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Palatable oral tablet for the treatment of heart failure in dogs and chronic renal insufficiency in cats.
Description and Composition
Palatable tablets of 3 strengths are available:
FORTEKOR 2.5 contains 2.5mg, FORTEKOR 5 contains 5mg, FORTEKOR 20 contains 20mg benazepril hydrochloride.
After oral administration, benazepril is rapidly absorbed from the gastrointestinal tract and hydrolysed to benazeprilat, a highly specific and potent inhibitor of angiotensin converting enzyme (ACE). Fortekor produces significant inhibition of plasma ACE activity for more than 24 hours after a single dose in cats and dogs.
Inhibition of ACE leads to reduced conversion of inactive angiotensin I into active angiotensin II and therefore reduction in the effects mediated by angiotensin II, including vasoconstriction of both arteries and veins, retention of sodium and water by the kidney and modeling changes (including pathological cardiac hypertrophy and degenerative renal changes).
In dogs with heart failure, Fortekor reduces the blood pressure and volume load on the heart. Fortekor produces an extension of the life span and also improves clinical signs, notably reduction in coughing, and improvement to the quality of life.
In cats with chronic renal insufficiency Fortekor reduces the protein loss in urine and reduces systemic and intraglomerular blood pressure. Fortekor increases the appetite, quality of life and survival time of the cats, particularly in advanced disease.
In contrast with other ACE Inhibitors, benazeprilat is excreted 54% via the biliary and 46% via the urinary route in dogs, and 85% via the biliary and 15% via the urinary route in cats. The clearance of benazeprilat is not affected in dogs or cats with impaired renal function and therefore no adjustment of FORTEKOR dose is required in either species in cases of renal insufficiency.
- Treatment of heart failure in dogs.
- Treatment of chronic renal insufficiency in cats.
Dosage and Administration
Fortekor should be given orally once daily, with or without food. The duration of treatment is unlimited. The dose may be doubled, still administered once daily, if judged clinically necessary and advised by the veterinary surgeon.
Special Precautions, Warnings and Undesirable Effects
Do not use in animals known to be hypersensitive to the active substance.
Transient signs of tiredness or dizziness may appear in rare cases.
As is routine in cases of chronic renal insufficiency, it is recommended to monitor plasma urea and creatinine concentrations. No evidence of renal toxicity to Fortekor has been observed in dogs during clinical trials.
Do not use in any dog that has evidence of cardiac output failure due to aortic stenosis.
In clinical trials in dogs with heart failure, Fortekor was well tolerated with an incidence of adverse effects statisically lower than observed in placebo treated dogs.
Fortekor may increase plasma creatinine concentrations at the start of therapy. This effect is related to the therapeutic effect of the product in reducing blood pressure, and therefore is not necessarily a reason to stop therapy in the absence of other signs. As is routine in cases of chronic renal insufficiency, it is recommended to monitor plasma urea and creatinine concentrations and erythrocyte counts.
FORTEKOR reduced erythrocyte counts in normal cats at high doses, but this effect was not observed at the recommended dose during clinical trials in cats with chronic renal insufficiency.
FORTEKOR may increase food consumption and body weight in cats.
The safety and efficacy of Fortekor has not been established in cats below 2.5kg.
Use during pregnancy and lactation
Fortekor is not recommended for use in breeding, pregnant or lactating dogs or cats. ACE inhibitors have been found to be teratogenic in the second and third trimesters in other species.
Interaction with other medications
No interactions known in dogs. In dogs with heart failure, FORTEKOR may be given in combination with digoxin, diuretics and anti-arrythmic drugs as necessary. Interactions with potassium preserving drugs like spironolactone, triamteren or amiloride cannot be ruled out. It is recommended to monitor plasma potassium levels when using benazepril in combination with a potassium sparing diuretic.
In man, the combination of ACE inhibitors and NSAIDs can lead to reduced anti-hypertensive efficacy or impaired renal function. Therefore concurrent use of NSAIDs should be considered with care.
As with other ACE inhibitors, the combination of benazepril with other anti-hypertensive agents (e.g. calcium channel blockers, beta-blockers or diuretics), anaesthetics or other medications with a hypotensive effect may lead to additive hypotensive effects and should be considered with care.
FORTEKOR is well tolerated in the target species. Transient reversible hypotension may occur in cases of accidental overdosage. Therapy should consist of intravenous infusion of warm isotonic saline.
Formulations and Packages
The tablets are available in blisters of 14 tablets, in packs containing 2 or 4 blisters.
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