Benazepril


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO HTN Initial: 10 mg once daily. Maintenance: 20-40 mg/day as a single or in 2 divided doses. Max: 80 mg/day. Heart failure Initial: 2.5 mg once daily. Max: 20 mg/day.
Dosage Details
Oral
Heart failure
Adult: Initially, 2.5 mg once daily adjusted according to response to max 20 mg/day.

Oral
Hypertension
Adult: Initially, 10 mg once daily. Maintenance: 20-40 mg/day as a single or in 2 divided doses. Max: 80 mg/day. Patients on diuretics: Initially, 5 mg once daily.
Child: ≥6 yr 0.2 mg/kg once daily. Maintenance: 0.6 mg/kg once daily. Max: 40 mg/day.
Renal Impairment
Hypertension
CrCl Dosage
<30 Initially, 5 mg once daily. Max: 40 mg/day.
Administration
May be taken with or without food.
Contraindications
History of angioedema due to previous ACE inhibitor treatment. Pregnancy.
Special Precautions
Patients w/ diarrhoea, severe volume and/or salt depletion, unilateral or bilateral renal artery stenosis. Patients on dietary salt restriction and dialysis. Increased risk of angioedema in black patients. Renal impairment. Lactation.
Adverse Reactions
Headache, dizziness, fatigue, persistent and non productive cough,  somnolence, nausea, transient elevations in BUN and serum creatinine, hyperkalaemia. Intestinal angioedema.
Potentially Fatal: Anaphylactoid reactions and angioedema. Cholestatic jaundice which may progress to fulminant hepatic necrosis.
Patient Counseling Information
May impair ability to drive and operate machinery.
MonitoringParameters
Monitor BP. Periodic monitoring of serum creatinine, and K levels.
Drug Interactions
Additive hyperkalaemic effects w/ K-sparing diuretics, K supplements, other drugs that can cause hyperkalaemia. May increase lithium concentration and toxicity.
Food Interaction
Avoid use of licorice as it may worsen HTN.
Action
Description: Benazepril, a prodrug of benazeprilat, acts by inhibiting ACE that catalyzes the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor), thus leading to reduced aldosterone (a hormone that causes water and Na retention) secretion by the adrenal cortex and decreased vasopressor activity.
Onset: W/in 1 hr.
Duration: Approx 24 hr.
Pharmacokinetics:
Absorption: Rapidly absorbed from the GI tract (approx 37%). Time to peak plasma concentration: 1-2 hr (fasting state); 2-4 hr (nonfasting state).
Distribution: Crosses placenta and enters breast milk (small amounts). Volume of distribution: Approx 8.7 L. Plasma protein binding: Approx 97% (benazepril); approx 95% (benazeprilat).
Metabolism: Undergoes rapid and extensive enzymatic hydrolysis to its active metabolite (benazeprilat) in the liver.
Excretion: Via urine (small amounts of benazepril; 20% as benazeprilat; 12% as other metabolites) and bile (approx 11-12%). Elimination half-life: 10-11 hr (benazeprilat).
Storage
Store below 30°C.
References
Anon. Benazepril. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 21/11/2013.

Benazepril HCl (Andrx Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 21/11/2013.

Benazepril: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER). U.S. FDA. https://www.fda.gov/. Accessed 21/11/2013.

Buckingham R (ed). Benazepril. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 21/11/2013.

McEvoy GK, Snow EK, Miller J et al (eds). Benazepril Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 21/11/2013.

Disclaimer: This information is independently developed by MIMS based on Benazepril from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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