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benazepril, Lotensin

GENERIC NAME: benazepril

BRAND NAME: Lotensin

DRUG CLASS AND MECHANISM: Benazepril is an ACE (angiotensin converting enzyme) inhibitor. ACE is an enzyme in the body which is important for the formation of angiotensin II. Angiotensin II causes constriction of arteries in the body, thereby elevating blood pressure. ACE inhibitors such as benazepril lower blood pressure by inhibiting the formation of angiotensin II, thus relaxing the arteries. Relaxing the arteries not only lowers blood pressure, but also improves the pumping efficiency of a failing heart and improves cardiac output in patients with heart failure.

PRESCRIPTION: yes

GENERIC AVAILABLE: no

PREPARATIONS: tablets: 5 mg, 10 mg, 20 mg, 40 mg.

STORAGE: Tablets should be stored at room temperature in a tightly closed container.

PRESCRIBED FOR: Benazepril can be used alone in treating high blood pressure. Its blood pressure lowering effect can be further enhanced by the addition of a diuretic medication. Lotensin HCT is an example of a medication which combines the effect of benazepril with a thiazide type diuretic (water pill) in treating hypertension. By reducing resistance in the arteries, benazepril can be useful in the treatment of congestive heart failure.

DOSING: May be taken on an empty or full stomach.

DRUG INTERACTIONS: Benazepril should not be taken by people with a known allergy to ACE inhibitors. Swelling of the facial tissues and even the upper airways has been reported with ACE inhibitors on very rare occasions, and can lead to serious breathing difficulties. Benazepril can interact with diuretics (water pills) and other blood pressure medicines to cause an excessive drop in blood pressure, which can result in symptoms of weakness, dizziness, and lightheadedness. Worsening of kidney function has been reported with ACE inhibitors, especially in patients with severe heart failure or pre-existing kidney disease. Combining benazepril with potassium supplements, potassium containing salt substitutes, and potassium conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium. Indomethacin (Indocin) and possibly other anti-inflammatory medications may decrease the blood pressure lowering effect of benazepril.

In rare instances, low white blood cell counts have been reported with the use of another ACE inhibitor. Low white blood cells increase the patient's risk of infections. When taken with lithium, benazepril can increase lithium to toxic levels in the blood. Safe use in children is not established. It is not habit forming.

Nitritoid reactions (symptoms includie facial flushing, nausea, vomiting and hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including benazepril.

PREGNANCY: ACE inhibitors, including benazepril, can be harmful to the fetus and should not be taken by pregnant women.

NURSING MOTHERS: It is also avoided in nursing mothers.

SIDE EFFECTS: Benazepril is generally well tolerated and side effects are usually mild and transient. A dry, persistent cough has been reported with the use of benazepril and other ACE inhibitors. Coughing resolves after discontinuing the medication. Other side effects are rare and include abdominal pain, constipation, diarrhea, dizziness, fatigue, headache, loss of taste, loss of appetite, nausea and vomiting, easy bruising or bleeding, chest pain, chills, difficulty breathing, severe dizziness or fainting, fever, numbness or tingling in the hands or feet, rash, and a sore or swollen throat. In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors.

Reference: FDA Prescribing Information

Last Editorial Review: 12/31/1997

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