Benazepril dosage, forms, and strengths

Benazepril is a commonly prescribed generic high blood pressure medication. Also sold as brand-name Lotensin, benazepril is an ACE inhibitor that relaxes and widens blood vessels to lower blood pressure. It is usually taken a one tablet daily, but at higher doses, a healthcare provider may divide the dose into two daily doses. If taking another blood pressure medication in addition to benazepril, patients should be careful and follow instructions for the other medication too. 

Benazepril forms and strengths

• Tablets: 5 mg, 10 mg, 20 mg, 40 mg

Benazepril dosage for adults

Benazepril lowers blood pressure and reduces the risk of heart attack and stroke in adults with hypertension. Contraindications include known allergies to benazepril or a history of angioedema (swelling of the face, neck, or mouth).

Benazepril dosage for hypertension

Benazepril treats hypertension, a problem that affects almost half of adults in the U.S. ACE inhibitors like benazepril reduce blood pressure by blocking angiotensin-converting enzyme, an enzyme that synthesizes a hormone called angiotensin II. Angiotensin means “blood vessel tension,” and that’s exactly what angiotensin does. It tenses up blood vessel muscles, so blood vessels get narrower and tighter. In turn, ACE inhibitors cause blood vessels to widen or relax, lowering blood pressure. It also reduces the heart’s “push” on the blood with each heartbeat, so that helps lower blood pressure, too. 

ACE inhibitors are usually the first type of drug used to treat high blood pressure, and benazepril is usually one of the first ACE inhibitors used. It’s not the most potent antihypertensive, but adverse effects are relatively minimal compared to other blood pressure drugs. The most significant problems it can cause are low blood pressure and high potassium (hyperkalemia).

Benazepril is usually started as monotherapy (“one-drug therapy”) unless there are other problems like heart disease or heart failure. If benazepril alone does not sufficiently control blood pressure, a healthcare provider may add another blood pressure drug, such as hydrochlorothiazide. Taking benazepril with other drugs is not uncommon. In those cases, people should understand that there may be different instructions for taking these other drugs, such as whether they can be taken with or without food.

Benazepril tablets are usually taken once daily. The doses start small and may increase until blood pressure is under control. When doses get high enough, a clinician may ask a patient to divide the daily dose into two daily doses.

• Standard adult dosage for hypertension: 10–40 mg daily taken as a single or divided dose

• Maximum adult dosage for hypertension: 80 mg daily

Benazepril dosage for children

The FDA has approved the pediatric use of benazepril to lower blood pressure in children 6 years of age or older. However, benazepril is not approved for use in children with severe kidney disease.

• Standard benazepril dosage for children ages 6 and older: 0.2–0.6 mg/kg daily

• Maximum benazepril dosage for children ages 6 and older: 0.6 mg/kg daily

Benazepril dosage restrictions

People with liver impairment do not require any change to their benazepril dose. However, people with severe kidney disease will require a lower starting dose and a lower maximum dose. 

• Patients with renal impairment (kidney disease): 

  • Mild to moderate renal impairment (CrCl 30–89 mL/min): no dosage adjustment required

  • Severe renal impairment or dialysis (end-stage renal disease): initial dose of 5 mg daily; maximum dosage of 40 mg/daily

Benazepril dosage for pets

Veterinarians use benazepril in dogs and cats to treat congestive heart failure, high blood pressure, and certain types of kidney problems. It’s safe for both dogs and cats but is used cautiously in pets with kidney dysfunction. Side effects are usually gastrointestinal issues such as vomiting or loss of appetite.

Dosages will vary depending on the practitioner and the condition being treated, but the standard benazepril dose for dogs and cats is 0.25–0.5 mg/kg taken by mouth every 12–24 hours. Some veterinarians may prescribe doses as high as 1 mg/kg taken once or twice daily. For some conditions, such as heart failure, veterinarians may use it along with other drugs such as furosemide (a diuretic or “water pill”) and pimobendan.

How to take benazepril

Taking benazepril is relatively simple and there are no special instructions for taking it correctly. Although benazepril comes in only one dosage form, a pharmacist can prepare a liquid version (oral suspension) for people who can’t swallow a tablet. In that case, follow the instructions given by the pharmacist for taking doses. The oral suspension must be refrigerated.

• Take benazepril as directed. Doses may need to change, particularly if another medication is added to the treatment.

• Do not stop using benazepril without talking to the prescriber.

• Tablets are taken once or twice daily depending on the prescription.

• Take benazepril tablets without regard to meals.

• Swallow the tablet whole with a glass of water.

• Store benazepril tablets in a light-resistant container at room temperature protected from moisture.

Benazepril dosage FAQs

How long does it take benazepril to work?

Benazepril lowers blood pressure about 30 minutes after a dose is taken and it reaches its peak effects in about one to two hours. Doses can be taken with or without food, but taking it with food could delay its peak effects by two to four hours.

How long does benazepril stay in your system?

A dose of benazepril is metabolized by the body into another drug called benazeprilat. Both lower blood pressure, but the second is more powerful than the original drug. Benazeprilat has a half-life of 10 to 11 hours, so it stays in the system for longer than two days. 

What happens if I miss a dose of benazepril?

Take a missed dose as soon as you remember. Do not take the missed dose if it’s almost time for the next dose. Instead, take the next dose at its regular time. Do not take extra benazepril to make up for a missed dose.

How long can you take benazepril?

Benazepril is a long-term and possibly lifelong drug treatment. There are no side effects or complications from long-term use.

How do I stop taking benazepril?

Benazepril can be stopped at any time without causing withdrawal symptoms. However, don’t stop taking benazepril until talking to a healthcare provider. Stopping benazepril without starting another blood pressure medication can cause a dangerous elevation in blood pressure. 

The prescriber may stop benazepril right away if you experience certain problems such as allergic reactions, worsening kidney or liver function, or if you become pregnant. The healthcare provider may also need to stop benazepril simply because it isn’t working well to lower blood pressure. 

Prescribers have a wide variety of medications they can use instead of benazepril. Most are more powerful than benazepril, but side effects may be an issue. These drugs include other ACE inhibitors, angiotensin-II receptor blockers (ARBS), beta blockers, calcium channel blockers such as amlodipine, alpha blockers, and diuretics.

What is the maximum dosage for benazepril?

The maximum dosage for benazepril is 80 mg daily for people with normal kidney function and 40 mg daily for people with severe kidney impairment.

Can you overdose on benazepril?

Do not take more benazepril than prescribed. If too much is taken, call a poison control helpline or get medical help. Too much benazepril could cause blood pressure to drop too low, so immediate medical care may be needed. Symptoms of low blood pressure (hypotension) include lightheadedness, dizziness, tiredness, fatigue, weakness, lethargy, feeling faint, passing out (syncope), blurry vision, confusion, and trouble thinking.

What interacts with benazepril?

Benazepril should never be taken with the blood pressure medications aliskiren or Entresto (sacubitril/valsartan). 

Benazepril has several significant drug interactions, so make sure the prescriber knows about all the prescription drugs, over-the-counter medications, and supplements you take, particularly: 

• Other medications that affect the renin-angiotensin system, such as other ACE inhibitors or angiotensin receptor blockers (ARBs) 

• Other medications that lower blood pressure 

• Medications that make you pee (diuretics), particularly potassium-sparing diuretics 

• Diabetes medications including insulin

• Nonsteroidal anti-inflammatory drugs (NSAIDs) 

• Immunosuppressants called mTor inhibitors, such as everolimus or sirolimus

• The bipolar drug lithium

• Potassium supplements or potassium salt substitutes

What happens when you mix benazepril and alcohol?

Alcohol does not interact with benazepril, but it can raise blood pressure and speed up the heart. No matter what antihypertensive is prescribed, a healthcare provider may ask you to decrease alcohol consumption or to stop drinking alcohol to help control blood pressure.

Is it safe to take benazepril during pregnancy?

Benazepril can harm an unborn baby, particularly in the second and third trimesters. The FDA warns healthcare providers to discontinue benazepril when a woman becomes pregnant and switch to another blood pressure-lowering medication.

Is it safe to take benazepril while breastfeeding?

Healthcare providers consider benazepril safe for nursing women because very little of the medication is present in human breast milk. 

What are the side effects of benazepril?

The most common side effects of benazepril are headache, dizziness, and dry cough. More serious side effects include low blood pressure, high potassium levels (hyperkalemia), chest pain, and liver problems (hepatic failure). To prevent more serious side effects, the healthcare provider will need to monitor blood pressure, kidney function, and electrolytes with regular checkups and appointments.

Sources

• Angiotensin-converting enzyme inhibitors for use in animals, Merck Veterinary Manual

• Benazepril, StatPearls

• Benazepril hydrochloride tablet prescribing information, DailyMed (NIH National Library of Medicine)

• Hypertension prevalence, awareness, treatment, and control among adults age 18 and older: United States, August 2021–August 2023, Centers for Disease Control and Prevention (CDC)

• Lotensin benazepril hydrochloride tablet prescribing information, DailyMed (NIH National Library of Medicine)

• Lotensin drug summary, Prescriber’s Digital Reference (PDR)

• Pharmacokinetics and pharmacodynamics of benazepril in hypertensive patients with normal and impaired renal function, Journal of Cardiovascular Pharmacology

• Plumb’s Veterinary Drug Handbook, 7th edition