Benazepril

By Lauren R. Forsythe, PharmD, MBA, DICVP; Rania Gollakner, BS, DVM, MPH

What is benazepril?

Benazepril (brand names: Fortekor®, Lotensin®, Apex®, Benazemav®, Benefortin®, Bexepril®, Nelio®, Prilben®, Vetace®) is an angiotensin-converting enzyme (ACE) inhibitor used to treat heart failure, high blood pressure, and various types of kidney diseases, such as chronic kidney disease and protein-losing glomerulonephropathies. It may also be useful for treating idiopathic kidney bleeding.

"Many drugs are commonly prescribed for off-label use in veterinary medicine."

Its use in cats and dogs to treat cardiovascular and kidney disease is “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is benazepril given?

  • Benazepril is given by mouth, in the form of a tablet. 
  • It may be given with or without food, but if stomach upset occurs when dosing on an empty stomach, give future doses with food.

This medication should take effect within 1 to 2 hours; however, effects may not be noticeable, so laboratory tests may be required to evaluate this medication’s effectiveness.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Benazepril may cause the following side effects:

  • vomiting, diarrhea, and lack of appetite

Rare side effects may include:

  • tiredness
  • incoordination

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Benazepril should NOT BE USED in pets that:

  • are allergic to it
  • are allergic to other ACE inhibitors
  • are pregnant (unless the benefits far outweigh the risks)

Benazepril should be USED WITH EXTREME CAUTION in pets that:

  • have acute kidney injury
  • are critically ill

This medication should be USED WITH CAUTION in pets that:

  • have low sodium
  • have low blood pressure
  • have cardiovascular disease
  • have lupus
  • have blood cell abnormalities
  • are lactating

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with benazepril:

  • acepromazine
  • amitriptyline
  • angiotensin receptor antagonists
  • antidiabetic agents
  • antihistamines
  • antihypertensive agents
  • aspirin
  • azathioprine
  • barbiturates
  • benzodiazepines
  • buspirone
  • corticosteroids
  • cyclosporine
  • dalteparin/enoxaparin
  • diuretics
  • interferon alfa
  • iron
  • mirtazapine
  • muscle relaxants
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • opioids
  • polyethylene glycol
  • pentoxifylline
  • potassium supplements
  • prazosin
  • pregabalin
  • selegiline
  • sildenafil
  • sulfamethoxazole/trimethoprim 
  • trazodone

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is any monitoring needed with this medication?

A veterinarian should monitor your pet with the following tests within two weeks of your pet starting this medication:

  • blood electrolyte levels
  • kidney values
  • urinalysis

If this medication is used to manage high blood pressure, your veterinarian will routinely measure your pet’s blood pressure to be sure that the medication is working.

Monitor your pet for serious side effects.

How do I store benazepril?

  • Store at room temperature, below 86°F (30°C).
  • Protect from moisture. 
  • Tablets that are dispensed in blister packs should remain in the pack until use; tablets that are removed from the blister pack should be used within 1–2 days, and then discarded.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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