None of these increases required discontinuation of treatment. Increases in these laboratory values are more likely to occur in patients with renal insufficiency or those pretreated with a diuretic and, based on experience with other ACE inhibitors, would be expected to be especially likely in patients with renal artery stenosis (see PRECAUTIONS, General). Potassium: Since benazepril decreases aldosterone secretion, elevation of serum potassium can occur. Potassium supplements and potassium-sparing diuretics should be given with caution, and the patient's serum potassium should be monitored frequently (see PRECAUTIONS). Hemoglobin: Decreases in hemoglobin (a low value and a decrease of 5 g/ dL) were rare, occurring in only 1 of 2014 patients receiving Lotensin alone and in 1 of 1357 patients receiving Lotensin plus a diuretic. No U. S. patients discontinued treatment because of decreases in hemoglobin. Other (causal relationships unknown): Clinically important changes in standard laboratory tests were rarely associated with Lotensin administration. Elevations of uric acid, blood glucose, serum bilirubin, and liver enzymes (see WARNINGS) have been reported, as have scattered incidents of hyponatremia, electrocardiographic changes, leukopenia, eosinophilia, and proteinuria. In U. S. trials, less than 0.5% of patients discontinued treatment because of laboratory abnormalities. 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). | ||||
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