Benazepril

Benazepril

File:Benazepril structure.svg
File:Benazepril-3D-balls.png
Systematic (IUPAC) name
2-[(3S)-3-[[(2S)-1-ethoxy-1-oxo-4-phenylbutan-2-yl]amino]-2-oxo-4,5-dihydro-3H-1-benzazepin-1-yl]acetic acid
Clinical data
Trade names	Lotensin
AHFS/Drugs.com	monograph
MedlinePlus	a692011
Pregnancy category	D
Legal status	℞ (Prescription only)
Routes of administration	Oral
Pharmacokinetic data
Protein binding	96.7%
Metabolism	Hepatic glucuronidation
Biological half-life	10-11 hours
Excretion	Renal and biliary
Identifiers
CAS Number	86541-75-5 Y
ATC code	C09AA07 (WHO)
PubChem	CID: 5362124
IUPHAR/BPS	6374
DrugBank	DB00542 Y
ChemSpider	4514935 Y
UNII	UDM7Q7QWP8 Y
ChEBI	CHEBI:3011 Y
ChEMBL	CHEMBL838 Y
Chemical data
Formula	C24H28N2O5
Molecular mass	424.49 g/mol
SMILES O=C(OCC)[C@@H](N[C@@H]2C(=O)N(c1ccccc1CC2)CC(=O)O)CCc3ccccc3
InChI InChI=1S/C24H28N2O5/c1-2-31-24(30)20(14-12-17-8-4-3-5-9-17)25-19-15-13-18-10-6-7-11-21(18)26(23(19)29)16-22(27)28/h3-11,19-20,25H,2,12-16H2,1H3,(H,27,28)/t19-,20-/m0/s1 Y Key:XPCFTKFZXHTYIP-PMACEKPBSA-N Y
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Benazepril, brand name Lotensin (Novartis), is an ACE inhibitor used primarily in treatment of hypertension, congestive heart failure, and heart attacks, and also in preventing the renal and retinal complications of diabetes. Its indications, contraindications, and side effects are similar to most ACE inhibitors. Benazepril is a prodrug which is metabolized by the liver into its active form benazeprilat via cleavage of the drug's ester group.

File:Benazeprilat.svg

Benazeprilat — the active metabolite of benazepril

Medical uses

Kidney disease

Patients with advanced renal insufficiency taking benazepril show "substantial" kidney benefits. A long-term study of patients' kidney disease revealed patients who took benazepril had better kidney function and slower progressions of kidney disease than their peers who took a placebo drug. This is notable because this category of pharmaceuticals has long been thought to cause further kidney damage or increase the rate of progression for kidney disease.

According to coverage of the study on WebMD: "ACE inhibitors can pose a potential threat to kidneys, as well. The key question was whether damaged kidneys would worsen if patients took ACE inhibitors. In a nutshell, concerns centered on blood levels of potassium and creatinine, waste products that are excreted by the kidneys. Testing creatinine levels in the blood is used as a way to monitor kidney function (...) kidney problems worsened more slowly in those taking Lotensin. Overall, there were no major differences in side effects between patients taking Lotensin or the placebo." This study marks the first indication that benazepril, and perhaps other ACE inhibitors, may actually be beneficial in the treatment of hypertension in patients with kidney disease.

Side effects

The most common side effects patients experience are a headache or a chronic cough. The chronic cough develops in about 20% of patients treated, and those patients that experience it find it develops after a few months of use. Anaphylaxis, angioedema, and elevation of potassium levels are more serious side effects that can also occur.

Contraindications

Benazepril should be discontinued during pregnancy, as it can harm the fetus.

Dosage forms

It is also available in combination with hydrochlorothiazide, under the trade name Lotensin HCT', and with amlodipine (trade name Lotrel).

Veterinary use

Under the brand names Fortekor (Novartis) and VetACE (Jurox Animal Health), benazepril hydrochloride is used to treat congestive heart failure in dogs and chronic renal failure in dogs and cats.

External links

• Prescribing Information for Lotensin