Benazepril Hydrochloride(ben a’ za pril)
Lotensin
PREGNANCY CATEGORY D
Drug Classes
ACE inhibitor
Antihypertensive
Therapeutic Actions
Blocks ACE from converting angiotensin I to angiotensin II, a potent vasoconstrictor, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.
Indications
Treatment of hypertension alone or in combination with thiazide diuretics
Unlabeled uses: Nondiabetic neuropathy, HF, post MI, diabetes, chronic kidney disease, recurrent stroke prevention
Contraindications and Cautions
Contraindicated with allergy to benazepril or other ACE inhibitors, pregnancy, history of angioedema.
Use cautiously with impaired renal function, immunosuppression, hypotension, heart failure, salt or volume depletion, lactation, first trimester of pregnancy, hyperkalemia.
Available Forms
Tablets—5, 10, 20, 40 mg
Dosages
Adults
Initial dose, 10 mg PO daily. Maintenance dose, 20–40 mg/day PO, single or two divided doses. Patients using diuretics should discontinue them 2–3 days prior to benazepril therapy. If BP is not controlled, add diuretic slowly. If diuretic cannot be discontinued, begin benazepril therapy with 5 mg. Maximum dose, 80 mg.
Pediatric patients (6 yr and older)
0.1–0.6 mg/kg/day. Starting dose for monotherapy—0.2 mg/kg/day. Do not exceed 0.6 mg/kg/day (40 mg daily).
Patients with renal impairment
For CrCl less than 30 mL/min (serum creatinine greater than 3 mg/dL), 5 mg PO daily. Dosage may be gradually increased until BP is controlled, up to a maximum of 40 mg/day. Not recommended for children with renal impairment.
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