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Indications and Dosage
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. |
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Renal Impairment
Hypertension
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Administration
May be taken with or without food.
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Contraindications
History of angioedema due to previous ACE inhibitor treatment. Pregnancy.
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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.
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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. |
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Patient Counseling Information
May impair ability to drive and operate machinery.
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Monitoring Parameters
Monitor BP. Periodic monitoring of serum creatinine, and K levels.
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Drug Interactions
Additive hyperkalaemic effects w/ K-sparing diuretics, K supplements, other drugs that can cause hyperkalaemia. May increase lithium concentration and toxicity.
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Food Interaction
Avoid use of licorice as it may worsen HTN.
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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). |
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Storage
Store below 30°C.
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MIMS Class
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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.
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