Drug interactions
Benazepril + Metolazone
Severity: Moderate
Benazepril and Metolazone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Adding metolazone to an ACE inhibitor produces additive blood pressure lowering, and first-dose or post-initiation hypotension can occur, especially with volume depletion. Combined diuretic and ACE inhibitor therapy can also reduce glomerular filtration and cause acute kidney injury.
What this interaction means in plain words
Benazepril and Metolazone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Benazepril belongs to Cardiovascular; Metolazone belongs to Cardiovascular.
Why it happens
Diuretic-induced volume and sodium depletion activates the renin-angiotensin system, so ACE inhibition produces exaggerated hypotension and reduced glomerular filtration.
What to do
Monitor blood pressure, serum creatinine and electrolytes after starting or adjusting either drug. Consider lowering the diuretic dose or starting benazepril at a low dose in volume-depleted patients.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metolazone
Other interactions of Benazepril
- Aliskiren + Benazepril Contraindicated
- Benazepril + Sacubitril / valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Amifostine + Benazepril Major
- Amiloride + Benazepril Major
- Amlodipine-hydrochlorothiazide-valsartan + Benazepril Major
Frequently asked questions
Can I take Benazepril with Metolazone?
MediHelp rates the interaction as moderate. Benazepril and Metolazone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Adding metolazone to an ACE inhibitor produces additive blood pressure lowering, and first-dose or post-initiation hypotension can occur, especially with volume depletion. Combined diuretic and ACE inhibitor therapy can also reduce glomerular filtration and cause acute kidney injury.
How serious is the interaction between Benazepril and Metolazone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, serum creatinine and electrolytes after starting or adjusting either drug. Consider lowering the diuretic dose or starting benazepril at a low dose in volume-depleted patients.
What other medicines interact with Metolazone?
MediHelp also lists interactions of Metolazone with, for example, Amifostine, Amlodipine-hydrochlorothiazide-valsartan, Amlodipine-olmesartan-hydrochlorothiazide. The full list is on the Metolazone page.
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