Benazepril: veterinary dose and monograph

At a glance

Drug class

Cardiovascular

Also known as

Fortekor, Benazepril hydrochloride, Benace

Species with doses

Dogs and Cats

General dose range

0.25–0.5 mg/kg PO q24h — check the species tables for the indication

Routes

PO

Last reviewed

1 October 2026

Indications

• Congestive heart failure (with diuretics ± pimobendan)
• Systemic hypertension (dogs and cats)
• Proteinuric chronic kidney disease / protein-losing nephropathy (reduces proteinuria)
• Preventive afterload reduction in some myxomatous mitral valve disease protocols

Benazepril dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• CHF / hypertension / proteinuria: Papich 5e: 0.25–0.5 mg/kg q12–24h PO (0.5 mg/kg q24h in most), increasing by 0.5 mg/kg if needed to a maximum of 2 mg/kg q24h. Plumb’s p.144: heart failure 0.25–0.5 mg/kg once or twice daily; hypertension/proteinuria 0.25–1 mg/kg q12–24h (Bartges 2009). Monitor creatinine and potassium.

Cats

• CKD proteinuria / CHF: Papich 5e: CKD 0.25–0.5 mg/kg q24h PO. Plumb’s p.144: heart failure 0.25–0.5 mg/kg once daily; CKD proteinuria/hypertension 0.25–0.5 mg/kg q12–24h (Polzin 2006). Monitor creatinine and potassium.
• Systemic hypertension: Papich 5e: 0.5–1 mg/kg/day PO, or 2.5 mg per cat daily for cats up to 5 kg. Plumb’s p.144: 0.5–1 mg/kg once daily (Sparkes; Adams). Usually second-line after amlodipine unless proteinuric.

Contraindications

Bilateral renal artery stenosis, significant pre-existing hypotension, dehydration/hypovolaemia, hyperkalaemia, and outflow-tract obstruction (e.g. severe sub-aortic stenosis). Pregnancy (fetotoxic — ACE inhibitors damage the developing kidney). Use cautiously with other RAAS drugs/diuretics; known ACE-inhibitor hypersensitivity.

Species-specific warnings

Cats: Monitor renal values closely in CKD cats; benazepril is generally well tolerated but azotaemia and hyperkalaemia can occur, especially with dehydration.

Adverse effects

• Hypotension (especially first dose with diuretics)
• Azotaemia / worsening renal values (reduced GFR)
• Hyperkalaemia
• GI upset (vomiting, inappetence)
• Rare cough/weakness, hypersensitivity

Drug interactions

• Diuretics (furosemide): additive hypotension and pre-renal azotaemia — start low, monitor
• Potassium-sparing diuretics (spironolactone) / potassium supplements: hyperkalaemia
• NSAIDs: blunt the ACE-inhibitor effect and increase nephrotoxicity risk
• Other antihypertensives: additive blood-pressure lowering
• Lithium: reduced clearance

Pregnancy and lactation

Contraindicated in pregnancy — ACE inhibitors are fetotoxic (renal dysgenesis, oligohydramnios-type effects). Avoid in breeding animals intended for pregnancy.

Monitoring

• Renal values (BUN/creatinine, SDMA) and electrolytes (potassium) at baseline, ~3–7 days after starting/dose changes, then periodically
• Blood pressure
• Body weight / clinical signs of CHF (resting respiratory rate)
• Urine protein:creatinine ratio in proteinuric patients

Toxicity and overdose

Overdose causes pronounced hypotension, weakness, azotaemia and hyperkalaemia. Generally well tolerated within therapeutic range; the main clinical hazards are first-dose hypotension and renal decompensation when combined aggressively with diuretics in a volume-depleted patient.

Management: No specific antidote. IV fluids to correct hypotension (cautiously in cardiac patients), treat hyperkalaemia (calcium gluconate, dextrose/insulin) and support renal function. Vasopressors if refractory hypotension. Monitor renal values and electrolytes until stable.

Clinical pearls

• Preferred ACE inhibitor in renal patients — partly biliary clearance means less accumulation than enalapril in CKD
• Expect a small rise in creatinine on starting; a stable mild increase is acceptable, but recheck and adjust if it climbs significantly
• Combine cautiously with furosemide — start low to avoid first-dose hypotension and pre-renal azotaemia
• A cornerstone of feline CKD proteinuria management and canine CHF (with pimobendan + diuretic)
• Stop and reassess if the patient becomes dehydrated or anorexic (RAAS blockade + volume depletion = azotaemia)

Mechanism of action

Benazeprilat inhibits angiotensin-converting enzyme, blocking conversion of angiotensin I to the potent vasoconstrictor angiotensin II and reducing aldosterone secretion. The result is arteriolar and venous dilation (reduced afterload and preload), lower blood pressure, less sodium/water retention, and reduced intraglomerular pressure — which decreases proteinuria and slows renal injury. Reduced bradykinin breakdown contributes to vasodilation.

Formulations and products

• 2.5 mg tablet (Fortekor)
• 5 mg tablet (Fortekor)
• 10 / 20 mg tablet (Fortekor / human)
• Fortekor (Elanco (Novartis)) — 2.5 / 5 / 20 mg flavoured tablet, Tablet
• Fortekor Plus (Elanco) — Benazepril + Pimobendan, Tablet (combination)
• Benace / Benazepril — 5 / 10 / 20 mg tablet, Tablet (human-label)

Storage

Tablets: 15–30 °C, dry, protected from light.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other cardiovascular drugs

• Amiodarone
• Amlodipine
• Atenolol
• Captopril
• Carvedilol
• Digoxin
• Diltiazem
• Dobutamine

Frequently asked questions