Benazepril Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Initial dose: 10 mg orally once a day, in patients not receiving a diuretic.
Maintenance dose: 20 to 40 mg/day orally in 1 to 2 divided doses.
Some patients appear to have a further response to 80 mg, but experience with this dose is limited.

Usual Adult Dose for Diabetic Nephropathy

Initial dose: 10 mg orally once a day (5 mg if on a diuretic).
Maintenance dose: 20 to 40 mg per day orally in 1 to 2 divided doses.
Dosage may be titrated upward every 3 days.

Usual Adult Dose for Congestive Heart Failure

Initial dose: 10 mg orally once a day (5 mg if volume depleted or hypotensive).
Maintenance dose: 20 to 40 mg orally per day in 1 to 2 divided doses.
Dosage should be increased, over a 3 day or longer period, to a dose that is maximal and tolerated but not exceeding 40 mg/day.

Usual Adult Dose for Left Ventricular Dysfunction

Initial dose: 10 mg orally once a day (5 mg if volume depleted or hypotensive).
Maintenance dose: 20 to 40 mg orally per day in 1 to 2 divided doses.
Dosage should be increased, over a 3 day or longer period, to a dose that is maximal and tolerated but not exceeding 40 mg/day.

Renal Dose Adjustments

CrCl < 30 mL/min:
Initial dose: 5 mg orally once a day.
Dosage may be titrated upward until blood pressure is controlled or to a maximum total daily dose of 40 mg.

Not recommended for use in pediatric patients with GFR <30 mL.

Liver Dose Adjustments

Data not available

Dose Adjustments

Dosage should be adjusted according to blood pressure response at peak (2-6 hours) and trough (about 24 hours after dosing) blood levels.
In some patients treated with once daily dosing, the antihypertensive effect may diminish toward the end of the dosing interval. If trough response is inadequate, dividing the daily dose should be considered. If blood pressure is not adequately controlled with benazepril alone, a diuretic may be added.

Precautions

In patients who are currently being treated with a diuretic, symptomatic hypotension occasionally can occur following the initial dose of benazepril. To reduce the likelihood of hypotension, the diuretic should, if possible, be discontinued 2 to 3 days prior to beginning therapy with benazepril. Then, if blood pressure is not controlled with benazepril alone, diuretic therapy should be resumed. If diuretic therapy cannot be discontinued, an initial dose of 5 mg of benazepril should be used with careful medical supervision for several hours and until blood pressure has stabilized.

Dialysis

Benazepril is only slightly dialyzable, but dialysis might be considered in overdosed patients with severely impaired renal function

Other Comments

Compared with Caucasian patients, Black patients have a reduced blood pressure response to monotherapy with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers; however, the reduced response is largely eliminated if combination therapy that includes an adequate dose of a diuretic is instituted.

Following first-time MI, all ACE inhibitors, at comparable appropriate dosages, appear to be equally effective for reducing mortality and recurrent MI rates.

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