Pregnancy Risk Category C (D in second and third trimesters)
How supplied
Tablets: 5 mg, 10 mg, 20 mg, 40 mg
Action
Drug and its active metabolite, benazeprilat, inhibit ACE, preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Reduced formation of angiotensin II decreases peripheral arterial resistance, thus decreasing aldosterone secretion, which in turn reduces sodium and water retention and lowers blood pressure. Drug also exhibits antihypertensive activity in patients with low-renin hypertension.
Indications & dosage
Hypertension--
Adults: for patients not receiving a diuretic, 10 mg P.O. daily initially. Dosage adjusted as needed and tolerated; most patients take 20 to 40 mg daily in one or two divided doses. For patients receiving a diuretic, 5 mg P.O. daily.
Adjust-a-dose: For renally impaired patients with creatinine clearance below 30 ml/minute, 5 mg P.O. daily. Dose may be adjusted up to 40 mg/day.
Adverse reactions
CNS: headache, dizziness, drowsiness, fatigue, somnolence.
CV: symptomatic hypotension.
GI: nausea.
GU: impotence, increased serum creatinine and BUN levels.
Metabolic: hyperkalemia.
Musculoskeletal: arthralgia, arthritis, myalgia.
Respiratory: dry, persistent, nonproductive cough.
Skin: hypersensitivity reactions, increased diaphoresis.
Interactions
Drug-drug. Diuretics, other antihypertensives: risk of excessive hypotension. Discontinue diuretic or lower dose of benazepril as needed.
Lithium: increased serum lithium levels and lithium toxicity. Coadminister with caution; monitor serum lithium levels.
Potassium-sparing diuretics, potassium supplements: risk of hyperkalemia. Monitor closely.
Drug-food. Salt substitutes containing potassium: risk of hyperkalemia. Monitor closely.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to ACE inhibitors.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING