Class: ACEI, Antihypertensive
Dosage Forms. Tablet: 5 mg, 10 mg, 20 mg, 40 mg
Common FDA Label Indication, Dosing, and Titration.
1. Hypertension: Adults, 10 mg po daily, may titrate to 20-40 mg po daily (max 80 mg/d); Children 6 y and older, 0.2 mg/kg po daily (max 0.6 mg/kg/d or 40 mg/d)
Off Label Uses.
1. Diabetic nephropathy: 10 mg po daily
2. CHF: 5-40 mg po daily
3. Kidney disease: 10 mg po daily
MOA. Benazepril is a competitive ACE inhibitor. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin–angiotensin system.
Drug Characteristics: Benzapril
Medication Safety Issues: Benzapril
Drug Interactions: Benzapril
Adverse Reactions: Benzapril
Efficacy Monitoring Parameters. Decreased BP.
Toxicity Monitoring Parameters. Signs/symptoms of angioedema (swelling of the face, eyes, lips, tongue, or throat), severe persistent cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, urine protein.
Key Patient Counseling Points. Avoid pregnancy. Use potassium supplements or salt substitutes only under medical supervision. May cause dizziness that may worsen if dehydrated.
Clinical Pearls. Observe patients who are volume depleted for at least 2 h after taking the initial dose of benazepril.