How does this medication work? What will it do for me?

Benazepril belongs to the class of medications called angiotensin converting enzyme (ACE) inhibitors. It is used to treat mild to moderately high blood pressure. It works by relaxing blood vessels and reducing the workload of the heart. Benazepril may be used in addition to diuretics (water pills) known as thiazide diuretics (e.g., hydrochlorothiazide) when one medication has not been found to control blood pressure satisfactorily.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Lotensin

5 mg
Each light yellow, ovaloid, slightly biconvex, film-coated tablet, imprinted "LV" on one side and "CG" on the other side with a score on both sides, contains benazepril HCl 5 mg. Nonmedicinal ingredients: cellulose compounds, colloidal silicon dioxide, cornstarch, crospovidone, hydrogenated castor oil, iron oxide, lactose, polyethylene glycol, talc, and titanium dioxide.

20 mg
Each light orange, round, slightly biconvex, film-coated tablet, with bevelled edges, contains benazepril HCl 20 mg. Nonmedicinal ingredients: cellulose compounds, colloidal silicon dioxide, cornstarch, crospovidone, hydrogenated castor oil, iron oxide, lactose, polyethylene glycol, talc, and titanium dioxide.

How should I use this medication?

The usual starting dose of benazepril for adults is 10 mg daily. If this dose does not lower the blood pressure enough after 2 weeks, the dose may be increased gradually to a maximum of 40 mg daily. The usual dose is 20 mg daily.

Lower doses may be used for people who take other medications that lower blood pressure (e.g., diuretics), or for people who have kidney disease. It may take up to 2 weeks to see the full effects of the medication.

Benazepril may be taken with or without meals.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to benazepril or any ingredients of the medication
  • are pregnant or are planning to become pregnant
  • have a history of angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any medications known as ACE inhibitors (e.g., captopril, enalapril, fosinopril, lisinopril, ramipril)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • change to the sense of taste
  • constipation
  • cough (dry, persistent)
  • decreased sexual ability
  • diarrhea
  • headache
  • heartburn
  • increased sensitivity to the sun
  • nausea
  • ringing in the ears
  • unusual tiredness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • decreased urine output
  • dizziness, lightheadedness, or fainting (signs of low blood pressure)
  • numbness or tingling in the hands or feet
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of an infection (e.g., fever and chills, hoarseness, other flu-like symptoms)
  • signs of bleeding (e.g., bloody nose, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
  • signs of low blood sugar (e.g., cold clammy skin, dizziness, fatigue, sweating)
  • signs of reduced liver function (e.g., stomach pain, itching of skin, yellow eyes or skin, abdominal pain, abdominal distention, fever, nausea, or vomiting)
  • signs of too much potassium in the body (e.g., confusion, irregular heartbeat, nervousness, numbness or tingling in hands, feet, or lips, shortness of breath or difficulty breathing, weakness or heaviness of legs)
  • skin rash with or without itching, fever, or joint pain
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
  • signs of severe allergic reaction (e.g., swelling of face, mouth, hands, or feet (signs of angioedema), sudden difficulty swallowing or breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

HEALTH CANADA ADVISORY

February 4, 2014

Health Canada has issued new restrictions concerning the use of benazepril. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with the use of ACE inhibitors, including benazepril. If you experience swelling of the face, tongue, or throat, stop taking benazepril at once and get immediate medical attention. Other medications known as ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving an ACE inhibitor.

Diabetes: People with diabetes who take benazepril may experience reduced blood sugar control. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may find it helpful to increase the number of times a day your check your blood sugar.

Fluid and electrolyte balance: Increases in blood levels of potassium occur in approximately 1.1% of patients receiving benazepril. This rarely causes problems, but your doctor will monitor your potassium levels regularly with blood tests. Contact your doctor as soon as possible if you experience symptoms of increased potassium in the body, such as confusion, irregular heartbeat, unusual nervousness, or tingling in the hands and feet. Avoid using salt substitutes while taking benazepril.

Infection: Some people taking benazepril experience a reduction in the cells that fight infection (white blood cells), which results in infections. Tell your doctor as soon as possible if you begin to notice the signs of an infection such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests to monitor the number of specific types of blood cells in your blood.

Kidney function: Changes in kidney function have been seen in certain people who use benazepril (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills) or nonsteroidal anti-inflammatory drugs (NSAIDs) may further increase the risk of kidney problems for those people already at risk. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Occasionally, hepatitis (inflammation of the liver) occurs with the use of benazepril. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Occasionally, blood pressure drops too low after taking benazepril. This usually happens after the first or second dose, or when the dose is increased. It is more likely to occur in those who take water pills, have a salt-restricted diet, are on dialysis, are suffering from diarrhea or vomiting, or have been sweating excessively and not drinking enough liquids. If low blood pressure causes you to faint or feel lightheaded, contact a doctor.

Surgery: Benazepril may affect how anaesthetics work. If you are scheduled for surgery, inform all doctors involved in your care that you take benazepril.

Pregnancy: Benazepril, like other ACE inhibitors, can cause birth defects and even death to the developing fetus when taken by a women who is pregnant. Pregnant women should not take this medication. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking benazepril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of benazepril have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between benazepril and any of the following:

  • acetylsalicylic acid (ASA)
  • alfuzosin
  • aliskiren
  • allopurinol
  • alpha-1 blockers (e.g., doxazosin, prazosin, tamsulosin)
  • alpha-2 blockers (e.g., clonidine, dexmedetomidine, methyldopa)
  • amifostine
  • amphetamines (e.g., dextroamphetamine, phentermine)
  • other angiotensin converting enzyme inhibitors (ACEIs; e.g., captopril, ramipril)
  • angiotensin II receptor blockers (e.g., irbesartan, losartan, valsartan)
  • antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
  • azathioprine
  • beta-blockers (e.g., atenolol, carvedilol, propranolol)
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • cyclosporine
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide)

 

  • ginger
  • ginseng
  • iron dextran complex
  • licorice
  • lithium
  • MAO inhibitors (e.g., moclobemide, phenelzine, rasagiline, selegiline)
  • medications that increase potassium levels (e.g., potassium supplements, salt substitutes containing potassium)
  • methylphenidate
  • nonsteroidal anti-inflammatory medications (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
  • phosphodiesterase-5-inhibitors (e.g., sildenafil, tadalafil)
  • potassium-sparing diuretics (e.g., spironolactone, amiloride, triamterene)
  • rituximab
  • sirolimus
  • sodium phosphates
  • temsirolimus
  • trimethoprim

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.