Drug ID: 2d00000017
Drug Name: Benazepril
Generic Names: Amace -BP | Amlo -B | Amace BP 5 | Benace (20mg) | Benace (5 mg) | Benace (10mg) | Lotensin
Category: ACE Inhibitors
Legal Status: Non Opioid Prescription only drug
Indication for Mother: Category D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: Adults- The recommended initial dose for patients not receiving a diuretic is 10 mg once a day.
Recommended In: This medication is an angiotensin-converting enzyme (ACE) inhibitor, prescribed for high blood pressure. It decreases a chemical that tightens blood vessels thereby making blood vessels to dilate, which lowers blood pressure.
Directions For Use: It comes as a tablet to take by mouth, with or without food.
Storage: Store at 20° to 25°C.
Dosage Forms: Tablet
Side Effects: Most Common- Headache and cough.
Central Nervous System- Dizziness, drowsiness, lightheadedness, fatigue, shock, anxiety, decreased libido, muscle tightness, sleeplessness, nervousness and tingling.
Heart- Low blood pressure.
Genitourinary- Increased urea in blood.
Gastrointestinal- Inflammation of pancreas/intestine, constipation, nausea, vomiting and blood in stool.
Blood- Anemia and decrease in platelets.
Miscellaneous- Asthma, inflammation of bronchus/sinus/joint, difficulty in breathing, urinary tract infection, frequent urination, infection, impotence, hair loss, muscle/joint pain, weakness and sweating.
In Case of Overdose: Human overdoses of benazepril have not been reported, but the most common manifestation of human benazepril overdosage is likely to be hypotension. No data are available to suggest physiological maneuvers (e.g., maneuvers to change the pH of the urine) that might accelerate elimination of benazepril and its metabolites. Benazepril is only slightly dialyzable, but dialysis might be considered in overdosed patients with severely impaired renal function.
Angiotensin II could presumably serve as a specific antagonist-antidote in the setting of benazepril overdose, but angiotensin II is essentially unavailable outside of scattered research facilities. Because the hypotensive effect of benazepril is achieved through vasodilation and effective hypovolemia, it is reasonable to treat benazepril overdose by infusion of normal saline solution.
Avoid If: It may cause drowsiness, dizziness, or lightheadedness, do not drive a car or operate machinery while taking this medication.
Caution should be exercised in patients with history of systemic lupus erythematosus (SLE or lupus),bone marrow suppression, low blood counts, low blood pressure, low blood sodium, high blood potassium, or narrowing or hardening of the arteries of the brain, any allergy, during pregnancy and breastfeeding.
Avoid alcohol consumption.
It may cause dry, unproductive cough; if it is so stop the medication.
Monitor blood pressure and sugar level regularly while taking this medication.
Contraindicated in patients with history of angioedema and hypersensitivity.
Drug Interaction: Diuretics
Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Benazepril. The possibility of hypotensive effects with Benazepril can be minimized by either discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with Benazepril. If this is not possible, the starting dose should be reduced.
Potassium Supplements and Potassium-Sparing Diuretics
Benazepril can attenuate potassium loss caused by thiazide diuretics. Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia. Therefore, if concomitant use of such agents is indicated, they should be given with caution, and the patient's serum potassium should be monitored frequently.
Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors (including benazepril) during therapy with lithium. These drugs should be coadministered with caution, and frequent monitoring of serum lithium levels is recommended. If a diuretic is also used, the risk of lithium toxicity may be increased.
Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy.
In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral anti-diabetics may develop hypoglycemia. Such patients should therefore be advised about the possibility of hypoglycemic reactions and should be monitored accordingly.
Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors)
In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including benazepril, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving benazepril and NSAID therapy.
The antihypertensive effect of ACE inhibitors, including benazepril, may be attenuated by NSAIDs.