Benazepril

Indications
Oral
Hypertension
Adult: Initially, 10 mg once daily. Maintenance: 20-40 mg daily as a single or in 2 divided doses. Max dose: 80 mg/day.
Child: ≥6 yr: 0.2 mg/kg/day. Max dose: 40 mg/day.
Max Dosage:
Renal impairment: Avoid usage in children with CrCl <30 ml/min.
CrCl (ml/min)Dosage Recommendation
<30Initial dose: 5 mg daily. Max maintenance dose: 40 mg daily.

Oral
Heart failure
Adult: Initially, 2.5 mg once daily adjusted according to patient's response. Max: 20 mg daily.

Special Populations: Initially, 5 mg once daily in patients with renal impairment. Not recommended for child with CrCl < 30 ml/min.
Contraindications
Hypersensitivity. History of bilateral renal artery stenosis, angioedema; pregnancy.
Warnings / Precautions
Valvular stenosis, before, during or immediately after anaesthesia, unilateral renal artery stenosis, preexisting renal insufficiency. Withdraw diuretics 2-3 days before benazepril treatment. SC epinephrine (1:1000) to be readily available in the event of angioedema. vol or salt-depleted states; collagen vascular disease; concomitant potassium supplements or potassium-sparing drugs; severe renal impairment (CrCl <30 ml/min). Lactation. Immunosuppressive therapy.
Adverse Reactions
Headache, dizziness, fatigue; cough; somnolence, nausea; hypotension, transient elevations in BUN and serum creatinine; palpitations; constipation, gastritis; melena, rash, pruritus; musculoskeletal pain; paraesthesia, anxiety; UTI; hyperkalaemia; leucopenia and flushing.
Potentially Fatal: Angioedema (rare).
Overdose Reactions
May lead to hypotension.
Drug Interactions
Thiazides and other diuretics may cause excessive fall in BP when used with benazepril. Increased risk of lithium toxicity when used concurrently.
Potentially Fatal: Concomitant potassium-sparing diuretics or potassium supplements can increase the risk of hyperkalaemia.
See Below for More benazepril Drug Interactions
Food Interactions
Rate of absorption delayed but the extent is not affected.
Mechanism of Actions
Benazepril and its metabolite benazeprilat inhibit ACE that catalyzes the conversion of angiotensin I to angiotensin II, thus leading to reduced aldosterone secretion by the adrenal cortex and decreased vasopressor activity.
Absorption: 37% of dose is absorbed from the GI tract (oral); peak plasma concentrations after 1-2 hr (fasting state), 2-4 hr (nonfasting state).
Distribution: Enters breast milk. Protein-binding: 95%.
Metabolism: Hepatic (almost complete); converted to benazeprilat (active metabolite).
Excretion: Mainly via urine; via bile (11-12% of dose); 10-11 hr (elimination half-life), may be slowed in renal impairment.
Administration
May be taken with or without food.
ATC Classification
C09AA07 - benazepril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.
Available As
  • Benazepril 10 mg
  • Benazepril 20 mg
  • Benazepril 5 mg
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