Benazepril

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Benazepril
Systematic (IUPAC) name
2-[(4S)-4-[[(1S)-1-ethoxycarbonyl-3-phenyl-propyl]amino]- 3-oxo-2-azabicyclo[5.4.0]undeca-7,9,11-trien-2-yl]acetic acid
Identifiers
CAS number	86541-75-5
ATC code	C09 AA07
PubChem	5362124
DrugBank	APRD00063
Chemical data
Formula	C₂₄H₂₈N₂O₅
Mol. weight	424.49 g/mol
Pharmacokinetic data
Bioavailability	?
Protein binding	96.7%
Metabolism	Hepatic glucuronidation
Half life	10-11 hours
Excretion	Renal and biliary
Therapeutic considerations
Pregnancy cat.	D
Legal status	℞ Prescription only
Routes	Oral

Benazepril, brand name Lotensin®, 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.

1 Dosage forms
2 Side effects
3 Contraindications
4 Kidney disease
- 4.1 Other species
5 References

[edit] Dosage forms

Oral tablets, 5 mg, 10 mg, 20 mg, and 40 mg.

Benazepril is also available in combination with hydrochlorothiazide, under the trade name Lotensin® HCT, and with amlodipine (trade name Lotrel®).

[edit] Side effects

Most commonly, headache and cough. Anaphylaxis and angioedema can occur. Hyperkalemia, or an elevation of potassium levels, can also occur.

Benazepril may cause harm to the fetus during pregnancy.

[edit] Contraindications

Benazepril should be discontinued during pregnancy.

[edit] 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 that patients who took benazepril had better kidney function and a slower progression of kidney disease. Kidney function was much better in the group of patients taking the drug than their peers who took a placebo drug.^[2] This is notable because this category of pharmaceuticals have 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.

[edit] Other species

Under the brand name Fortekor® (Novartis), benazepril hydrochloride is used to treat congestive heart failure in dogs and chronic renal failure in cats.

[edit] 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. PMID 16407508.
^ ^a ^b Hitti, Miranda; Chang, Louise (January 11, 2006). Drug May Treat Advanced Kidney Disease. WebMD. Retrieved on 2006-09-07.