Select Species Dataset
Benazepril
Proteinuria Reduction
No Recommendations
There is no community consensus on diagnosing or staging rabbit proteinuria. Therefore, until our understanding of rabbit chronic kidney disease is better developed, identifying ideal target patients, therapeutic strategies, and assessing proteinuria treatment efficacy remains elusive.
MSE Extrapolation
ACEi-induced reduction in intraglomerular hypertension occurs because of a vasodilating effect on efferent glomerular arterioles. This has a proteinuric-reducing effect; however, an increase in serum creatinine concentration may accompany any reduction in glomerular hypertension.
MSE: Major species extrapolation (MSE) and anecdotal expert opinion in textbooks
MSE Proteinuria Reduction: 0.5 mg/kg, PO, q24h gradually increased by 0.5 mg/kg.PO, q24h to a maximum of 2 mg/kg, PO, q24h. Total daily doses can be divided and administered q12h.
Multi-Modal Use: Benazepril therapy with telmisartan may result in better outcomes than benazepril alone (Fowler BL, Stefanovski D, Hess RS, McGonigle K. Effect of telmisartan, angiotensin-converting enzyme inhibition, or both, on proteinuria and blood pressure in dogs. J Vet Intern Med. 2021;35(3):7).
Therapeutic Aim: Decreasing proteinuria preferably to <0.5) (i.e., urinary protein-to-creatinine [UPC] ratio decreased by ≥50%).
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.