BENAZEPRIL HYDROCHLORIDE
| BENAZEPRIL HYDROCHLORIDE (ben-a'ze-pril) Lotensin Classifications: antihypertensive agent; angiotensin-converting enzyme (ace) inhibitor; Therapeutic: antihypertensive agent; ace inhibitor Prototype: Enalapril Pregnancy Category: D second and third trimester; C first trimester |
Availability
5 mg, 10 mg, 20 mg, 40 mg tablets
Action
Lowers blood pressure by specific inhibition of the angiotensin-converting enzyme (ACE) and thus by decreasing angiotensin II (a potent vasoconstrictor) and aldosterone secretion.
Therapeutic Effect
Achieves an antihypertensive effect by suppression of the renin-angiotensin-aldosterone system.
Uses
Treatment of mild to moderate hypertension.
Unlabeled Uses
CHF, reno-protective agent.
Contraindications
Hypersensitivity to benazepril or another ACE inhibitor; pregnancy (category C first trimester and category D second and third trimester), lactation, or in children <6 y or with a GFR <30 mL/h.
Cautious Use
Renal impairment, renal-artery stenosis; patients with hypovolemia, receiving diuretics, undergoing dialysis; patients in whom excessive hypotension would present a hazard (e.g., cerebrovascular insufficiency); CHF; hepatic impairment; diabetes mellitus.
Route & Dosage
| Hypertension Adult: PO 10–40 mg/d in 1–2 divided doses |
Administration
Oral- Consult physician about initial dose if patient is also receiving diuretics. Typically an initial dose of 5 mg is used to minimize the risk of hypotension.
- Store at room temperature, but not above 30° C (86° F).
Adverse Effects (≥1%)
CV: Hypotension. CNS: Headache, dizziness, fatigue, weakness. Endocrine: Hyperkalemia (at higher doses). GI: Nausea, diarrhea or constipation, gastritis. Urogenital: Azotemia, oliguria, renal failure in patients with CHF. Respiratory: Cough, rhinitis, bronchitis. Other: Back pain.Diagnostic Test Interference
Elevations in serum bilirubin have been observed after benazepril administration. Benazepril inhibits aldosterone secretion, which causes an increase in serum potassium.
Interactions
Drug: potassium-sparing diuretics may increase the risk of hyperkalemia. Benazepril may increase lithium levels, resulting in lithium toxicity.Pharmacokinetics
Absorption: Readily from GI tract; 37% reaches the systemic circulation. Peak: 2–6 h. Duration: 20–24 h. Distribution: Small amounts cross the blood-brain barrier; crosses placenta; small amount excreted in breast milk. Metabolism: In liver to active metabolite, benazeprilat. Elimination: Benazeprilat is primarily excreted in urine. Half-Life: Benazepril 0.6 h; benazeprilat 22 h.Nursing Implications
Assessment & Drug Effects
- Assess for hypotension, especially in patients who may be volume depleted (e.g., prolonged diuretic therapy, recent vomiting or diarrhea, salt restriction) or who have CHF.
- Lab tests: Monitor serum potassium levels for hyperkalemia (see Appendix F).
Patient & Family Education
- Do not use salt substitutes unless recommended by physician.
- Report swelling of face, eyes, lips, or tongue or difficulty breathing immediately to physician.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug