About Benazepril and Hypertension

Benazepril is a prodrug that inhibits the conversion of angiotensin-I to angiotensin-II by inhibiting angiotensin-converting enzyme (ACE) after being hydrolyzed in the liver to benazeprilat. 

Adverse Effects Profile

• Severe CHF: Monitor for progressive azotaemia, especially where aggressive diuresis has recently occurred. Avoid use in cardiac output failure due, for example, to aortic stenosis.

• GI Distress: Typically anorexia, vomiting, and diarrhoea.

• Hypotension:  Animals may experience excessive hypotension, and fatigue, lethargy, ataxia, and incoordination may be observed. 

• Azotaemia: Renal dysfunction, azotaemia and hyperkalemia may occur. Plasma creatinine concentration may increase at the start of therapy in patients with CKD or dehydration.

Contraindications

• AKI: Avoid use in animals at risk of azotaemia as use may decrease GFR and worsen azotemia

• Hypersensitivity: Avoid use in patients with known hypersensitivity to ACE inhibitors.

• Hyponatremia or sodium depletion: Avoid use. 

• Hypotension:  Avoid use in animals with or at risk of hypotension. 

• Hypovolemia:  Avoid use. 

• Coronary or cerebrovascular insufficiency:  Avoid use. 

• Pre-existing hematologic abnormalities: Avoid use. 

• SLE or Collagen Vascular Disease: Avoid use (e.g., systemic lupus erythematosus [SLE]). 

Reproductive Safety

• Pregnancy: Avoid use. Benazepril crosses the placenta. Embryotoxic effects (foetal urinary tract malformation) were seen in trials with laboratory animals (rats) at maternally non-toxic doses (SPC data).

• Lactation: Benazepril is not expected to cause adverse effects in an infant being nursed. However, in some countries, its use is contraindicated during pregnancy and lactation (SPC data).

• Male Fertility: No data located.

• Female Fertility: Avoid use. Benazepril reduced ovary/oviduct weights in cats when administered daily at 10 mg/kg body weight for 52 weeks (SPC data).

• Neonates: Benazepril is not expected to cause adverse effects in an infant being nursed (SPC data).

Interactions

• Anti-hypertensive Agents: e.g. calcium channel blockers, β-blockers or diuretics), anaesthetics or sedatives may lead to additive hypotensive effects (SPC data).

• NSAIDs: e.g., carprofen, meloxicam, robenacoxib): can lead to reduced anti-hypertensive efficacy or impaired renal function (SPC data).

Alternative Products 

• We refer clinicians to current ACVIM Hypertension recommendations. 

Alternative Protocols

• We refer clinicians to current ACVIM Hypertension recommendations. 

Formulations

• Oral Forms:  2.5 mg, 5mg and 20mg Tablets

• UK Availability: Sole agent or combined with other diuretics such as hydrochlorothiazide.