Benazepril Hydrochloride

• Type of Drug: Angiotensin-converting-enzy me (ACE) inhibitor.
• Prescribed for: High blood pressure.

General Information

Benazepril Hydrochloride belongs to the class of drugs known as angiotensin-converting-enzyme (ACE) inhibitors. ACE inhibitors prevent the conversion of a hormone called angiotensin I to another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes (dilates) blood vessels and helps to reduce blood pressure and relieve the symptoms of heart failure by making it easier for a failing heart to pump blood through the body. The production of other hormones and enzymes that participate in the regulation of blood-vessel dilation is also affected by Benazepril and probably plays a role in its effectiveness. Benazepril starts working in 1 hour and continues for about 24 hours.

Some people, especially heart-failure patients, who start taking Benazepril after they are already on a diuretic (water pill) experience a rapid blood-pressure drop after their first dose or when their dose is increased. To prevent this from happening, your doctor may tell you to stop taking your diuretic 2 or 3 days before starting Benazepril or increase your salt intake during that time. The diuretic may then be restarted gradually.

Cautions and Warnings

Do not take Benazepril Hydrochloride if you have had an allergic reaction to it in the past. It can (rarely) cause very low blood pressure and affect kidney function. Your doctor should check your urine for protein content during the first few months of treatment.

Because this drug is generally eliminated from the body via the kidneys, dosage adjustment of Benazepril is necessary if you have reduced kidney function.

Benazepril can affect white-blood-cell counts, possibly increasing your susceptibility to infection. Your doctor should monitor your blood counts periodically.

Possible Side Effects

• Most common: dizziness, tiredness, headache, and chronic cough. The cough usually goes away a few days after you stop taking the medicine. Nausea can also occur.
• Rare: low blood pressure, chest pains, dizziness when rising from a sitting or lying position, fainting, heart palpitations, sleeping difficulty, tingling in the hands or feet, vomiting, constipation, abdominal pain, blood in the stool, itching, rash, flushing, anxiety, nervousness, reduced sex drive, impotence, muscle and joint aches, arthritis, asthma, bronchitis, breathing difficulty, weakness, increased sweating, urinary tract infection, and swelling of the arms, legs, lips, tongue, face, and throat.

Drug Interactions

• The blood-pressure-lowering effect of Benazepril is additive with diuretics and beta blockers. Any other drug that causes a rapid blood-pressure drop should be used with caution if you are taking Benazepril.
• Benazepril may increase blood-potassium levels, especially if taken with Dyazide or other potassium-sparing diuretics.
• Benazepril may increase the effect of Lithium; this combination should be used with caution.
• Antacids may reduce the amount of Benazepril absorbed into the blood. Separate doses of these 2 medicines by at least 2 hours.
• Capsaicin may cause or aggravate the cough associated with Benazepril therapy.
• Indomethacin may reduce the blood-pressure-lowering effects of Benazepril.
• Phenotbiazine tranquilizers and antivomiting drugs may increase the effects of Benazepril.
• Combining Allopurinol and Benazepril increases the risk of adverse drug reactions. Avoid this combination.
• Benazepril increases blood levels of Digoxin, possibly increasing the chance of Digoxin-related side effects.

Food Interactions

Benazepril may be taken without regard to food. You may take it with food if it upsets your stomach.

Usual Dose

10 to 40 mg once or twice a day. People with poor kidney function may need less medicine to lower blood pressure.

Overdosage

The principal effect of Benazepril overdose is a rapid drop in blood pressure, as evidenced by dizziness or fainting. Take the overdose victim to a hospital emergency room immediately. ALWAYS bring the medicine bottle.

Special Information

Benazepril Hydrochloride can cause swelling of the face, lips, hands, and feet. This swelling can also affect the larynx (throat) and tongue, and interfere with breathing. If this happens, go to a hospital at once. Call your doctor if you develop a sore throat, mouth sores, abnormal heartbeat, sudden difficulty breathing, chest pain, a persistent rash, or loss of taste perception.

You may get dizzy if you rise to your feet too quickly from a sitting or lying position. Avoid strenuous exercise and/or very hot weather because heavy sweating or dehydration can cause a rapid blood-pressure drop.

Avoid nonprescription diet pills, decongestants, and stimulants that can raise blood pressure while taking Benazepril.

If you take Benazepril once a day and forget to take a dose, take it as soon as you remember. If it is within 8 hours of your next dose, skip the one you forgot and continue with your regular schedule.

If you take it twice a day and miss a dose, take it right away. If it is within 4 hours of your next dose, take one dose then and another in 5 or 6 hours, and then go back to your regular schedule. Do not take a double dose.

Special Populations

Pregnancy/Breast-feeding
ACE inhibitors have caused low blood pressure, kidney failure, slow formation of the skull, and death in developing fetuses when taken during the last 6 months of pregnancy. Women who are, or may become, pregnant should not take any ACE inhibitor drugs. Sexually active women who must take Benazepril must use an effective contraceptive method, or use a different medicine. If you become pregnant, stop taking the medicine, and call your doctor immediately.
Relatively small amounts of Benazepril pass into breast milk, and the effect on a nursing infant is likely to be small. However, nursing mothers who must take this drug should consider bottle-feeding with formula because infants, especially newborns, are more susceptible to this medicine’s effects than adults.

Seniors
Older adults may be more sensitive to the effects of this drug because of normal age-related declines in kidney or liver function. Dosage must be tailored to suit your needs.