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Benazepril side effects and how to avoid them

What to expect when taking benazepril and how to prevent side effects
Vanessa Ling headshot
By | Mar. 10, 2025 Medically reviewed by Anne Jacobson, MD, MPH
A pill bottle with white pills falling out of it: Benazepril side effects and how to avoid them

Key takeaways

  • The most common side effects of benazepril include headache, cough, and dizziness.

  • Serious side effects of benazepril include allergic reactions, abdominal pain, and swelling of the head and neck or intestines.

  • Benazepril can interact with other medications to increase the risk of side effects such as low blood pressure and low blood sugar.

  • Benazepril shouldn’t be taken with alcohol and shouldn’t be taken by people who are pregnant.

  • Experts recommend informing your healthcare providers as soon as new symptoms appear after taking benazepril.

In this article:

Benazepril is the generic form of the brand name drug Lotensin (benazepril hydrochloride). It’s classified as an angiotensin-converting enzyme (ACE) inhibitor medication. Benazepril is approved by the Food and Drug Administration (FDA) to treat high blood pressure (hypertension), but it can be prescribed off-label to treat other conditions, such as heart failure and kidney disease (nephropathy). The medication comes with risks of some side effects that range from mild to serious. Read on to learn more about the common and serious side effects of benazepril and what you should know before taking the medication.

Common side effects of benazepril

The most commonly reported side effect of benazepril is headache, which occurred in about 6% of patients taking Lotensin (benazepril) in clinical trials. Other common side effects of benazepril include dizziness (4%), drowsiness (2%), and cough. 

A common side effect of benazepril is a dry cough, which happens in 5%–35% of people taking ACE inhibitors.

Less common side effects (<1%) of benazepril include:

  • Allergic reactions 
  • Skin symptoms such as Stevens-Johnson syndrome, blistering, peeling, rashes, and skin flushing
  • Gastrointestinal symptoms such as nausea and vomiting, pancreatitis, constipation, gastritis, and stomach pain
  • Changes in urination amount and frequency
  • Lightheadedness and fainting
  • Anxiety, insomnia, and decreased libido
  • Asthma and bronchitis
  • Sinusitis
  • Muscle pain and arthritis
  • Hair loss
  • Low blood counts
  • Sweating

Serious side effects of benazepril

There are a few side effects of benazepril that can be serious and may require immediate medical attention. 

If you experience any of the following side effects while taking benazepril, seek medical help immediately: 

  • Allergic reaction: Symptoms include itching; swelling of hands, mouth, or throat; chest tightness; skin rash; and trouble breathing
  • Dizziness, lightheadedness, or fainting: These can be a sign of low blood pressure, which can increase your risk of falls and injury.
  • Stevens-Johnson Syndrome: This rare skin reaction results in blistering, peeling skin and may be fatal.
  • Angioedema: This condition causes swelling of the face, lips, tongue, throat, or fingers. 
  • Abdominal pain: With or without nausea or vomiting, abdominal pain can be a sign of swelling in the intestines. 

Other possible serious side effects of taking benazepril include changes in kidney function and liver failure, further discussed below.

People who take medications that interact with benazepril may be at higher risk of developing side effects such as hyperkalemia (high blood potassium) and low blood pressure (e.g., with other hypertension medications or anesthesia). 

How soon do benazepril side effects start?

Someone taking benazepril may experience side effects within minutes of taking the medication, while others may experience side effects only after months of taking the medication regularly. Christopher Norman, board-certified geriatric nurse practitioner and advanced practice holistic nurse in Central New York says, “It generally depends on the individual. If someone has an allergic reaction to benazepril (like swelling of the throat or face, or difficulty breathing), these effects can show up within minutes. Side effects for benazepril more commonly might show up within one to seven days.” 

The dry cough that may develop as a result of taking an ACE inhibitor can begin within hours of taking the medication. However, others may develop this cough weeks or months after taking benazepril. 

How long do benazepril side effects last?

The side effects of benazepril can last from a few hours to a few days, depending on the symptoms experienced. According to its drug label, benazepril is eliminated by the kidneys and colon. It takes 10–11 hours for benazepril concentrations to decrease to half its initial concentration. “If a side effect is truly from the medication, then stopping the medication should curb the side effect within one to two days,” Norman explains. “If you experience side effects from taking benazepril but still need to control your blood pressure, your prescriber may adjust your dose or recommend another blood pressure medication,” he says. Contact your healthcare provider about any side effects you experience while on benazepril before you stop taking it. 

What are the long-term side effects of benazepril?

Benazepril’s drug label includes several warnings about its potential serious side effects. Liver failure and kidney problems are long-term side effects that may take some time to develop. Benazepril works on hormones that affect the kidneys to control blood pressure, which is why it may affect kidney function and possibly cause kidney failure. Despite this warning, benazepril has also been shown to be beneficial for many people with chronic kidney disease. 

According to benazepril’s drug label, people who take ACE inhibitors have a risk of developing jaundice (yellowing skin), a symptom of liver dysfunction, and possible liver failure. The risk of liver failure while taking ACE inhibitors is low, but it can be serious, possibly resulting in death. Liver injury can be seen within 12 weeks of starting an ACE inhibitor. 

Benazepril interactions

People on benazepril should be aware that taking certain medications may increase the risk of some side effects. According to its drug label, some drugs that interact with benazepril include:

  • Diuretics: Both diuretics and benazepril reduce blood pressure, which may result in low blood pressure (hypotension). Certain types of diuretics, called potassium-sparing diuretics, may result in high blood potassium (hyperkalemia) when taken with benazepril. Low blood pressure can cause fainting and falls, while high blood potassium can affect heart and muscle function. 
  • Diabetes medications: Benazepril may also reduce blood sugar and enhance the effects of insulin and other medications for diabetes. Low blood sugar (hypoglycemia) can cause dizziness, fainting, falls, and confusion. 
  • Nonsteroidal anti-inflammatory agents (NSAIDs): Benazepril and NSAIDs can both affect kidney function and increase the risk of sudden kidney failure.
  • Other ACE inhibitors and aliskiren: Taking these medications together with benazepril can result in an increased risk of side effects such as low blood pressure, changes in kidney function, and high blood potassium. 

Other medications that interact with benazepril include temsirolimus, sirolimus, everolimus, lithium, neprilysin, and injectable gold (sodium aurothiomalate). This is not a complete list of interactions. Tell your healthcare provider about all medications you take, including prescription and over-the-counter drugs, vitamins, herbal remedies, and supplements.

Benazepril and alcohol

Taking benazepril and drinking alcohol is generally not recommended, as the two substances can interact and increase the risk of side effects. Combining benazepril with alcohol can increase the risks of:

  • Low blood pressure
  • Dehydration
  • Liver problems
  • Heart palpitations
  • Dizziness, lightheadedness, and sleepiness, which can increase the risk of falls and injuries
  • Headaches
  • Nausea
  • Flushing

Safety measures while using benazepril

Benazepril in people who are pregnant or breastfeeding

People who are pregnant should not take benazepril. The FDA has issued a boxed warning for benazepril due to its risk of fetal toxicity. ACE inhibitors are contraindicated during pregnancy. Taking these medications during the second or third trimester may increase the risks of fetal malformations. People who become pregnant should contact their healthcare provider to discontinue benazepril as soon as possible. 

Benazepril is considered safe to take while breastfeeding because the low level of the drug in breast milk is not expected to cause any side effects. 

Benazepril in children, older adults, and other populations

“Benazepril is not recommended for kids under the age of 6 years old,” advises Norman. According to its drug label, benazepril has not been studied in patients under 6 years old. 

Older adults are generally started at a lower dose of benazepril to lower the risk of side effects. People with kidney disease need to be monitored more closely by their healthcare providers when they’re on benazepril. “People with chronic kidney issues (renal disease) also require dose adjustments of this medication,” Norman says.

Angioedema, which can be a life-threatening side effect, is more common in Black and African American people who take ACE inhibitors. Talk to your healthcare provider about the risks and benefits of benazepril for you. As Norman states, “There is no medication that is ‘one size fits all,’ which is why I advise anyone taking any medication (prescribed or over the counter or otherwise obtained without a prescription) to keep open communication with a qualified healthcare provider to help you best understand how a medication could help (or harm) you.”

Benazepril overdose may result in very low blood pressure. Seek medical attention for anyone who may have taken large quantities of benazepril.

How to avoid benazepril side effects

Here are a few steps you can take to avoid some of the common side effects of benazepril:

  1. Let your healthcare provider know about all the medications (prescription and over the counter), supplements, and recreational drugs you may be taking so they can be aware of any interactions.
  2. Follow the dosage instructions given by your healthcare provider, and make sure you’re taking the medication regularly to avoid over- or under-dosing. 
  3. Stay hydrated throughout the day while you’re taking benazepril to avoid experiencing low blood pressure. 
  4. Monitor your blood pressure regularly and record your readings to share with your healthcare provider. 
  5. Contact your healthcare provider as soon as you experience new symptoms after taking benazepril. 

How to treat side effects of benazepril

If you experience side effects of benazepril, a prescriber may recommend a few options to treat the issue. Nieca Goldberg, a cardiologist at NYU Langone in New York City, shares, “If a patient develops a cough, the medication should be stopped. For fatigue or lightheadedness, it is important to check the blood pressure and see if the blood pressure is too low or too high. Depending on the blood pressure, the medication dose can be adjusted up or down.”

According to benazepril’s drug label, if someone has dangerously low blood pressure due to the medication, healthcare providers may provide an intravenous (IV) infusion of saline solution. They may also recommend activated charcoal or inducing vomiting if someone recently took too high of a dose of the medication. 

It’s always important to let your healthcare provider know if you’re experiencing new symptoms after starting a medication. They can adjust your dose, stop a medication, or recommend a different medication for you based on your medical history. 

Bottom line: Is benazepril safe?

Benazepril is a medication commonly recommended for people with high blood pressure and heart failure. Although it’s not safe for people who are pregnant, it has been found to be safe to use by most people who need it. Healthcare providers can provide a full workup of your concerns and medical history to determine whether benazepril would be safe and effective for you. Experts we interviewed recommend contacting your healthcare provider as soon as possible should you experience side effects from benazepril. 

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