Generic Name and Formulations:
Benazepril (as HCl) 5mg, 10mg, 20mg, 40mg; tabs.
Indications for LOTENSIN:
If not on diuretic: initially 10mg once daily. Usual maintenance: 20–40mg daily in 1 or 2 divided doses; usual max 80mg/day. If on diuretic: initially 5mg once daily. If BP not controlled on benazepril alone, may add low dose diuretic. CrCl<30mL/min/1.73m2: initially 5mg daily; max 40mg/day.
<6yrs or CrCl<30mL/min/1.73m2: not recommended. ≥6yrs: Initially 0.2mg/kg daily; usual max 0.6mg/kg/day (or 40mg/day). Prepare suspension if unable to swallow tablets or if calculated mg/kg dosage does not correspond to available tablet strengths (see full labeling).
History of ACEI-associated or other angioedema. Concomitant neprilysin inhibitors (eg, sacubitril); do not administer benazepril within 36hrs of switching to or from sacubitril/valsartan. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Salt/volume depletion. CHF. Renal impairment. Dialysis (esp. high-flux membrane). Renal artery stenosis. Surgery. Diabetes. Discontinue and monitor if angioedema, laryngeal edema, jaundice or marked elevations of hepatic enzymes develop. Monitor BP, electrolytes, and renal function. Black patients may have higher rate of angioedema than non-Black patients. Neonates. Elderly. Pregnancy (Cat.D); monitor. Nursing mothers.
See Contraindications. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Hyperkalemia with K+-sparing diuretics, K+ supplements, or K+-containing salt substitutes. May increase lithium levels. Potentiated by diuretics. May be antagonized by, and renal toxicity potentiated by, NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume depleted). Increased risk of angioedema with concomitant mTOR inhibitors (eg, temsirolimus, sirolimus, everolimus) or neprilysin inhibitors. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare. Hypoglycemia with insulin and oral antidiabetics; rare.
Headache, dizziness, fatigue, GI upset, cough, angioedema, orthostatic hypotension, hyperkalemia; rare: hepatic failure.
Hepatic. Approx. 96% protein bound.
Renal (primarily), biliary.
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