BLACK BOX WARNING
- fetal toxicity
benazepril
Brand: Lotensin
⚠ BBW Prototype: lisinopril
Drug Class: ACE inhibitor
Drug Family: antihypertensive
Subclass: prodrug ACE inhibitor
Organ Systems: cardiovascularrenal
Mechanism of Action
Prodrug converted to benazeprilat; inhibits ACE reducing angiotensin II formation.
ACE (angiotensin-converting enzyme)
Indications
- hypertension
- CKD (non-diabetic)
- heart failure
Contraindications
- pregnancy
- ACE-inhibitor angioedema
Adverse Effects
Common
- cough
- hyperkalemia
- dizziness
Serious
- angioedema
- AKI
- teratogenicity
Pharmacokinetics (ADME)
| Absorption | 37% bioavailability |
| Distribution | moderate |
| Metabolism | hepatic to benazeprilat |
| Excretion | biliary and renal (dual) |
| Half-life | 10-11 hours |
| Onset | 1 hour |
| Peak | 2-4 hours |
| Duration | 24 hours |
| Protein Binding | 95% |
| Vd | moderate |
Drug Interactions
| Drug / Agent | Mechanism | Severity |
|---|---|---|
| potassium-sparing diuretics | additive hyperkalemia | major |
| NSAIDs | reduced efficacy | moderate |
Nursing Considerations
- Monitor BP, K+, creatinine
- Dual excretion useful in severe renal impairment
- Report cough or swelling immediately
Clinical Pearls
- Dual excretion (biliary+renal) may be advantageous in patients with renal impairment
- High protein binding
Safety Profile
Pregnancy contraindicated
Lactation avoid
Renal Adjustment Required
Hepatic Adjustment Not required
TDM Not required
Concordance Terms
Cross-referenced clinical concepts — click any term to see all content where it appears.