Loading...
Loading...
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Thiazide Diuretic [EPC]
Benazepril is an Angiotensin-Converting Enzyme (ACE) inhibitor used primarily to treat hypertension. It works by relaxing blood vessels to lower blood pressure and improve blood flow.
Name
Benazepril
Raw Name
BENAZEPRIL HYDROCHLORIDE
Category
Thiazide Diuretic [EPC]
Salt Form
Hydrochloride
Drug Count
7
Variant Count
191
Last Verified
February 17, 2026
RxCUI
898346, 898350, 898356, 898687, 898689, 898690, 898692, 898719, 898721, 898723, 898342, 898353, 898359, 898362, 898366, 898367, 898371, 898372, 898376, 898378, 898344, 898348, 898355, 898358, 308136
UNII
864V2Q084H, N1SN99T69T, 0J48LPH2TH
About Benazepril
Benazepril is an Angiotensin-Converting Enzyme (ACE) inhibitor used primarily to treat hypertension. It works by relaxing blood vessels to lower blood pressure and improve blood flow.
Detailed information about Benazepril
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Benazepril.
In clinical practice, Benazepril is classified as a prodrug. When ingested, it undergoes extensive hepatic metabolism to form its active metabolite, benazeprilat. This active form is responsible for the drug's therapeutic effects. By lowering blood pressure, Benazepril significantly reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions (heart attacks). These benefits have been observed in numerous controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes, including the ACE inhibitor class to which Benazepril belongs.
To understand how Benazepril works, one must understand the Renin-Angiotensin-Aldosterone System (RAAS), a complex hormonal cascade that regulates blood pressure and fluid balance in the body. The kidneys release an enzyme called renin into the bloodstream in response to low blood pressure or low salt levels. Renin acts on a protein called angiotensinogen to produce Angiotensin I. While Angiotensin I is relatively inactive, it is converted into Angiotensin II by the Angiotensin-Converting Enzyme (ACE).
Angiotensin II is a powerful vasoconstrictor, meaning it causes the muscles surrounding blood vessels to contract, narrowing the vessels and significantly increasing blood pressure. Additionally, Angiotensin II stimulates the release of aldosterone from the adrenal cortex, which causes the kidneys to retain sodium and water, further increasing blood volume and pressure. Benazepril works by binding to and inhibiting the ACE enzyme. By blocking this enzyme, Benazepril prevents the conversion of Angiotensin I to Angiotensin II.
The clinical result of this inhibition is twofold: first, the blood vessels remain dilated (relaxed), which lowers peripheral vascular resistance; second, aldosterone secretion is reduced, leading to a decrease in sodium and water retention. Furthermore, ACE is also responsible for the breakdown of bradykinin, a peptide that has vasodilatory properties. By inhibiting ACE, Benazepril may increase levels of bradykinin, which further contributes to the blood-pressure-lowering effect, although this mechanism is also believed to be responsible for the common side effect of a dry cough.
Understanding the pharmacokinetics of Benazepril is essential for optimizing its clinical use.
Benazepril is FDA-approved for the treatment of hypertension in adults and children aged 6 years and older. It is effective as monotherapy or in combination with other classes of antihypertensive medications.
Beyond its primary indication, Benazepril is frequently used off-label or as part of standard care for several other conditions:
Benazepril Hydrochloride is primarily available in oral tablet form. The standard strengths available in the United States include:
It is also available in fixed-dose combination tablets with other medications, most notably with Hydrochlorothiazide (a diuretic) and Amlodipine (a calcium channel blocker). These combinations are often used when blood pressure is not adequately controlled by a single medication.
> Important: Only your healthcare provider can determine if Benazepril is right for your specific condition. This overview is for educational purposes and does not replace professional medical advice.
The dosage of Benazepril must be individualized based on the patient's clinical response and the specific condition being treated.
Benazepril is approved for use in pediatric patients aged 6 to 16 years for the treatment of hypertension.
In patients with a creatinine clearance (CrCl) of less than 30 mL/min/1.73m² (standard measure of kidney function), the recommended starting dose is reduced to 5 mg once daily. The dose may be titrated upward to a maximum of 40 mg based on blood pressure control. Patients with renal impairment require frequent monitoring of serum potassium and creatinine levels.
No specific dosage adjustment is typically required for patients with mild to moderate hepatic (liver) impairment, as the conversion of the prodrug to the active metabolite remains relatively intact. However, caution is advised in severe hepatic failure.
Clinical studies have not identified overall differences in safety or effectiveness between elderly patients (65 and older) and younger patients. However, because older adults are more likely to have decreased renal function, healthcare providers often start with the lower end of the dosing range and monitor closely.
If you miss a dose of Benazepril, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular dosing schedule. Do not take two doses at once to make up for a missed one, as this increases the risk of severe hypotension (low blood pressure).
The most likely symptom of a Benazepril overdose is severe hypotension (excessive low blood pressure), which can lead to dizziness, fainting, or shock. Other signs may include electrolyte imbalances (such as high potassium) or kidney failure.
Emergency Measures: In the event of a suspected overdose, contact your local poison control center or seek emergency medical attention immediately. Treatment typically involves intravenous fluids to increase blood pressure and supportive care to manage electrolyte levels. Benazeprilat can be removed from the body via hemodialysis, though this is rarely necessary unless severe renal impairment is present.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop taking this medication without medical guidance, as stopping suddenly can cause your blood pressure to rise rapidly.
While Benazepril is generally well-tolerated, some patients may experience side effects. The most common side effect associated with Benazepril and other ACE inhibitors is a dry, persistent, non-productive cough.
> Warning: Stop taking Benazepril and call your doctor immediately if you experience any of the following serious symptoms:
With long-term use, the primary concern is the monitoring of renal function and electrolyte balance. In some patients, especially those with pre-existing renal artery stenosis (narrowing of the arteries to the kidneys), Benazepril can cause a slow decline in kidney function. Chronic use is also associated with a sustained risk of hyperkalemia, which can lead to dangerous heart rhythm abnormalities if not monitored.
Fetal Toxicity Warning: Benazepril carries a boxed warning regarding its use during pregnancy. When pregnancy is detected, Benazepril should be discontinued as soon as possible. Drugs that act directly on the renin-angiotensin system (like Benazepril) can cause injury and even death to the developing fetus, particularly during the second and third trimesters. Risks include oligohydramnios (low amniotic fluid), which can lead to fetal lung hypoplasia (underdeveloped lungs) and skeletal deformations. Neonatal risks include skull hypoplasia, anuria (lack of urine production), hypotension, renal failure, and death.
Report any unusual symptoms or side effects to your healthcare provider promptly. Regular blood tests are often required to ensure the medication is not negatively affecting your kidneys or potassium levels.
Benazepril is a powerful cardiovascular medication that requires careful medical supervision. Patients must be aware that the first few doses may cause a significant drop in blood pressure, especially if they are dehydrated or taking other diuretics. It is recommended to take the first dose at bedtime or under conditions where dizziness will not lead to injury.
Angioedema of the face, extremities, lips, tongue, glottis, and larynx has been reported in patients treated with ACE inhibitors. This is a medical emergency. If laryngeal stridor or angioedema of the face, tongue, or glottis occurs, treatment should be discontinued and appropriate therapy instituted immediately. Patients with a history of angioedema unrelated to ACE inhibitor therapy may be at increased risk of angioedema while receiving an ACE inhibitor. Black patients have been reported to have a higher incidence of angioedema compared to non-Black patients.
Benazepril can cause symptomatic hypotension, particularly after the initial dose. This is most common in patients who are volume- or salt-depleted due to prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. Volume depletion should be corrected before starting Benazepril.
In patients with severe heart failure or renal artery stenosis, ACE inhibitors can cause a rapid decline in kidney function. Healthcare providers will typically monitor serum creatinine and blood urea nitrogen (BUN) levels closely during the first few weeks of therapy.
Elevated serum potassium (greater than 5.7 mEq/L) can occur. Risk factors include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements, or potassium-containing salt substitutes.
Patients taking Benazepril require periodic laboratory monitoring, including:
Benazepril may cause dizziness or fatigue, especially during the first few days of treatment or when the dose is increased. Patients should observe how they react to the medication before driving, operating heavy machinery, or performing tasks that require mental alertness.
Alcohol consumption can enhance the blood-pressure-lowering effect of Benazepril, potentially leading to severe dizziness, lightheadedness, or fainting. It is generally advised to limit alcohol intake while taking this medication.
Do not stop taking Benazepril abruptly. While it does not typically cause a "rebound" effect like some other blood pressure medications (e.g., beta-blockers), your blood pressure will likely return to pre-treatment levels if the drug is stopped. Always consult your doctor before discontinuing therapy to ensure a safe transition to an alternative treatment if necessary.
> Important: Discuss all your medical conditions, including any history of heart, kidney, or liver disease, with your healthcare provider before starting Benazepril.
Benazepril may cause false-positive results in certain urine tests for acetone. It may also slightly increase serum bilirubin levels.
For most interactions, the management strategy involves:
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete list is essential to prevent dangerous drug-drug interactions.
Benazepril must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by a healthcare provider:
There is a high degree of cross-sensitivity among members of the ACE inhibitor class. If a patient has had a non-angioedema allergic reaction (such as a severe rash) to another ACE inhibitor, they should use Benazepril with extreme caution, if at all. However, if the prior reaction was angioedema, Benazepril is strictly contraindicated.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of allergies or organ dysfunction, before prescribing Benazepril.
FDA Pregnancy Category D. Benazepril is known to cause fetal harm. Use of drugs that act on the RAAS during the second and third trimesters reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. If a patient becomes pregnant, Benazepril must be stopped immediately. Women of childbearing age should be counseled on the risks and should use effective contraception while on this medication.
Limited data suggest that Benazepril and its active metabolite, benazeprilat, are excreted into human breast milk in very small amounts. The levels found in milk are approximately 0.3% of the maternal weight-adjusted dose. While this is unlikely to cause adverse effects in the nursing infant, caution should be exercised. Alternative antihypertensive medications with more extensive safety data in breastfeeding (such as Enalapril or Captopril) may be preferred, especially when nursing a newborn or preterm infant.
Benazepril is indicated for the treatment of hypertension in children 6 years of age and older. The safety and effectiveness in children under 6 years have not been established. In pediatric patients with a GFR < 30 mL/min/1.73m², Benazepril is not recommended as there are no data to support its use. Long-term effects on growth and development in children have not been specifically studied, but no adverse signals have emerged in clinical use.
In clinical trials, no overall differences in safety or effectiveness were observed between patients over 65 and younger patients. However, greater sensitivity in some older individuals cannot be ruled out. Since the elderly are more likely to have decreased renal function, the dose should be selected with caution, usually starting at the low end of the dosing range (5 mg or 10 mg).
In patients with CrCl < 30 mL/min, the elimination of benazeprilat is slowed, leading to higher blood levels of the drug. The starting dose should be 5 mg, and the patient should be monitored closely for signs of hypotension or worsening renal function. Benazepril is cleared by hemodialysis; therefore, dosing should ideally occur after the dialysis session.
In patients with hepatic dysfunction due to cirrhosis, the levels of benazeprilat are essentially unchanged. No specific dosage adjustment is required for mild to moderate liver disease. However, in severe hepatic failure, the body's ability to convert the prodrug to its active form may be impaired, though this is rarely clinically significant for blood pressure control.
> Important: Special populations, particularly pregnant women and those with kidney disease, require individualized medical assessment and frequent monitoring while taking Benazepril.
Benazepril is a competitive inhibitor of Angiotensin-Converting Enzyme (ACE). ACE is a peptidyl dipeptidase that catalyzes the conversion of Angiotensin I to the vasoconstrictor substance, Angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. Inhibition of ACE results in decreased plasma Angiotensin II, which leads to decreased vasopressor activity and decreased aldosterone secretion. The latter decrease may result in a small increase of serum potassium. Removal of Angiotensin II negative feedback on renin secretion leads to increased plasma renin activity.
Following oral administration of Benazepril, the onset of antihypertensive activity is usually seen within 1 hour, with peak reduction of blood pressure achieved by 2 to 4 hours. The antihypertensive effect persists for at least 24 hours, allowing for once-daily dosing. Abrupt withdrawal of Benazepril has not been associated with a rapid increase in blood pressure. In patients with heart failure, Benazepril reduces systemic vascular resistance and pulmonary capillary wedge pressure.
| Parameter | Value |
|---|---|
| Bioavailability | ~37% (absorbed) |
| Protein Binding | 96.7% (Benazeprilat) |
| Half-life | 10–11 hours (Benazeprilat) |
| Tmax | 0.5–1 hour (Benazepril); 1–2 hours (Benazeprilat) |
| Metabolism | Hepatic (to active benazeprilat) |
| Excretion | Renal (primary), Biliary (secondary) |
Benazepril belongs to the ACE Inhibitor [EPC] (Angiotensin-Converting Enzyme Inhibitor) class. It is chemically related to other ACE inhibitors such as Lisinopril, Enalapril, and Ramipril. Unlike Lisinopril, which is active as administered, Benazepril is a prodrug requiring hepatic activation.
Medications containing this ingredient
Common questions about Benazepril
Benazepril is primarily used to treat hypertension, also known as high blood pressure, in both adults and children at least 6 years old. By lowering blood pressure, it helps prevent serious cardiovascular events such as strokes and heart attacks. It belongs to a class of drugs called ACE inhibitors, which work by relaxing the blood vessels. In some cases, healthcare providers may also prescribe it off-label to protect the kidneys in patients with diabetes or chronic kidney disease. It is often used as a first-line therapy because of its proven effectiveness and once-daily dosing schedule.
The most frequently reported side effect of Benazepril is a persistent, dry, and non-productive cough, which affects up to 10% of patients. Other common side effects include dizziness, headache, and fatigue, which often occur as the body adjusts to lower blood pressure levels. Some patients may also experience nausea or a faint feeling when standing up too quickly. Most of these side effects are mild, but the cough can be bothersome enough for some patients to switch medications. If you experience swelling of the face or difficulty breathing, you should seek emergency medical care immediately as these are signs of a serious allergic reaction.
It is generally recommended to limit or avoid alcohol consumption while taking Benazepril. Alcohol can enhance the blood-pressure-lowering effects of the medication, which may lead to excessive hypotension. This can result in severe dizziness, lightheadedness, or even fainting, particularly when you first start the medication or when your dose is increased. Drinking alcohol while on antihypertensive medication can also make it more difficult for your doctor to determine the correct dosage for your condition. Always discuss your alcohol consumption habits with your healthcare provider to ensure your safety.
No, Benazepril is not safe during pregnancy and carries a strict FDA Black Box Warning. Taking this medication during the second and third trimesters can cause severe injury or death to the developing fetus by affecting its kidney development and skull formation. It can also lead to a lack of amniotic fluid, which results in underdeveloped lungs and skeletal deformities. If you are planning to become pregnant or find out that you are pregnant while taking Benazepril, you must contact your doctor immediately to switch to a safer alternative. Women of childbearing age should use effective birth control while on this medication.
Benazepril begins to lower blood pressure within about one hour of taking the first dose, with the maximum effect occurring between 2 and 4 hours after administration. However, it may take several weeks of consistent daily use to see the full therapeutic benefits of the medication on your resting blood pressure. Your doctor will likely monitor your blood pressure over the first few weeks to determine if the dose needs to be adjusted. It is important to continue taking the medication even if you do not feel an immediate difference, as high blood pressure often has no symptoms. Do not stop taking the drug without consulting your healthcare provider.
You should not stop taking Benazepril suddenly without first consulting your healthcare provider. While stopping Benazepril does not usually cause a dangerous 'rebound' spike in blood pressure like some other heart medications, your blood pressure will likely rise back to its previous high levels once the drug is discontinued. This increases your long-term risk of heart attack and stroke. If you need to stop the medication due to side effects, your doctor will provide a plan to transition you to another blood pressure medication. Always follow professional medical guidance when changing your medication regimen.
If you miss a dose of Benazepril, you should take it as soon as you remember on that same day. However, if it is almost time for your next scheduled dose, skip the missed dose entirely and continue with your regular schedule. Never take two doses at the same time to 'make up' for a missed one, as this can cause your blood pressure to drop to dangerously low levels. To help you remember, try taking your medication at the same time every day, such as with breakfast or before bed. If you frequently miss doses, talk to your pharmacist about using a pill organizer or a reminder app.
Weight gain is not a typical or common side effect of Benazepril. Clinical trials have not shown a direct link between taking ACE inhibitors and an increase in body fat or weight. However, if you notice rapid weight gain accompanied by swelling in your feet, ankles, or hands, this could be a sign of fluid retention or a change in kidney function, which requires medical attention. It is also possible that other medications taken alongside Benazepril, or underlying conditions like heart failure, could be responsible for weight changes. Always report sudden weight changes to your doctor.
Benazepril can interact with several other medications, so it is vital to inform your doctor of everything you are taking. It is often safely combined with diuretics or calcium channel blockers, but combining it with potassium supplements or potassium-sparing diuretics can lead to dangerously high potassium levels. Taking Benazepril with NSAIDs like ibuprofen can reduce its effectiveness and potentially harm your kidneys. There is also a major interaction with Entresto (sacubitril/valsartan), which requires a 36-hour gap between doses. Your pharmacist can provide a full screening for drug interactions based on your current medication list.
Yes, Benazepril is widely available as a generic medication, which is typically much more affordable than the brand-name version, Lotensin. Generic Benazepril contains the same active ingredient and meets the same FDA standards for quality, strength, and purity as the brand-name drug. Most insurance plans and Medicare Part D programs cover generic Benazepril as a low-cost 'Tier 1' medication. Because it has been available as a generic for many years, it is a cost-effective option for long-term management of high blood pressure. Check with your pharmacist to see if the generic version is right for you.