Brand Name: Lotensin
Generic Name: Benazepril

Benazepril is an angiotensin converting enzyme (ACE) inhibitor which is used in the treatment of hypertension.

Benazepril, after hydrolytic bioactivation to benazeprilat, inhibits angiotensin converting enzyme (ACE), a peptidyl dipeptidase catalyzing the conversion of angiotensin I to the vasoconstrictor angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex, leading to sodium resorption and potassium secretion by the distal renal tubules.

Inhibition of ACE results in a decrease in plasma angiotensin II, leading to decreased vasoconstriction and a small decrease in aldosterone secretion and plasma aldosterone concentrations. Although the decrease in aldosterone is small, it can result in small increases in serum potassium. Slight increases in serum potassium have been observed in some hypertensive patients treated with benazepril alone. Essentially no change in mean serum potassium was seen in patients treated with benazepril and a thiazide diuretic

Removal of inhibition of renin secretion by angiotensin II leads to increased plasma renin activity (due to removal of negative feedback of renin release).

ACE is identical to kininase II. Thus, benazepril may interfere with degradation of the potent peptide vasodilator, bradykinin. Whether increased levels of bradykinin play a role in the therapeutic effects of benazepril is unknown.

While the mechanism through which benazepril lowers blood pressure is believed to be primarily suppression of the renin-angiotensin-aldosterone system, benazepril has an antihypertensive effect even in patients with low renin hypertension. In particular, benazepril was antihypertensive in all races studied, although it was somewhat less effective in blacks than in nonblacks.

In the treatment of mild to moderate essential hypertension. It may be used alone or in association with thiazide diuretics.

In using benazepril, consideration should be given to the risk of angioedema.

Benazepril should normally be used in those patients in whom treatment with a diuretic or a beta-blocker was found ineffective or has been associated with unacceptable adverse effects.

Benazepril can also be tried as an initial agent in those patients in whom use of diuretics and/or beta-blockers is contraindicated or in patients with medical conditions in which these drugs frequently cause serious adverse effects.

The safety and efficacy of benazepril in congestive heart failure and renovascular hypertension have not been established and therefore, its use in these conditions is not recommended.

The safety and efficacy of concurrent use of benazepril with antihypertensive agents other than thiazide diuretics have not been established.