Benazepril Hydrochloride

Benazepril Hydrochloride

Benazepril Hydrochloride Recall

Get an alert when a recall is issued.

Questions & Answers

Side Effects & Adverse Reactions

Anaphylactoid and Possibly Related Reactions

Presumably because angiotensin-converting enzyme inhibitors affect the metabolism of eicosanoids and polypeptides, including endogenous bradykinin, patients receiving ACE inhibitors (including benazepril hydrochloride) may be subject to a variety of adverse reactions, some of them serious.

Head and Neck Angioedema 

Angioedema of the face, extremities, lips, tongue, glottis, and larynx has been reported in patients treated with angiotensin-converting enzyme inhibitors. In U.S. clinical trials, symptoms consistent with angioedema were seen in none of the subjects who received placebo and in about 0.5% of the subjects who received benazepril hydrochloride. Angioedema associated with laryngeal edema can be fatal. If laryngeal stridor or angioedema of the face, tongue, or glottis occurs, treatment with benazepril hydrochloride should be discontinued and appropriate therapy instituted immediately. Where there is involvement of the tongue, glottis, or larynx, likely to cause airway obstruction, appropriate therapy, e.g., subcutaneous epinephrine injection 1:1000 (0.3 mL to 0.5 mL) should be promptly administered (see ADVERSE REACTIONS).

Black patients receiving ACE inhibitors have been reported to have a higher incidence of angioedema compared to nonblacks.

Intestinal Angioedema

Intestinal angioedema has been reported in patients treated with ACE inhibitors. These patients presented with abdominal pain (with or without nausea or vomiting); in some cases there was no prior history of facial angioedema and C-1 esterase levels were normal. The angioedema was diagnosed by procedures including abdominal CT scan or ultrasound, or at surgery, and symptoms resolved after stopping the ACE inhibitor. Intestinal angioedema should be included in the differential diagnosis of patients on ACE inhibitors presenting with abdominal pain.

Anaphylactoid Reactions During Desensitization 

Two patients undergoing desensitizing treatment with hymenoptera venom while receiving ACE inhibitors sustained life-threatening anaphylactoid reactions. In the same patients, these reactions were avoided when ACE inhibitors were temporarily withheld, but they reappeared upon inadvertent rechallenge.

Anaphylactoid Reactions During Membrane Exposure 

Anaphylactoid reactions have been reported in patients dialyzed with high-flux membranes and treated concomitantly with an ACE inhibitor. Anaphylactoid reactions have also been reported in patients undergoing low-density lipoprotein apheresis with dextran sulfate absorption (a procedure dependent upon devices not approved in the United States).

Hypotension

Benazepril hydrochloride can cause symptomatic hypotension. Like other ACE inhibitors, benazepril has been only rarely associated with hypotension in uncomplicated hypertensive patients. Symptomatic hypotension is most likely to occur in patients who have been volume- and/or salt-depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. Volume- and/or salt-depletion should be corrected before initiating therapy with benazepril hydrochloride.

In patients with congestive heart failure, with or without associated renal insufficiency, ACE inhibitor therapy may cause excessive hypotension, which may be associated with oliguria or azotemia and, rarely, with acute renal failure and death. In such patients, benazepril hydrochloride therapy should be started under close medical supervision; they should be followed closely for the first 2 weeks of treatment and whenever the dose of benazepril or diuretic is increased.

If hypotension occurs, the patient should be placed in a supine position, and, if necessary, treated with intravenous infusion of physiological saline. Benazepril hydrochloride treatment usually can be continued following restoration of blood pressure and volume.

Fetal Toxicity
Pregnancy Category D

Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue benazepril hydrochloride as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus.

In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. Perform serial ultrasound examinations to assess the intra-amniotic environment. If oligohydramnios is observed, discontinue benazepril hydrochloride, unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Closely observe infants with histories of in utero exposure to benazepril hydrochloride for hypotension, oliguria, and hyperkalemia (see PRECAUTIONS, Pediatric Use).

No teratogenic effects of benazepril hydrochloride were seen in studies of pregnant rats, mice, and rabbits. On a mg/m2 basis, the doses used in these studies were 60 times (in rats), 9 times (in mice), and more than 0.8 times (in rabbits) the maximum recommended human dose (assuming a 50-kg woman). On a mg/kg basis these multiples are 300 times (in rats), 90 times (in mice), and more than 3 times (in rabbits) the maximum recommended human dose.

Hepatic Failure

Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis and (sometimes) death. The mechanism of this syndrome is not understood. Patients receiving ACE inhibitors who develop jaundice or marked elevations of hepatic enzymes should discontinue the ACE inhibitor and receive appropriate medical follow-up.

Legal Issues

There is currently no legal information available for this drug.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

Uses

Benazepril hydrochloride tablets USP are indicated for the treatment of hypertension. They may be used alone or in combination with thiazide diuretics.

History

There is currently no drug history available for this drug.

Other Information

Benazepril hydrochloride is a white to off-white crystalline powder, soluble (>100 mg/mL) in water, in ethanol, and in methanol. Its chemical name is benazepril 3-[[1-(ethoxy-carbonyl)-3-phenyl-(1S)-propyl]amino]-2,3,4,5-tetrahydro-2-oxo-1H-1-(3S)-benzazepine-1-acetic acid monohydrochloride; its structural formula is:

Chemical Structure

Its empirical formula is C24H28N2O5•HCl, and its molecular weight is 460.96.

Benazeprilat, the active metabolite of benazepril, is a non-sulfhydryl angiotensin-converting enzyme inhibitor. Benazepril is converted to benazeprilat by hepatic cleavage of the ester group.

Benazepril hydrochloride tablets USP contain 5 mg, 10 mg, 20 mg, and 40 mg of benazepril hydrochloride for oral administration. The inactive ingredients are lactose monohydrate, microcrystalline cellulose, pregelatinized starch, hydrogenated castor oil, crospovidone, colloidal silicon dioxide, zinc stearate, hypromellose, titanium dioxide, polyethylene glycol 400 and polysorbate 80. The 5 mg and 10 mg tablets also contain D&C yellow No. 10 and FD&C yellow No. 6. The 20 mg tablets also contain FD&C red No. 40 and FD&C yellow No. 6. The 40 mg tablets also contain FD&C red No. 40.

Benazepril Hydrochloride Manufacturers


  • Golden State Medical Supply, Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Golden State Medical Supply, Inc.]
  • Proficient Rx Lp
    Benazepril Hydrochloride Tablet, Coated [Proficient Rx Lp]
  • St. Mary’s Medical Park Pharmacy
    Benazepril Hydrochloride Tablet [St. Mary’s Medical Park Pharmacy]
  • Remedyrepack Inc.
    Benazepril Hydrochloride Tablet, Coated [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Benazepril Hydrochloride Tablet, Coated [Remedyrepack Inc. ]
  • Preferred Pharmaceuticals, Inc.
    Benazepril Hydrochloride Tablet, Coated [Preferred Pharmaceuticals, Inc.]
  • Direct Rx
    Benazepril Hydrochloride Tablet [Direct Rx]
  • Blenheim Pharmacal, Inc.
    Benazepril Hydrochloride Tablet [Blenheim Pharmacal, Inc.]
  • Ethex
    Benazepril Hydrochloride (Benazepril Hydrochloride) Tablet, Film Coated [Ethex]
  • Andrx Pharmaceuticals
    Benazepril Hydrochloride (Benazepril Hydrochloride) Tablet, Film Coated [Andrx Pharmaceuticals]
  • Stat Rx Usa
    Benazepril Hydrochloride Tablet [Stat Rx Usa]
  • Ranbaxy Pharmaceuticals Inc.
    Benazepril Hydrochloride Tablet, Film Coated Benazepril Hydrochloride Tablet, Film Coated [Ranbaxy Pharmaceuticals Inc.]
  • Major Pharmaceuticals
    Benazepril Hydrochloride Tablet [Major Pharmaceuticals]
  • Remedyrepack Inc.
    Benazepril Hydrochloride Tablet [Remedyrepack Inc. ]
  • Bryant Ranch Prepack
    Benazepril Hydrochloride Tablet, Coated [Bryant Ranch Prepack]
  • Pd-rx Pharmaceuticals, Inc.
    Benazepril Hydrochloride Tablet, Coated [Pd-rx Pharmaceuticals, Inc.]
  • Pd-rx Pharmaceuticals, Inc.
    Benazepril Hydrochloride Tablet, Coated [Pd-rx Pharmaceuticals, Inc.]
  • Physicians Total Care, Inc.
    Benazepril Hydrochloride Tablet, Coated [Physicians Total Care, Inc.]
  • Bryant Ranch Prepack
    Benazepril Hydrochloride Tablet, Film Coated [Bryant Ranch Prepack]
  • Teva Pharmaceuticals Usa Inc
    Benazepril Hydrochloride Tablet, Coated [Teva Pharmaceuticals Usa Inc]
  • Mylan Pharmaceuticals Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Mylan Pharmaceuticals Inc.]
  • Trigen Laboratories, Inc.
    Benazepril Hydrochloride Tablet, Film Coated Benazepril Hydrochloride Tablet, Film Coated [Trigen Laboratories, Inc.]
  • Unit Dose Services
    Benazepril Hydrochloride Tablet, Film Coated [Unit Dose Services]
  • Pd-rx Pharmaceuticals, Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Pd-rx Pharmaceuticals, Inc.]
  • Unit Dose Services
    Benazepril Hydrochloride Tablet, Film Coated [Unit Dose Services]
  • Unit Dose Services
    Benazepril Hydrochloride Tablet, Film Coated [Unit Dose Services]
  • Amneal Pharmaceuticals
    Benazepril Hydrochloride Tablet [Amneal Pharmaceuticals]
  • Bryant Ranch Prepack
    Benazepril Hydrochloride Tablet, Coated [Bryant Ranch Prepack]
  • Eon Labs, Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Eon Labs, Inc.]
  • Apotex Corp
    Benazepril Hydrochloride Tablet, Film Coated [Apotex Corp]
  • Pd-rx Pharmaceuticals, Inc.
    Benazepril Hydrochloride Tablet, Coated [Pd-rx Pharmaceuticals, Inc.]
  • Lake Erie Medical Dba Quality Care Products Llc
    Benazepril Hydrochloride Tablet, Film Coated [Lake Erie Medical Dba Quality Care Products Llc]
  • Aurobindo Pharma Limited
    Benazepril Hydrochloride Tablet, Film Coated [Aurobindo Pharma Limited]
  • Preferred Pharmaceuticals, Inc
    Benazepril Hydrochloride Tablet, Film Coated [Preferred Pharmaceuticals, Inc]
  • Preferred Pharmaceuticals, Inc
    Benazepril Hydrochloride Tablet, Film Coated [Preferred Pharmaceuticals, Inc]
  • Ranbaxy Pharmaceuticals Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Ranbaxy Pharmaceuticals Inc.]
  • International Labs, Inc.
    Benazepril Hydrochloride Tablet, Film Coated [International Labs, Inc.]
  • Aidarex Pharmaceuticals Llc
    Benazepril Hydrochloride Tablet [Aidarex Pharmaceuticals Llc]
  • Avkare, Inc.
    Benazepril Hydrochloride Tablet [Avkare, Inc.]
  • St Marys Medical Park Pharmacy
    Benazepril Hydrochloride Tablet, Film Coated [St Marys Medical Park Pharmacy]
  • Pd-rx Pharmaceuticals, Inc.
    Benazepril Hydrochloride Tablet, Coated [Pd-rx Pharmaceuticals, Inc.]
  • Solco Healthcare U.s., Llc
    Benazepril Hydrochloride Tablet, Coated [Solco Healthcare U.s., Llc]
  • Mylan Institutional Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Mylan Institutional Inc.]
  • American Health Packaging
    Benazepril Hydrochloride Tablet [American Health Packaging]
  • Northwind Pharmaceuticals
    Benazepril Hydrochloride Tablet, Film Coated [Northwind Pharmaceuticals]
  • Bryant Ranch Prepack
    Benazepril Hydrochloride Tablet, Film Coated [Bryant Ranch Prepack]
  • Cardinal Health
    Benazepril Hydrochloride Tablet, Film Coated [Cardinal Health]
  • Avpak
    Benazepril Hydrochloride Tablet [Avpak]
  • St Marys Medical Park Pharmacy
    Benazepril Hydrochloride Tablet [St Marys Medical Park Pharmacy]
  • Medsource Pharmaceuticals
    Benazepril Hydrochloride Tablet, Coated [Medsource Pharmaceuticals]
  • Blenheim Pharmacal, Inc.
    Benazepril Hydrochloride Tablet, Film Coated [Blenheim Pharmacal, Inc.]

Login To Your Free Account