Benazepril

Oral
Heart failure

Oral
Hypertension

Hypertension

CrCl	Dosage
<30	Initially, 5 mg once daily. Max: 40 mg/day.

May be taken with or without food.

History of angioedema due to previous ACE inhibitor treatment. Pregnancy.

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.

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.

PO: D

May impair ability to drive and operate machinery.

Monitor BP. Periodic monitoring of serum creatinine, and K levels.

Additive hyperkalaemic effects w/ K-sparing diuretics, K supplements, other drugs that can cause hyperkalaemia. May increase lithium concentration and toxicity.

Avoid use of licorice as it may worsen HTN.

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).

Store below 30°C.

ACE Inhibitors/Direct Renin Inhibitors

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.