Details About Generic Salt ::  Benazepr

Main Medicine Class:: Antihypertensive,ACE inhibitor   

(BEN-AZE-uh-prill HIGH-droe-KLOR-ide)
Lotensin
Class: Antihypertensive/ACE inhibitor

 

Drugs Class ::

 Action Competitively inhibits angiotensin I-converting enzyme, resulting in the prevention of angiotensin I conversion to angiotensin II, a potent vasoconstrictor that stimulates aldosterone secretion. Results in decrease in sodium and fluid retention, decrease in blood pressure, and increase in diuresis.

Indications for Drugs ::

 Indications Treatment of hypertension.

Drug Dose ::

 Route/Dosage

ADULTS: Initial dose: PO 10 mg qd for patients not receiving a diuretic. In patients taking diuretics that cannot be discontinued, give initial dose of 5 mg. Maintenance: PO 20 to 40 mg/day as single dose or in 2 divided doses; doses up to 80 mg have been used.

Contraindication ::

 Contraindications Hypersensitivity to ACE inhibitors.

Drug Precautions ::

 Precautions

Pregnancy: Category D (second and third trimester); Category C (first trimester). ACE inhibitors can cause injury or death to fetus if used during second or third trimester. When pregnancy is detected, discontinue ACE inhibitors as soon as possible. Lactation: Excreted in breast milk; avoid use in nursing mothers if possible. Children: Safety and efficacy not established. Angioedema: Use with extreme caution in patients with hereditary angioedema. Angioedema associated with laryngeal edema may be fatal. Hypotension/First-dose effect: Significant decreases in blood pressure may occur after first dose, especially in severely salt- or volume-depleted patients (eg, those undergoing dialysis or vigorous diuretic therapy), or those with heart failure. Risk is minimized by discontinuing use of diuretics, increasing salt intake » 1 wk before initiating benazepril or decreasing benazepril dose. Neutropenia/agranulocytosis: Has occurred with other ACE inhibitors. Renal impairment: Reduce dosage.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Hypotension; ECG changes. CNS: Headache; dizziness; fatigue; hypertonia. DERM: Hypersensitivity reaction (eg, dermatitis, pruritus or rash with or without fever). GI: Nausea. HEPA: Elevated liver enzymes, elevated serum bilirubin. META: Hyperkalemia; hyponatremia; elevated uric acid; elevated blood glucose. RESP: Chronic dry cough. OTHER: Arthralgia; myalgia; angioedema; leukopenia; eosinophilia; proteinuria.

Drug Mode of Action ::  

 Action Competitively inhibits angiotensin I-converting enzyme, resulting in the prevention of angiotensin I conversion to angiotensin II, a potent vasoconstrictor that stimulates aldosterone secretion. Results in decrease in sodium and fluid retention, decrease in blood pressure, and increase in diuresis.

Drug Interactions ::

 Interactions

Allopurinol: Greater risk of hypersensitivity possible with coadministration. Antacids: May decrease bioavailability of benazepril; separate administration by 1 to 2 hr. Capsaicin: Cough may be exacerbated. Digoxin: Increased digoxin levels. Diuretics: May cause symptomatic hypotension after initial dose of benazepril. Indomethacin: May reduce effects of benazepril, especially in low-renin or volume-dependent hypertensive patients. Lithium: May increase lithium levels and symptoms of lithium toxicity. Phenothiazines: May increase effects of benazepril. Potassium preparations, potassium-sparing diuretics: May increase serum potassium levels.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note liver disease, CHF, concurrent use of diuretics, or dialysis.
  • Ensure that kidney function tests and baseline electrolytes have been obtained prior to administration and monitor during therapy.
  • Review baseline ECG.
  • Assess BP and pulse before administration. If systolic BP is < 90 mm Hg, withhold medication and notify physician.
  • Monitor for hyperkalemia in patients with impaired renal function, diabetes mellitus, and patients receiving potassium supplementation or potassium-sparing diuretics.
  • Monitor closely for at least 2 hr after initial dose and during first 2 wk of therapy. If patient experiences sudden marked decrease in BP, withhold medication and notify physician.
  • If sudden severe dyspnea, swelling of lips or eyes, or edema of hands and feet develop, withhold medication and notify physician.
  • If BP is not controlled with bezapril alone, add a diuretic.

OVERDOSAGE: SIGNS & SYMPTOMS
  Hypotension

Drug Storage/Management ::

 Administration/Storage

  • May be administered with or without food.
  • Store in tightly closed container in a cool location.

Drug Notes ::

 Patient/Family Education

  • Instruct patient not to discontinue medication suddenly. Loss of BP control can result.
  • Explain that exercise, salt restriction, and weight loss will enhance efficacy of medication and may allow for lowering of dosage.
  • Tell patient that missed doses should be taken as soon as remembered but not to double up on doses.
  • Explain that frequent follow-up appointments with physician are very important to adjust medication dosage.
  • Teach patient how to monitor BP and instruct to check before taking drug. Warn patient not to take drug if systolic BP is < 90 mm Hg and to call physician.
  • Advise patient to avoid intake of caffeine, salt substitutes, and foods high in potassium or sodium.
  • Instruct patient to avoid sudden position changes to prevent orthostatic hypotension.
  • Tell patient that medication causes dizziness and to avoid driving.
  • Instruct patient to notify physician if chronic dry cough or other persistent symptoms occur.
  • Explain that drug may cause impaired taste perception. Tell patient to notify physician if this symptom occurs.
  • Tell patient not to take otc medications without notifying physician.

Disclaimer ::

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