Lotensin Side Effects

Generic Name: benazepril

Note: This document contains side effect information about benazepril. Some of the dosage forms listed on this page may not apply to the brand name Lotensin.

Some side effects of Lotensin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to benazepril: oral tablet

Along with its needed effects, benazepril (the active ingredient contained in Lotensin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking benazepril:

Less common
  • Chills
  • cold sweats
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • unusual tiredness or weakness
Incidence not known
  • Arm, back, or jaw pain
  • blistering, peeling, or loosening of the skin
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • chest pain or discomfort
  • diarrhea
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feeling of warmth
  • fever
  • general feeling of tiredness or weakness
  • itching
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • nausea
  • rapid breathing
  • rapid weight gain
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • redness of the face, neck, arms, and occasionally, upper chest
  • shortness of breath
  • skin rash
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • sweating
  • tingling of the hands or feet
  • unusual weight gain or loss
  • wheezing

Some side effects of benazepril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Headache
Less common
  • Cough
  • dizziness
  • sleepiness or unusual drowsiness

For Healthcare Professionals

Applies to benazepril: oral tablet

General

Benazepril has generally been well-tolerated. In large analyses, 20% to 52% of patients experienced an adverse drug event associated with benazepril (the active ingredient contained in Lotensin) but most were mild to moderate and did not require cessation of therapy.

Nervous system

Nervous system side effects have included headache (5% to 13%), fatigue (5%), and dizziness (5%). Somnolence or vertigo has been reported in 1% of patients.

Respiratory

Respiratory side effects have included eosinophilic pneumonitis which has been reported with other ACE inhibitors.

A retrospective study has revealed a significantly higher incidence of discontinuation of angiotensin converting enzyme inhibitor therapy due to cough among black patients compared with nonblack patients (9.6% vs. 2.4%).

Several agents have been studied for treating cough with ACE inhibitors. No long term trials exist to allow a definitive treatment option. Cromolyn has been shown with the most data showing some benefit. Other agents studied have included baclofen, theophylline, sulindac, and benzonatate.

Respiratory side effects have been unusually reported. An increase in cough or rhinitis has been reported in 2% to 3% of patients. Up to 7% of patients experienced an upper respiratory tract infection during benazepril therapy.

Gastrointestinal

Gastrointestinal side effects have included nausea, pancreatitis, constipation, gastritis, vomiting, and melena.

A 70 year old man with non-insulin dependent diabetes developed epigastric pain with cramping 30 minutes after taking a single dose of 5 mg benazepril. The same response occurred the following day after the next dose. After the third dose, the man presented to the emergency room with severe epigastric pain, nausea, and vomiting. Serum amylase was 234 units/L and serum lipase was 755 units/L. The signs and symptoms of pancreatitis resolved over the next several days once the drug was discontinued.

Cardiovascular

Cardiovascular effects have included postural hypotension or dizziness in 1% of patients. Angioneurotic edema has been reported rarely.

Angiotensin converting enzyme (ACE) inhibitors, in general, have been more likely to cause hypotension in sodium depleted or dehydrated patients.

Postural hypotension or dizziness has been more likely to occur with concomitant diuretic therapy.

Renal

Renal insufficiency has been more likely to occur in patients with renal artery stenosis, hypovolemia, and sodium depletion.

Renal side effects have included renal insufficiency (increase in serum creatinine by 150% above pretreatment value) in 2% of patients.

Metabolic

Hyperkalemia is due to inhibition of aldosterone by benazepril (the active ingredient contained in Lotensin)

Metabolic side effects including hyperkalemia have been reported.

Hypersensitivity

Patients with intestinal angioedema generally presented with abdominal pain (with or without nausea or vomiting) and in some cases there was no prior history of facial angioedema, and C-1 esterase levels were normal. These symptoms resolved after stopping the ACE inhibitor.

Hypersensitivity reactions to ACE inhibitors have been life threatening.

Hypersensitivity side effects including angioedema of the face, extremities, lips, tongue, glottis and/or pharynx have been reported rarely in patients receiving ACE inhibitors. Intestinal angioedema, including small bowel angioedema, has been reported in patients treated with ACE inhibitors, including benazepril. Dermatitis, rash, flushing, and pruritus have been reported. Anaphylactoid reactions have been reported during postmarketing experience.

Hematologic

Hematologic side effects have been rarely reported and have included thrombocytopenia and hemolytic anemia. Agranulocytosis and neutropenia have been reported during postmarketing experience.

In two studies, 1 of 2,014 and 1 of 1,357 patients developed decreased hemoglobin during benazepril therapy. Neither patient required stopping the drug.

Genitourinary

Genitourinary side effects including frequent urination have been reported during postmarketing experience.

Dermatologic

Dermatological side effects have included Stevens-Johnson syndrome, pemphigus, apparent hypersensitivity reactions (manifested by dermatitis, pruritus, or rash), photosensitivity, and flushing.

Psychiatric

Psychiatric side effects have included anxiety, decreased libido, hypertonia, insomnia, nervousness, and paresthesia.

Other

Other side effects have included fatigue, asthma, bronchitis, dyspnea, sinusitis, urinary tract infection, frequent urination, infection, arthritis, impotence, alopecia, arthralgia, myalgia, asthenia, and sweating.

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