Benazepril

What it is used for

• Adjunctive treatment of heart failure
• Adjunctive treatment of heart failure
• Adjunctive treatment of hypertension and/or proteinuria (first step)
• Adjunctive treatment of hypertension and/or proteinuria
• Hypertension associated with protein-losing renal disease
• Proteinuria, hypertension
• Heart failure
• Adjunctive treatment of hypertension/proteinuria
• Adjunctive treatment of heart failure
• CHF or hypertension
• Adjunctive treatment of hypertension
• Adjunctive treatment of hypertension
• Adjunctive treatment of hypertension

How it is given

Possible side effects

• Anorexia
• Vomiting
• Diarrhea
• Hypotension
• Renal dysfunction (worsening azotemia)
• Hyperkalemia

Cautions & contraindications

• Known hypersensitivity to ACE inhibitors
• > **Important Warnings:** * Use with caution in patients with **hyponatremia** or sodium depletion, coronary or cerebrovascular insufficiency, preexisting hematologic abnormalities, or collagen vascular diseases (e.g., SLE). * Patients with severe congestive heart failure (CHF) should be monitored very closely upon initiation of therapy due to the risk of profound hypotension. * ACE inhibitors can potentially worsen preexisting **azotemia**. It is recommended to use a lower starting dose and closely monitor BUN and creatinine. * **Pregnancy:** Mildly fetotoxic at high dosages. Use during pregnancy only when potential benefits outweigh the risks to the offspring (FDA Category C in first trimester, Category D in second/third trimesters).

Drug interactions

• Aspirin: May potentially negate the decrease in systemic vascular resistance induced by ACE inhibitors (though low-dose aspirin may not significantly affect hemodynamics).
• Antidiabetic Agents (insulin, oral agents): Possible increased risk for hypoglycemia; enhanced monitoring recommended.
• Diuretics (e.g., furosemide, hydrochlorothiazide): Potential for increased hypotensive effects. Reducing furosemide doses by 25-50% is often recommended when initiating ACE inhibitors for heart failure.
• Potassium-Sparing Diuretics (e.g., spironolactone, triamterene): Increased risk of hyperkalemia; enhanced monitoring of serum potassium is required.
• Lithium: Possible increased serum lithium levels; increased monitoring required.
• Potassium Supplements: Increased risk for hyperkalemia.
• Spironolactone: Potential for hyperkalemia due to additive potassium-sparing effects, though concurrent use is generally safe in practice.
• NSAIDs: Increased risk of nephrotoxicity and decreased clinical efficacy of benazepril.
• Diuretics (e.g., Furosemide): Increased risk of hypotension and prerenal azotemia.

Frequently asked questions