Unique combination of benazepril and spironolactone.
Heart failure causes the activation of the RAAS System and the production of angiotensin II and aldosterone1, which both have harmful effects that contribute to the viscious cycle of heart failure2,3. Angiotensin II, for example, causes vasoconstriction (narrowing of the blood vessels) whereas aldosterone causes cardiovascular remodelling/ fibrosis, which results in thickening of the blood vessels and stiffening of the heart muscle.
The leading ACE Inhibitor benazepril inhibits the production of angiotensin II2. Aldosterone levels, however, can continue to rise in patients receiving an ACE Inhibitor as other factors (such as K+, ACTH and the diuretic furosemide) can also stimulate aldosterone production2,3. Spironolactone, which takes the place of aldosterone on its receptor, is therefore needed to blocks the harmful effects of aldsterone3,4.
By containing the ACE Inhibitor benazepril and the aldosterone antagonist spironolactone in one tablet, Cardalis® uniquely provides “dual blockade” of the RAAS system2,3. Dual blockade with an ACE Inhibitor and Spironolactone has been shown improve survival in both people and dogs with heart failure4,8. For example, in clinical studies, dogs receiving benazepril and spironolactone (compared to benazepril alone) were shown to have a better quality of life and, at any one time, were three times less likely to die from heart failure5.
* For the home-care treatment of congestive heart failure caused by degenerative valvular disease, with diuretic support as appropriate.
1 – Oyama, M.A. (2009), Neurohormonal activation in canine degenerative mitral valve disease: implications on pathophysiology and treatment, Journal of Small Animal Practice, 50 (Suppl/1), 3-11,
2– Atkins, C.E., Häggström, J. (2012), Pharmacological management of myxomatous mitral valve disease in dogs, Journal of Veterinary, Cardiology, 14, 165-184,
3 – Ovaert, P. et al. (2010), Aldosterone receptor antagonists – how cardiovascular actions may explain their beneficial effects in heart failure, Journal of Veterinary Pharmacology and Therapeutics, 33(2), 109-117
4 – Bernay, F. et al. (2010), Efficacy of Spironolactone on Survival in Dogs with Naturally-occuring Mitral Regurgitation caused by Myxomatous Mitral Valve Disease, Journal of Veterinary Internal Medicine, 24(2), 331-341,
5 – Cardalis® SPC
6 – Ollivier, E. et al. (2012), Concomitant use of the FETCH questionnaire and the veterinary evaluation to assess quality of life of cardiac dogs treated with a veterinary product combining spironolactone and benazepril (Cardalis®), ECVIM Congress Proceedings and Poster
7 – Ollivier, E. et al. (2012), Safety of a veterinary product combining spironolactone and benazepril (Cardalis®) in healthy and cardiac dogs, ECVIM Congress Proceedings and Poster
8 - Pitt, B. et al. (2000), The Effect of Spironolactone on Morbidity and Mortality in Patients With Severe Heart Failure, The New England Journal of Medicine, 341 (10), 709 – 717
Cardalis® should be given as part of your standard heart failure therapy as soon as clinical signs (such as exercise intolerance, coughing and/or dyspnoea) appear*.
Clinical trials have shown that Cardalis® is well tolerated when combined with pimobendan and furosemide. The dose of furosemide that you need to control oedema will usually remain the same. This is because the diuretic effect of spironolactone is very mild, and the main reason for using Cardalis® is to counteract the harmful effects of angiotensin II and aldosterone, which include vasoconstriction and cardiovascular remodeling/ fibrosis.
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