Benazepril is an angiotensin-converting enzyme (ACE) inhibitor primarily used to treat hypertension, heart failure, and diabetic nephropathy. This medication works by inhibiting the angiotensin-converting enzyme, reducing the levels of angiotensin II in the blood, which causes vasodilation and decreases fluid retention, thereby lowering blood pressure and improving cardiac function. Clinical evidence confirms that this drug effectively reduces hospitalization rates and mortality in patients with heart failure.
Benazepril is usually considered a first-line treatment, especially suitable for patients with diabetic nephropathy, as it can slow the progression of renal impairment. Regular monitoring of blood pressure, serum creatinine, and potassium levels is necessary during treatment to ensure efficacy and safety.
The generic name of this medication is Benazepril, with the main brand name being Lotensin. Different manufacturers may have other trade names, but the active ingredient and mechanism of action are the same. Patients should verify the active component on the medication packaging to avoid confusion with other drugs of similar names.
Benazepril belongs to the class of "Angiotensin-Converting Enzyme (ACE) Inhibitors," categorized as antihypertensive and cardiac therapy drugs. In drug classification systems, it is also grouped under "Circulatory System Drugs" and "Metabolic Regulation Drugs," due to its significant effects on blood pressure control and renal hemodynamics.
Main indications include primary hypertension, left ventricular failure (hypertensive patients with heart failure), type 1 diabetic nephropathy, and post-myocardial infarction cardiac function recovery. For patients with multiple cardiovascular risk factors, this medication can reduce the incidence of cardiac events.
In certain cases, physicians may prescribe this drug for other indications such as pulmonary hypertension or proteinuria, with dosage adjustments based on individual conditions.
Mild side effects include persistent dry cough (occurring in approximately 10-20% of patients), dizziness, fatigue, and upper respiratory tract discomfort. About 5-10% of patients may experience nonspecific gastrointestinal symptoms such as diarrhea or nausea, which usually improve with continued use.
Contraindications include:
Use during the first trimester of pregnancy may increase the risk of miscarriage, and use in later pregnancy can harm the fetus. Patients with severe hepatic impairment or dehydration should use this medication cautiously, possibly requiring dose adjustments.
Concomitant use with diuretics may enhance the risk of excessive blood pressure reduction; starting with a low dose is recommended. When combined with potassium supplements or potassium-sparing diuretics (such as amiloride), potassium levels should be monitored to prevent hyperkalemia.
Use with non-steroidal anti-inflammatory drugs (NSAIDs) may diminish the antihypertensive effect. When combined with antidiabetic medications, blood glucose should be monitored closely. Co-administration with cobalt-containing agents (such as hexamine silver) may increase nephrotoxicity. During treatment, avoid herbal supplements that promote potassium retention.
The initial dose is typically 10 mg once daily, adjusted to 20-40 mg daily based on response, administered once or divided into multiple doses. Tablets should be swallowed whole without chewing, preferably at the same time each day to maintain stable blood levels. Patients with severe hepatic impairment should start at half the dose, and those with renal impairment should adjust based on serum creatinine clearance.
Maintain normal salt intake during treatment; sudden salt restriction can cause excessive blood pressure drop. Regular blood pressure monitoring and biochemical tests are recommended during the initial phase of therapy.
If a dose is missed and it is not close to the next scheduled dose, take it as soon as remembered and extend the interval before the next dose. If it is near the time for the next dose, skip the missed dose and resume the regular schedule. Do not double doses to compensate for missed ones. Frequent missed doses should be reported to the healthcare provider to reassess the treatment plan.
Overdose may lead to severe hypotension, dizziness, and acute renal failure. In case of suspected overdose, seek immediate medical attention. Intravenous vasopressors or dialysis may be necessary. If ingestion occurred within 2 hours, induce vomiting or gastric lavage under medical supervision. Supportive care should be provided as needed.
Some patients may experience a dry, irritating cough related to ACE inhibition. If the cough persists for more than a week or affects daily life, contact your physician for evaluation and possible medication adjustment. During short-term observation, staying well-hydrated and avoiding irritant fumes may help, but do not stop the medication without medical advice.
When combining Benazepril with diuretics, what blood parameters should be monitored?Concomitant use with diuretics may increase the risk of hypokalemia or hypotension. Regular monitoring of serum electrolytes and blood pressure is essential. Avoid vigorous exercise during the first two weeks of therapy. If dizziness, orthostatic hypotension, or weakness occur, measure blood pressure immediately and consider discontinuing or adjusting medication.
How should diet be managed for hypertensive patients taking Benazepril?Adopt a low-sodium diet (less than 5 grams of salt daily), avoid processed foods and high-sodium seasonings to enhance drug efficacy. Potassium-rich foods (such as bananas and spinach) can be consumed normally, but patients with renal impairment should follow medical advice for potassium intake. Avoid concurrent use of potassium-sparing medications or supplements.
What should I do if I forget to take a dose of Benazepril?If more than 6 hours have passed since the missed dose, take it as soon as remembered and adjust the next dose accordingly. If it is close to the next scheduled dose, skip the missed dose and continue with the regular schedule. Do not double doses to make up for missed ones. If missed doses occur frequently, consult your healthcare provider for a reassessment of your medication plan.
What effects can Benazepril have on liver function tests?Long-term use may cause mild elevations in liver transaminases, but severe hepatotoxicity is rare. Liver function should be checked every 3-6 months. If ALT or AST exceeds three times the upper normal limit, dose adjustment or medication change may be necessary. Avoid excessive alcohol consumption during therapy to reduce liver burden.
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