ベナゼプリル
Benazepril
Benazepril HCl
別名: Fortekor · Lotensin · Benace · Boncordin · Briem · Cibacene · Labopal · Lotrel · Tensanil · Zinadril · Cardalis · Nelio · Benefortin · Benazecare · CGS-14824A · benazepril hydrochloride · Benazeprilum
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
監査済み v13 用量エビデンス
構造化された用量計算エビデンスAdjunctive treatment of hypertrophic heart failure (extralabel)
- q12-24h
NA
必ず考慮する臨床コンテキスト (2)
- ■ This medicine may be given with or without food. It is usually well tolerated but vomiting and diarrhea can occur. Give with food if vomiting or lack of appetite becomes a problem.
- Benazepril tablets (and combination products) should be stored at temperatures less than 30°C (86°F) and protected from moisture.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
ベナゼプリルは、犬および猫の心不全、全身性高血圧、慢性腎不全、および蛋白漏出性腎疾患の管理に獣医療で広く使用されるアンジオテンシン変換酵素（ACE）阻害薬です。
臨床上のポイント:
- ほぼ完全に腎臓から排泄されるエナラプリルとは異なり、ベナゼプリルの活性代謝物（ベナゼプリラト）は犬において肝臓（55%）と腎臓（45%）の両方の経路から排泄されます。この二重の排泄経路により、腎機能障害を併発している患者においてより適したACE阻害薬となります。
- 糸球体内の高血圧を低下させる効果があり、慢性腎臓病における蛋白尿の減少に特に有効です。
- （カプトプリルとは異なり）スルフヒドリル基を持たないため、免疫介在性の副作用を引き起こす傾向が低いです。
作用機序
Benazepril is a prodrug that is hydrolyzed in the liver to its active metabolite, benazeprilat. It competitively inhibits Angiotensin-Converting Enzyme (ACE).
- Pathway: Angiotensin I → (blocked by ACE) → Angiotensin II
- Hemodynamic Effects: By preventing the formation of Angiotensin II (a potent vasoconstrictor), benazepril promotes vasodilation, reducing both preload and afterload in heart failure patients.
- Renal Effects: It dilates the efferent arterioles of the glomerulus more than the afferent arterioles, reducing intraglomerular capillary pressure and subsequently decreasing proteinuria.
- Endocrine Effects: Decreased Angiotensin II leads to reduced secretion of aldosterone from the adrenal cortex, minimizing sodium and water retention.
安全性・警告
禁忌
- Known hypersensitivity to ACE inhibitors
有害事象
- Anorexia
- Vomiting
- Diarrhea
- Hypotension
- Renal dysfunction (worsening azotemia)
- Hyperkalemia
注意事項
Important Warnings:
- Use with caution in patients with hyponatremia or sodium depletion, coronary or cerebrovascular insufficiency, preexisting hematologic abnormalities, or collagen vascular diseases (e.g., SLE).
- Patients with severe congestive heart failure (CHF) should be monitored very closely upon initiation of therapy due to the risk of profound hypotension.
- ACE inhibitors can potentially worsen preexisting azotemia. It is recommended to use a lower starting dose and closely monitor BUN and creatinine.
- Pregnancy: Mildly fetotoxic at high dosages. Use during pregnancy only when potential benefits outweigh the risks to the offspring (FDA Category C in first trimester, Category D in second/third trimesters).
医薬品相互作用
May potentially negate the decrease in systemic vascular resistance induced by ACE inhibitors (though low-dose aspirin may not significantly affect hemodynamics).
Possible increased risk for hypoglycemia; enhanced monitoring recommended.
Potential for increased hypotensive effects. Reducing furosemide doses by 25-50% is often recommended when initiating ACE inhibitors for heart failure.
Increased risk of hyperkalemia; enhanced monitoring of serum potassium is required.
Possible increased serum lithium levels; increased monitoring required.
Increased risk for hyperkalemia.
Potential for hyperkalemia due to additive potassium-sparing effects, though concurrent use is generally safe in practice.
Increased risk of nephrotoxicity and decreased clinical efficacy of benazepril.
Increased risk of hypotension and prerenal azotemia.
Additive hypotensive effects.
Increased risk of hypotension due to negative inotropic effects.
監視
- Clinical signs of Congestive Heart Failure (CHF)
- Serum electrolytes (especially potassium)
- Renal panel (Creatinine, BUN)
- Urine protein (UPC ratio)
- Blood pressure (especially if treating hypertension or if signs of hypotension arise)
薬物動態
半減期
吸収
Rapidly absorbed after oral dosing in healthy dogs. In humans, food apparently does not affect the extent of absorption.
分布
Crosses the placenta and is distributed into milk in very small amounts. Highly bound to serum proteins (~95% in humans).
代謝
Hydrolyzed in the liver to the active metabolite, benazeprilat.
消失
In dogs, benazeprilat is cleared via both renal (45%) and hepatic (55%) routes. Mild to moderate renal dysfunction does not significantly alter elimination as biliary clearance compensates.
過剰投与
In overdose situations, the primary concern is hypotension.
- Treatment: Supportive treatment with volume expansion using normal saline is recommended to correct blood pressure.
- Monitoring: Because of the drug's long duration of action, prolonged monitoring and treatment may be required.
- Decontamination: Recent massive overdoses should be managed using standard gut-emptying protocols (emesis, activated charcoal) as appropriate.
製品
製剤
- Oral tablets
動物用医薬品
- Benazepril Tablets: 2.5 mg, 5 mg, & 20 mg (Fortekor® - UK/POM-V)
ヒト用医薬品
- Benazepril HCl Oral Tablets: 5 mg, 10 mg, 20 mg, & 40 mg (Lotensin®, generic)
- Fixed dose combination with amlodipine (Lotrel®)
- Fixed dose combination with hydrochlorothiazide (Lotensin HCT®)
規制ステータス
POM-V classification.
POM-V classification.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store tablets at temperatures less than 86°F (30°C) and protect from moisture. Dispense in tight containers.
飼主向け情報
- 自己判断での休薬不可: 獣医師の承認なしに投薬を急に中止したり、減量したりしないでください。
- 副作用の観察: 嘔吐や下痢が続く、または重度である場合、あるいはペットの体調が悪化（無気力、虚弱、失神など）した場合は、すぐに獣医師に連絡してください。
- 投与方法: 食事の有無にかかわらず投与できます。常に新鮮な水を飲めるようにしてください。
- 定期的なモニタリング: 投薬中は、血圧や腎機能の定期的な検査を受けるための通院が非常に重要です。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。