Benazepril is an ACE inhibitor prodrug used primarily for hypertension. It is also available in combination with amlodipine (Lotrel) and hydrochlorothiazide (Lotensin HCT) for enhanced blood pressure control.
Evidence rating strong. Most-documented uses: effective blood pressure reduction, favorable for combination therapy, renoprotective effects. 10 sources indexed (1996–2026), with 2 interaction records on file.
The science
How it works, mechanistically.
Core mechanism
Prodrug hydrolyzed in the liver to the active metabolite benazeprilat. Inhibits ACE, preventing formation of angiotensin II from angiotensin I. Reduces peripheral vascular resistance without reflex tachycardia. Decreases aldosterone secretion and inhibits bradykinin degradation, contributing to vasodilatory effects.
Class
ACE Inhibitor
Dosing
Dosing & protocol.
Common range
5–40 mg daily in 1–2 divided doses (as prescribed by your physician)
Recommended form
Oral tablet
Can be taken with or without food; food slows absorption but does not significantly affect total bioavailability
Depletions
What it depletes.
Nutrients this medication can lower over time, and what to replace.
Zinc
Mild
ACE inhibition has been associated with increased urinary zinc excretion and altered taste in some long-term users.
Benazepril blocks angiotensin II formation, which lowers aldosterone and reduces renal potassium excretion. Adding a potassium supplement on top of this can push serum potassium into hyperkalemic territory, risking muscle weakness, cardiac arrhythmias, and in severe cases cardiac arrest. Risk is highest in patients with kidney disease, diabetes, or those also taking NSAIDs, potassium-sparing diuretics, or trimethoprim.
Recommendation: Do not take potassium supplements with benazepril unless your prescriber has confirmed a deficiency and ordered them. If both are required, have potassium levels checked within 1-2 weeks of starting and then periodically. Avoid potassium-based salt substitutes as well.
Benazepril is an ACE inhibitor that reduces sodium reabsorption and lowers glomerular filtration. This causes the kidney to retain lithium and raises serum lithium concentrations. Case series of patients on prescription lithium have shown rises of about 36% in steady-state lithium levels after starting an ACE inhibitor. Lithium Orotate doses are smaller, but the same renal handling applies and the margin to toxicity is narrow.
Recommendation: Avoid Lithium Orotate while taking benazepril. If used together, keep the dose low, stay well hydrated, and ask your prescriber to check serum lithium after 1-2 weeks. Hold the supplement during any vomiting, diarrhea, or fever.
Yan X, Xu D, Huang J et al.. [Effect of benazepril on cardiac function in Chinese patients with chronic heart failure: a meta-analysis of randomized controlled trials]. Zhonghua yi xue za zhi. 2014
Ruggenenti P, Cortinovis M, Parvanova A et al.. Preventing microalbuminuria with benazepril, valsartan, and benazepril-valsartan combination therapy in diabetic patients with high-normal albuminuria: A prospective, randomized, open-label, blinded endpoint (PROBE) study. PLoS medicine. 2021
Ruggenenti P, Trillini M, P Barlovic D et al.. Effects of valsartan, benazepril and their combination in overt nephropathy of type 2 diabetes: A prospective, randomized, controlled trial. Diabetes, obesity & metabolism. 2019
Kuschnir E, Acuña E, Sevilla D et al.. Treatment of patients with essential hypertension: amlodipine 5 mg/benazepril 20 mg compared with amlodipine 5 mg, benazepril 20 mg, and placebo. Clinical therapeutics. 1996
Ding C, Song H, Qiu B et al.. Effect of High-Fat Food on the Pharmacokinetics and Safety of Amlodipine/Benazepril in Healthy Chinese Participants. Clinical pharmacology in drug development. 2026
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