貝那普利
Benazepril
Benazepril HCl
別名: Fortekor · Lotensin · Benace · Boncordin · Briem · Cibacene · Labopal · Lotrel · Tensanil · Zinadril · Cardalis · Nelio · Benefortin · Benazecare · CGS-14824A · benazepril hydrochloride · Benazeprilum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Adjunctive treatment of hypertrophic heart failure (extralabel)
- q12-24h
NA
必須一併考量的臨床脈絡 (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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
貝那普利（Benazepril）是一種血管張力素轉化酶（ACE）抑制劑，廣泛用於獸醫學中，以治療犬貓的心臟衰竭、全身性高血壓、慢性腎衰竭及蛋白質流失性腎病。
臨床重點：
- 與幾乎完全由腎臟排泄的依那普利（Enalapril）不同，貝那普利的活性代謝物（benazeprilat）在犬隻體內同時經由肝臟（55%）與腎臟（45%）雙重途徑排泄。這種雙重排泄途徑使其成為併發腎功能不全病患的較佳選擇。
- 它能有效降低腎絲球內高壓，從而減少慢性腎臟病患的蛋白尿。
- 由於其結構中不含巰基（與卡托普利 Captopril 不同），引發免疫介導不良反應的機率較低。
作用機轉
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.
安全性與警告
禁忌症
- Known hypersensitivity to ACE inhibitors
不良反應
- 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).
藥物交互作用
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.
監測
- 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)
藥物動力學
半衰期
吸收
Rapidly absorbed after oral dosing in healthy dogs. In humans, food apparently does not affect the extent of absorption.
分佈
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.
排除
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.
過量
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.
可用產品
劑型
- Oral tablets
獸醫用
- Benazepril Tablets: 2.5 mg, 5 mg, & 20 mg (Fortekor® - UK/POM-V)
人用標示
- 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®)
各地核准狀態
POM-V classification.
POM-V classification.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store tablets at temperatures less than 86°F (30°C) and protect from moisture. Dispense in tight containers.
飼主須知
- 請勿自行停藥：未經獸醫師同意，請勿突然停止給藥或減少劑量。
- 觀察副作用：如果寵物出現持續或嚴重的嘔吐、腹瀉，或病情惡化（如嗜睡、虛弱、昏厥），請立即聯繫獸醫師。
- 給藥方式：可與食物一起或空腹餵食。請確保寵物隨時有充足的新鮮飲水。
- 定期回診：使用此藥物期間，定期回診讓獸醫師監測寵物的血壓與腎功能是非常重要的。
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