Benazepril

Benazepril is used for: Hypertension

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. Heart failure Adult: Initially, 2.5 mg once daily adjusted according to response to max 20 mg/day.

Oral Hypertension Child: >6 yr 0.2 mg/kg once daily. Maintenance: 0.6 mg/kg once daily. Max: 40 mg/day.

Renal impairment: CrCl (ml/min) Dosage Recommendation <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. Patient Counselling May impair ability to drive and operate machinery. Monitoring Parameters Monitor BP. Periodic monitoring of serum creatinine, and K levels.

Pregnancy Lotensin can cause fetal harm when administered to a pregnant woman; use of drugs that act on renin-angiotensin system during second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death; most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in first trimester have not distinguished drugs affecting renin-angiotensin system from other antihypertensive agents; when pregnancy is detected, discontinue Lotensin as soon as possible Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section, and post-partum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; pregnant women with hypertension should be carefully monitored and managed accordingly Oligohydramnios in pregnant women who use drugs affecting renin-angiotensin system in second and third trimesters of pregnancy can result in reduced fetal renal function leading to anuria and renal failure, fetal lung hypoplasia and skeletal deformations, including skull hypoplasia, hypotension, and death; in the unusual case that there is no appropriate alternative to therapy with drugs affecting renin-angiotensin system for a particular patient, apprise the mother of potential risk to fetus Perform serial ultrasound examinations to assess intra-amniotic environment; fetal testing may be appropriate, based on week of pregnancy; patients and physicians should be aware, however, that oligohydramnios may not appear until after fetus has sustained irreversible injury; closely observe infants with histories of in utero exposure to drug for hypotension, oliguria, and hyperkalemia; if oliguria or hypotension occur in neonates with a history of in utero exposure to drug support blood pressure and renal perfusion; exchange transfusions or dialysis may be required as a means of reversing hypotension and substituting for disordered renal function Lactation Minimal amounts of unchanged benazepril and of benazeprilat are excreted into the breast milk of lactating women receiving therapy; a newborn child ingesting entirely breast milk would receive less than 0.1% of mg/kg maternal dose of benazepril and benazeprilat

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

Side effects of Benazepril : 1-10% Cough (1-10%) Headache (6%) Dizziness (4%) Fatigue (2%) Postural dizziness (2%) Serum creatinine increased (2%) Somnolence (2%) Nausea (1%) ARF if renal artery stenosis (1%)

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.