Nurses Compass
Drug Guide
Benazepril Hydrochloride
Classification
Therapeutic: Antihypertensive
Pharmacological: ACE inhibitor (Angiotensin-Converting Enzyme Inhibitor)
FDA Approved Indications
- Hypertension
- Heart failure (off-label)
Mechanism of Action
Benazepril inhibits the angiotensin-converting enzyme, preventing conversion of angiotensin I to angiotensin II, leading to vasodilation and decreased blood pressure.
Dosage and Administration
Adult: Initial dose: 10 mg once daily. Dose may be titrated based on response, up to a maximum of 40 mg per day.
Pediatric: Not generally approved for pediatric use.
Geriatric: Start at lower dose; monitor renal function and electrolytes.
Renal Impairment: Adjust dose accordingly; cautious titration.
Hepatic Impairment: Use with caution; no specific dose adjustment provided.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed in body fluids and tissues.
Metabolism: Partially hydrolyzed to active metabolite of benazaprilat.
Excretion: Renal and fecal routes.
Half Life: Approximately 10-11 hours.
Contraindications
- History of angioedema related to previous ACE inhibitor therapy.
- Bilateral renal artery stenosis.
Precautions
- Pregnancy (category D), Lactation, Renal impairment, Hepatic impairment, Patients taking other antihypertensives, Patients with electrolyte abnormalities
Adverse Reactions - Common
- Cough (Common)
- Dizziness (Common)
- Headache (Common)
- Fatigue (Common)
Adverse Reactions - Serious
- Angioedema (Rare but serious)
- Hyperkalemia (Less common)
- Hypotension (Less common)
Drug-Drug Interactions
- Diuretics, Other antihypertensives, Potassium supplements, Lithium, NSAIDs.
Drug-Food Interactions
- Avoid salt substitutes containing potassium.
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood pressure, renal function, serum electrolytes.
Diagnoses:
- Risk for decreased cardiac output
- Risk for electrolyte imbalance
- Risk for injury due to hypotension
Implementation: Administer as prescribed, monitor vitals, assess for side effects.
Evaluation: Assess blood pressure response, monitor labs, and watch for adverse reactions.
Patient/Family Teaching
- Take medication as directed, even if feeling well.
- Rise slowly to prevent dizziness.
- Report symptoms of angioedema, persistent cough, or hyperkalemia.
- Avoid potassium-rich foods and salt substitutes as advised.
Special Considerations
Black Box Warnings:
- Pregnancy: Category D due to risk of fetal injury and death when used during pregnancy.
Genetic Factors: N/A
Lab Test Interference: May increase serum potassium and decrease renal function tests.
Overdose Management
Signs/Symptoms: Hypotension, dizziness, hyperkalemia.
Treatment: Discontinue medication, maintain airway, elevate legs, administer IV fluids, monitor electrolytes and renal function, use vasopressors if necessary.
Storage and Handling
Storage: Store at room temperature, 20-25°C (68-77°F).
Stability: Stable under recommended storage conditions.