Benazepril: Difference between revisions
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==Mechanism of Action== | ==Mechanism of Action== | ||
Benazepril inhibits [[angiotensin-converting enzyme|angiotensin-converting enzyme (ACE)]] | Benazepril inhibits [[angiotensin-converting enzyme|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 to decreased [[aldosterone]] secretion. The latter decrease may result in a small increase of serum [[potassium]]. | ||
==Dosage forms== | ==Dosage forms== | ||
Revision as of 17:40, 11 February 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
For patient information about Benazepril, click here.
Synonyms / Brand Names: Lotensin
Overview
Benazepril, brand name Lotensin (Novartis), is a medication used to treat high blood pressure (hypertension), congestive heart failure, and chronic renal failure. Upon cleavage of its ester group by the liver, benazepril is converted into its active form benazeprilat, a non-sulfhydryl angiotensin-converting enzyme (ACE) inhibitor.
Category
Antihypertensive Agents, ACE Inhibitors
FDA Package Insert
LOTENSIN (benazepril hydrochloride) tablet
Indications and Usage | Dosage and Administration | Contraindications | Warnings and Precautions | Adverse Reactions | Drug Interactions | Overdosage | Description | Clinical Pharmacology | Clinical Studies | How Supplied/Storage and Handling | Patient Counseling Information | Labels and Packages
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Mechanism of Action
Benazepril inhibits 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 to decreased aldosterone secretion. The latter decrease may result in a small increase of serum potassium.
Dosage forms
Benazepril is available as oral tablets, in 5-, 10-, 20-, and 40-mg doses.
Benazepril is also available in combination with hydrochlorothiazide, under the trade name Lotensin HCT, and with amlodipine (trade name Lotrel).
Side effects
Most commonly, headaches and cough can occur with its use. Anaphylaxis, angioedema and hyperkalemia, the elevation of potassium levels, can also occur.
Benazepril may cause harm to the fetus during pregnancy.
Contraindications
Benazepril should be discontinued during pregnancy.
Kidney disease
According to a 2006 article in the New England Journal of Medicine, patients with advanced renal insufficiency taking benazepril showed "substantial" kidney benefits.[1]
A long-term study of patients' kidney disease revealed patients who took benazepril had better kidney function and slower progressions of kidney disease than their peers who took a placebo drug.[2] This is notable because this category of pharmaceuticals has long been thought to cause further kidney damage or increase the rate of progression for kidney disease.
According to coverage of the study on WebMD:
| “ | ACE inhibitors can pose a potential threat to kidneys as well. The key question was whether damaged kidneys would worsen if patients took ACE inhibitors. In a nutshell, concerns centered on blood levels of potassium and creatinine, waste products that are excreted by the kidneys. Testing creatinine levels in the blood is used as a way to monitor kidney function (...) kidney problems worsened more slowly in those taking Lotensin. Overall, there were no major differences in side effects between patients taking Lotensin or the placebo.[2] | ” |
This study marks the first indication that benazepril, and perhaps other ACE inhibitors, may actually be beneficial in the treatment of hypertension in patients with kidney disease.
Veterinary use
Under the brand names Fortekor (Novartis) and VetACE (Jurox Animal Health),[citation needed] benazepril hydrochloride is used to treat congestive heart failure in dogs[3][4] and chronic renal failure in dogs and cats.[citation needed]
References
- ↑ Hou F, Zhang X, Zhang G, Xie D, Chen P, Zhang W, Jiang J, Liang M, Wang G, Liu Z, Geng R (2006). "Efficacy and safety of benazepril for advanced chronic renal insufficiency". N Engl J Med. 354 (2): 131–40. doi:10.1056/NEJMoa053107. PMID 16407508.
- ↑ 2.0 2.1 Hitti, Miranda (January 11, 2006). "Drug May Treat Advanced Kidney Disease". WebMD. Retrieved 2006-09-07. Unknown parameter
|coauthors=ignored (help) - ↑ King JN, Mauron C, Kaiser G (December 1995). "Pharmacokinetics of the active metabolite of benazepril, benazeprilat, and inhibition of plasma angiotensin-converting enzyme activity after single and repeated administrations to dogs". Am. J. Vet. Res. 56 (12): 1620–8. PMID 8599524.
- ↑ O'Grady MR, O'Sullivan ML, Minors SL, Horne R (2009). "Efficacy of benazepril hydrochloride to delay the progression of occult dilated cardiomyopathy in Doberman Pinschers". J. Vet. Intern. Med. 23 (5): 977–83. doi:10.1111/j.1939-1676.2009.0346.x. PMID 19572914.