NAME OF THE VETERINARY MEDICINAL PRODUCT
QUALITATIVE AND QUANTITATIVE COMPOSITION
Each tablet contains: Active substance:
Benazepril (as hydrochloride) . 2.30 mg
(equivalent to benazepril hydrochloride . 2.50 mg) Excipients
For a full list of excipients, see section 6.1. 3.
Oblong scored beige tablet, divisible into halves. 4.
4.1 Target species
Cats. 4.2 Indications for use,specifying the target species
Treatment of chronic renal insufficiency.
Do not use in case of known hypersensitivity to ACE inhibitors or to any ingredient of the
See also section 4.7.
4.4 Special warnings for each target species
4.5 Special precautions for use i) Special precautions for use in animals
Efficacy and safety of benazepril have not been established in cats of weight less than 2.5
No evidence of renal toxicity to benazepril has been observed in cats during clinical trials.
However, as is routine in cases of renal insufficiency, it is recommended to monitor plasma
urea and creatinine levels.
ii) Special precautions to be taken by the person administering the veterinary
medicinal product to animals
Pregnant women should take special care to avoid accidental oral exposure, because ACE
inhibitors have been found to affect the unborn child during pregnancy in humans.
Wash hands after use.
In case of accidental ingestion by children, seek medical advice immediately and show this
label to the doctor.
4.6 Adverse reactions (frequency and seriousness)
Benazepril may cause mild, intermittent diarrhea in a small proportion of cats.
In cats with chronic renal insufficiency, benazepril 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.
Benazepril 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. As is routine in cases of chronic renal insufficiency, it is recommended to
monitor erythrocyte counts during therapy.
Emesis, anorexia, dehydration and lethargy have been reported in rare occasions in cats.
4.7 Use during pregnancy, lactation or lay
Laboratory studies in rats have shown embryotoxic effects of Benazepril at non-maternotoxic
doses (urinary system abnormalities in foetus). Benazepril administered to cats at a daily
dose of 10 mg / kg for 52 weeks resulted in the reduction of ovary / oviduct weights. Safety
of this product has not been tested in pregnant or lactating queens.
Do not use in pregnant or lactating females or in queens intended for breeding. 4.8 Interaction with other medicinal products and other forms of interaction
Blood pressure may be monitored during anesthesia in cats receiving benazepril.
Interactions with potassium preserving diuretics like spironolactone, triamterene or amiloride
cannot be ruled out. It is recommended to monitor plasma potassium levels when using
benazepril in combination with a potassium sparing diuretic as life threatening reactions are
4.9 Amounts to be administered and administration route
Oral administration of 0.46 mg of benazepril per kg and per day, equivalent to 0.50 mg of
benazepril hydrochloride per kg and per day, as one administration, whether or not with a
meal, i.e one tablet per 5 kg as shown in the following table:
In case of use of half tablets: Put the remaining half of the tablet back into the blister pocket and use for the next administration. The tablets are flavoured and may be taken spontaneously by cats, but can also be administered directly into the cat's mouth or be given with food if necessary.
4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary
Transient and reversible signs of hypotension may appear in case of accidental overdose.
Treatment is symptomatic, involving intravenous infusion with warm isotonic saline.
In cats a 10-fold overdosage daily for one year was asymptomatic.
4.11 Withdrawal period(s)
Not applicable. 5.
Pharmacotherapeutic group: Cardiovascular system, ACE Inhibitor, Benazepril.
ATCvet code: QC09AA07 5.1 Pharmacodynamic properties
Benazepril hydrochloride is a prodrug hydrolysed in vivo to benazeprilat. This active
metabolite inhibits angiotensin converting enzyme (ACE), thus preventing the conversion of
inactive angiotensin I into active angiotensin II. Therefore, benazeprilat inhibits all effects
induced by angiotensin II, in particular, vasoconstriction of both arteries and veins and
retention of sodium and water by the kidney. Benazeprilat causes long-lasting inhibition of
plasma ACE, with significant inhibition persisting for 24 hours after a single dose.
In cats with renal insufficiency, benazepril reduces systemic and intraglomerular blood
pressure. At the same time, it decreases glomerular basal membrane permeability. In
consequence, it reduces protein loss in the urine and renal insufficiency progression. 5.2 Pharmacokinetic particulars
After oral administration, benazepril is rapidly absorbed from the gastrointestinal tract. One
part of absorbed benazepril is hydrolyzed by hepatic enzymes to the active substance,
benazeprilat; unchanged benazepril and hydrophilic metabolites account for the remainder.
The absolute systemic bioavailability, calculated for oral benazepril versus intravenous
benazepril is about 9% both in fasting and fed situations. After administration of Nelio 5 at
0.65 mg/kg in cats, peak benazeprilat concentrations (approximately 110 ng/ml) are
achieved within about 1 and half hours. The apparent terminal half-life of benazeprilate was
Benazepril and benazeprilat are both extensively bound to plasma proteins.
Repeated administration leads to slight accumulation of benazeprilat in plasma, steady state
being achieved in less than 4 days.
In cats, benazeprilat is excreted 85% via the biliary route and 15% via the urinary route. The
clearance of benazeprilat is not affected in cats with decreased glomerular filtration;
therefore no adjustment of the dose is required.
6.1 List of excipients
Pig liver flavour
Anhydrous colloidal silica
Hydrogenated castor oil
Not known. 6.3 Shelf life Shelf-life of the veterinary medicinal product as packaged for sal
e: 21 months.
Shelf-life of divisions of the tablets:
24 hours 6.4. Special precautions for storage
Do not store above 30°C
Store in original package.
Any part-used tablet should be returned to the opened blister and used within 24 hours 6.5 Nature and composition of immediate packaging
Aluminium/Aluminium heat-sealed blister pack 10 tablets per strip.
Not all pack sizes may be marketed. 6.6 Special precautions for the disposal of unused veterinary medicinal product or
waste materials derived from the use of such products
Any unused veterinary medicinal product or waste materials derived from such veterinary
medicinal products should be disposed of in accordance with local requirements. 7.
MARKETING AUTHORISATION HOLDER
SOGEVAL SA 200 avenue de Mayenne, BP 2227 53022 LAVAL Cedex 9 France Tel: 33 2 43 49 51 51 Fax: 33 2 43 53 97 00 E-mail:
MARKETING AUTHORISATION NUMBER
Vm 20749/4018 9.
DATE OF FIRST AUTHORISATION
16 February 2010 10
DATE OF REVISION OF THE TEXT
16 February 2010
Vol. 60, No. 2, February 2009, pp 364–371© 2009, American College of RheumatologyGenetic Risk Factors for Rheumatoid ArthritisDiffer in Caucasian and Korean PopulationsHye-Soon Lee,1 Benjamin D. Korman,2 Julie M. Le,2 Daniel L. Kastner,2 Elaine F. Remmers,2 Objective. Recent studies have identified a num- in Caucasian patients with RA contributed significantly ber of novel rheuma
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