التداخل بين أملوديبين وبينازيبريل وأتينولول وكلورثاليدون

Symptomatic hypotension is most likely to occur in patients who have heart failure, severe aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy or have been volume or salt depleted as a result of diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting.

In patients with congestive heart failure, start amlodipine and benazepril hydrochloride therapy under close medical supervision; follow closely for the first 2 weeks of treatment and whenever the dose of the benazepril component is increased or a diuretic is added or its dose increased.

Risk factors for the development of hyperkalemia include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes.

Potassium supplements/potassium-sparing diuretics: hyperkalemia ( 7.1 )

Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia.

Because of its relative beta 1 -selectivity, however, atenolol and chlorthalidone may be used with caution in patients with bronchospastic disease who do not respond to or cannot tolerate, other antihypertensive treatment.

Drug Interactions Atenolol and chlorthalidone may potentiate the action of other antihypertensive agents used concomitantly.

Calcium channel blockers may also have an additive effect when given with atenolol and chlorthalidone.

Concomitant Use of Calcium Channel Blockers Bradycardia and heart block can occur and the left ventricular end diastolic pressure can rise when beta- blockers are administered with verapamil or diltiazem.