benazepril hydrochloride Nursing Considerations & Management

 Drug Name

Generic Name:  benazepril hydrochloride

Brand Name: Lotensin

Classification: Antihypertensive, ACE inhibitor

Pregnancy Category C (first trimester)
Pregnancy Category D (second and third trimesters)

Dosage & Route



  • Adult: Initially, 10 mg once daily. Maintenance: 20-40 mg daily as a single or in 2 divided doses. Max dose: 80 mg/day.
  • Child: ≥6 yr: 0.2 mg/kg/day. Max dose: 40 mg/day.
  • Renal impairment: Avoid usage in children with CrCl <30 ml/min.
 CrCl (ml/min)
 Dosage Recommendation
 <30 Initial dose: 5 mg daily.     Max maintenance dose: 40  mg daily.

Heart failure

  • Adult: Initially, 2.5 mg once daily adjusted according to patient’s response. Max: 20 mg daily.
Therapeutic actions
  • Benazepril and its metabolite benazeprilat inhibit ACE that catalyzes the conversion of angiotensin I to angiotensin II, thus leading to reduced aldosterone secretion by the adrenal cortex and decreased vasopressor activity.
  • Treatment of hypertension alone or in combination with thiazide-type diuretics
Adverse effects
  • Headache, dizziness, fatigue; cough; somnolence, nausea; hypotension, transient elevations in BUN and serum creatinine; palpitations; constipation, gastritis; melena, rash, pruritus; musculoskeletal pain; paraesthesia, anxiety; UTI; hyperkalaemia; leucopenia and flushing.
  • Potentially Fatal: Angioedema (rare).
  • Hypersensitivity. History of bilateral renal artery stenosis, angioedema; pregnancy.
Nursing considerations
  • History: Allergy to benazepril or other ACE inhibitors, impaired renal function, CHF, salt or volume depletion, lactation, pregnancy
  • Physical: Skin color, lesions, turgor; T; P, BP, peripheral perfusion; mucous membranes, bowel sounds, liver evaluation; urinalysis, LFTs, renal function tests, CBC and differential
  • WARNING: Alert surgeon: Note use of benazepril on patient’s chart; the angiotensin II formation subsequent to compensatory renin release during surgery will be blocked; hypotension may be reversed with volume expansion.
  • Monitor patient for possible drop in BP secondary to reduction in fluid volume (excessive perspiration and dehydration, vomiting, diarrhea) because excessive hypotension may occur.
  • BLACK BOX WARNING: Ensure that patient is not pregnant; fetal abnormalities and death have occurred if used during second or third trimester. Encourage use of contraceptive measures.
  • Reduce dosage in patients with impaired renal function.
Teaching points
  • Do not stop taking the medication without consulting your health care provider.
  • Be careful in any conditions that may lead to a drop in blood pressure (such as diarrhea, sweating, vomiting, dehydration); if light-headedness or dizziness occurs, consult your health care provider.
  • You should not become pregnant while on this drug. Serious fetal abnormalities could occur; use of contraceptives is advised.
  • You may experience these side effects: GI upset, loss of appetite (transient effects; if persistent consult health care provider); light-headedness (transient; change position slowly, and limit activities to those that do not require alertness and precision); dry cough (irritating but not harmful; consult health care provider).
  • Report mouth sores; sore throat, fever, chills; swelling of the hands, feet; irregular heartbeat, chest pains; swelling of the face, eyes, lips, tongue, difficulty breathing, persistent cough.