Benazepril Hydrochloride

Contraindicated in patients with diabetes. Avoid in patients with renal impairment (GFR < 60 mL/min). Associated with hypotension, hyperkalemia, and acute renal failure.

Dual RAS blockade associated with increased risks of hypotension, hyperkalemia, and acute renal failure. Avoid combined use.

May cause nitritoid reactions.

Risk of lithium toxicity symptoms with concomitant use.

Increased risk of angioedema with concomitant use.

Increased risk of renal impairment, acute renal failure, and loss of antihypertensive efficacy, especially in elderly, volume-depleted, or renal-compromised patients.

Neprilysin inhibitor increases risk of angioedema when combined with benazepril.

Nitritoid reactions (facial flushing, nausea, vomiting, hypotension) have been reported rarely with injectable gold and ACE inhibitor therapy.

Concomitant administration may increase the risk of hypoglycemia.

Increased risk of hyperkalemia. Monitor serum potassium frequently during concomitant use.

Increased risk of hypoglycemia with concomitant administration.

7 DRUG INTERACTIONS Diuretics: Excessive drop in blood pressure ( 7.1 ) Antidiabetics: Increased risk of hypoglycaemia ( 7.2 ) NSAIDS: Increased risk of renal impairment and loss of antihypertensive efficacy ( 7.3 ) Dual inhibition of the renin-angiotensin system: Increased risk of renal impairment, hypotension and hyperkalemia ( 7.4 ) Lithium: Symptoms of lithium toxicity ( 7.6 ) Neprilysin Inhibitor: Increased risk of angioedema ( 7.7 ) Gold: Nitritoid reactions ( 7.8 ) 7.1 Diuretics Hypotension 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. The possibility of hypotensive effects with benazepril hydrochloride can be minimized by either discontinuing or decreasing the dose of diuretic prior to initiation of treatment with benazepril hydrochloride [see Dosage and Administration ( 2.1 )]. Benazepril hydrochloride attenuates potassium loss caused by thiazide-type diuretics.

Excessive drop in blood pressure, especially with recent diuretic initiation. Potassium-sparing diuretics increase hyperkalemia risk.

mTOR inhibitor; coadministration with ACE inhibitors requires monitoring.

Increased risk of hypoglycemia with concomitant administration.

ACE inhibitors including benazepril may cause hypoglycemia in diabetic patients. Advise patients of hypoglycemic risk and monitor accordingly.

Concomitant use may affect potassium levels. Monitor potassium periodically.

7.5 Mammalian Target of Rapamycin (mTOR) Inhibitors Patients receiving coadministration of ACE inhibitor and mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema.

Increased risk of hyperkalemia. Monitor serum potassium frequently during concomitant use.

mTOR inhibitor; coadministration with ACE inhibitors requires monitoring.

Increased risk of hyperkalemia. Monitor serum potassium frequently during concomitant use.

Interaction studies failed to identify clinically important effects on serum concentrations or clinical effects of acenocoumarol.

Interaction studies failed to identify clinically important effects on serum concentrations or clinical effects of warfarin.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine.

The pharmacokinetics of benazepril are not affected by the following drugs: hydrochlorothiazide, furosemide, chlorthalidone, digoxin, propranolol, atenolol, nifedipine, amlodipine, naproxen, acetylsalicylic acid, or cimetidine.