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Benazepril hydrochloride
Benazepril hydrochloride (Lotensin)
Benazepril hydrochloride
(beh-NAYZ-eh-prill)
Pregnancy Category: D Lotensin (Rx)

Classification: Antihypertensive, ACE inhibitor

See Also: See also Angiotensin-Converting Enzyme Inhibitors.

Action/Kinetics: Both supine and standing BPs are reduced with mild-to-moderate hypertension and no compensatory tachycardia. Also an antihypertensive effect in clients with low-renin hypertension. Food does not affect the extent of absorption. Almost completely converted to the active benazeprilat, which has greater ACE inhibitor activity. Onset: 1 hr. Duration: 24 hr. Peak plasma levels, benazepril: 30-60 min. Peak plasma levels, benazeprilat: 1-2 hr if fasting and 2-4 hr if not fasting. t1/2, benazeprilat: 10-11 hr. Peak reduction in BP: 2-4 hr after dosing. Peak effect with chronic therapy: 1-2 weeks. Highly bound to plasma protein and excreted through the urine with about 20% of a dose excreted as benazeprilat.

Uses: Alone or in combination with thiazide diuretics to treat hypertension.

Contraindications: Hypersensitivity to benazepril or any other ACE inhibitor.

Special Concerns: Use with caution during lactation. Safety and effectiveness have not been determined in children.

Side Effects: CNS: Headache, dizziness, fatigue, anxiety, insomnia, drowsiness, nervousness. GI: N&V;, constipation, abdominal pain, gastritis, melena, pancreatitis. CV: Symptomatic hypotension, postural hypotension, syncope, angina pectoris, palpitations, peripheral edema, ECG changes. Dermatologic: Flushing, photosensitivity, pruritus, rash, diaphoresis. GU: Decreased libido, impotence, UTI. Respiratory: Cough, asthma, bronchitis, dyspnea, sinusitis, bronchospasm. Neuromuscular: Paresthesias, arthralgia, arthritis, asthenia, myalgia. Hematologic: Occasionally, eosinophilia, leukopenia, neutropenia, decreased hemoglobin. Miscellaneous: Angioedema, which may be associated with involvement of the tongue, glottis, or larynx; hypertonia; proteinuria; hyponatremia; infection.

Laboratory Test Alterations: Serum creatinine, BUN, serum potassium. Hemoglobin. ECG changes.

Drug Interactions: Diuretics / Excessive in BP Lithium / Serum lithium levels with risk of lithium toxicity Potassium-sparing diuretics, potassium supplements / Risk of hyperkalemia

How Supplied: Tablet: 5 mg, 10 mg, 20 mg, 40 mg

Dosage
•Tablets Clients not receiving a diuretic.
Initial: 10 mg once daily; maintenance: 20-40 mg/day given as a single dose or in two equally divided doses. Total daily doses greater than 80 mg have not been evaluated.
Clients receiving a diuretic.
Initial: 5 mg/day.

C_CR < 30 mL/min/1.73 m². The recommended starting dose is 5 mg/day; maintenance: titrate dose upward until BP is controlled or to a maximum total daily dose of 40 mg.