mg daily. Doses may be increased to 20-40 mg once daily or divided and administered twice daily.

DRUG INTERACTIONS: Combining benazepril with potassium supplements, potassium containing salt substitutes, and potassium conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium.

Combining benazepril or other ACE inhibitors with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.

There have been reports that aspirin and other NSAIDs such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, and many others), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors. When taken with lithium (Eskalith, Lithobid), benazepril can increase lithium to toxic levels in the blood.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including benazepril.




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