Benazepril

Benjamin Clanner-Engelshofen is a freelance writer in the medical department. He studied biochemistry and pharmacy in Munich and Cambridge / Boston (USA) and noticed early on that he particularly enjoyed the interface between medicine and science. That is why he went on to study human medicine.

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The active ingredient benazepril is a so-called ACE inhibitor. It is used to treat high blood pressure (hypertension) and heart failure (heart failure). Like other antihypertensive drugs, the active ingredient can lead to increased dizziness, weakness and malaise at the beginning of therapy. Here you can read everything you need to know about benazepril: effect, use and side effects.

This is how benazepril works

One of the most important blood pressure regulation systems in the human body is the so-called renin-angiotensin-aldosterone system (RAAS). It is a complex structure for the control and fine regulation of blood pressure. This is vital, because too high a blood pressure damages the organs and too low a blood pressure leads to an insufficient supply of oxygen and nutrients to the tissues.

The central location for measuring blood pressure in the RAAS are the kidneys: if they have a reduced blood flow, they release more of the enzyme renin, and if there is increased blood flow, they release less. Renin ensures that the hormone angiotensin I is produced from a precursor. Angiotensin I is then converted by the enzyme "angiotensin converting enzyme" (ACE for short), which occurs in the lungs and kidneys, into another messenger substance: angiotensin II Reduced water and salt excretion in the kidneys.

ACE inhibitors like benazepril block the ACE enzyme. This prevents an increase in blood pressure. This is desirable and necessary for people with high blood pressure: because a permanently increased pressure (over 140/90 mmHg) damages the blood vessels. This can have serious consequences such as heart attack, stroke, heart failure and severe damage to the eyes and kidneys.

If you have a weak heart, lowering your blood pressure makes sense because it relieves the load on the heart.

The uptake, breakdown and excretion of benazepril

After ingestion, the active ingredient quickly passes through the intestines into the blood, where it reaches its highest level after 30 minutes. Since benazepril is a precursor to the active substance benazeprilat, the active substance must first be activated in the liver. The active form of action reaches its highest blood level after 90 minutes. After ten to eleven hours, half of the active substance is excreted or broken down into other, inactive substances. Excretion occurs mainly through the kidneys with the urine.

When is benazepril used?

The active ingredient benazepril is approved for the treatment of:

• essential hypertension (high blood pressure with no apparent cause)

In more severe cases of heart failure, benazepril is usually combined with water tablets (diuretics) or digitalis glycosides.

Benazepril must be taken long-term as the active ingredient only relieves symptoms but does not cure the underlying disease.

This is how benazepril is used

The ACE inhibitor benazepril is taken as a tablet in the morning with or without a meal. For high blood pressure, treatment is usually started with an initial dose of ten milligrams of benazepril. The dosage can then be increased gradually up to 40 milligrams. In the case of heart failure, the starting and maximum doses are lower (2.5 milligrams and 20 milligrams, respectively). If the blood pressure could be kept stable for some time with the drug, a maintenance dose of usually ten milligrams benazepril is switched to.

Any salt or fluid deficiency should be compensated for before the start of treatment, as otherwise the drop in blood pressure at the beginning of the therapy can be excessive.

If the highest dose of benazepril cannot lower blood pressure sufficiently, most patients will also be given other blood pressure medication.

What are the side effects of benazepril?

At the beginning of therapy with benazepril, dizziness and weakness are common, especially when getting up from a sitting or lying position. The reason is that the patient first has to get used to the unusually low but normal blood pressure.

One in ten to one hundred benazepril patients develop impaired kidney function, inflammation of the bronchi, dry cough, nausea, indigestion, headache, tiredness and changes in blood values. In particular, the treating doctor should be informed of the dry cough, as this may be a sign that benazepril is not tolerated.

What should be considered when taking benazepril?

The active ingredient benazepril can cause interactions in combination with other active ingredients, even if such preparations are taken at a different time of the day.

Other antihypertensive drugs, as well as agents that lower blood pressure only as a side effect (such as antidepressants, anti-angina drugs, and alcohol) can increase the effects of benazepril unpredictably.

So-called NSAIDs (non-steroidal anti-inflammatory drugs) can make benazepril less effective. In addition, they may increase the kidney-damaging side effect. NSAIDs are pain relievers and anti-inflammatory drugs that are used for things like rheumatism, inflammation, and general pain (such as headaches). These include, for example, ASA (acetylsalicylic acid), ibuprofen, diclofenac, indomethacin and naproxen.

If active substances that affect the potassium level are taken at the same time, these should be closely monitored. Examples include potassium supplements, some dehydrating agents (spironolactone, eplerenone, amiloride, triamterene) and the anticoagulant heparin.

Some active substances can (as a side effect) change the blood count, such as the number of certain white blood cells. Combining this with benazepril can make this more likely. Such active ingredients are, for example, anti-cancer agents, immunosuppressants (active ingredients that suppress the immune system), glucocorticoids ("cortisone") and gout drugs.

Benazepril may increase the blood sugar lowering effects of diabetes medications (oral blood sugar lowering drugs and insulin). At the beginning of benazepril therapy, diabetics should therefore measure their blood sugar level more frequently.

Pregnant women, breastfeeding women and children should not be treated with the antihypertensive drug benazepril.

How to get benazepril medication

The active ingredient benazepril requires a prescription and prescription in every dosage. So you can only get it with a doctor's prescription in the pharmacy.

Since when is benazepril known?

The ACE inhibitor benazepril is a further development of the first ACE inhibitor captopril. This in turn is a chemical derivative of a substance in the poison of the Brazilian Jararaca lance viper. In contrast to captopril, benazepril has a longer duration of action in the body and does not lead to bad taste sensations. Preparations with the active ingredient benazepril were approved in Germany in 1996.

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