Amlodipine vs. Benazepril
See how Amlodipine and Benazepril compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Amlodipine is a calcium channel blocker taken once daily that also treats angina, while benazepril is an ACE inhibitor approved only for high blood pressure.
Amlodipine's most common side effect is leg or ankle swelling, while benazepril more often causes headache and dizziness.
Benazepril carries a boxed warning for fetal harm and must be stopped immediately if pregnancy occurs, a risk that does not apply to amlodipine.
Amlodipine vs. Benazepril Drug Summary
Amlodipine
Amlodipine is a dihydropyridine calcium channel blocker used to treat high blood pressure, chronic stable angina, and vasospastic angina. It works by relaxing blood vessels through blocking calcium from entering vascular smooth muscle cells. It is taken as a single oral tablet once a day, with or without food.
Benazepril
Benazepril is an ACE inhibitor approved to lower blood pressure in adults. It works by blocking the enzyme that produces angiotensin II, a hormone that narrows blood vessels. It is taken as an oral tablet, usually once daily, and is often combined with a diuretic.
Amlodipine vs. Benazepril Side Effects
Amlodipine
Benazepril
Amlodipine vs. Benazepril Dosage
Amlodipine
Benazepril
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 4 increases | As tolerated |
Amlodipine
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Benazepril
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 4 increases | As tolerated |
Amlodipine vs. Benazepril Indications
Amlodipine
Amlodipine treats high blood pressure and several types of chest pain caused by narrowed or spasming coronary arteries. It is one of the few blood pressure medications also approved for angina, giving it a broader role for patients who have both conditions.
Hypertension
Chronic stable angina
Vasospastic (Prinzmetal's) angina
Coronary artery disease
Benazepril
Benazepril is FDA-approved only to lower blood pressure in adults. It is not approved for angina or other cardiac conditions, though it is commonly combined with other blood pressure medications, including diuretics and calcium channel blockers.
Hypertension in adults
Often paired with a diuretic
Sometimes combined with a calcium channel blocker
Not approved for children under 6
Amlodipine vs. Benazepril Pros and Cons
Amlodipine
Amlodipine's long half-life means a missed dose is less likely to cause a blood pressure spike, and it works across a wide range of kidney function without dose changes. Its main drawback is dose-related swelling in the legs and ankles, which is more common in women and can prompt some patients to switch medications.
Pros
Also approved for angina and coronary artery disease
No dose adjustment needed for kidney function
Long half-life makes missed doses more forgiving
Cons
Swelling in the legs or ankles is the most common side effect
Swelling occurs more often in women than men
Can worsen angina if started in severe coronary disease
Risk of symptomatic low blood pressure with aortic stenosis
Benazepril
Benazepril lowers blood pressure through a different mechanism than amlodipine, which makes it a reasonable option when swelling from a calcium channel blocker is unwanted. Its boxed warning for fetal harm and small but serious risk of angioedema are its most important safety considerations.
Pros
Avoids the leg swelling common with calcium channel blockers
May be combined with a diuretic for added blood pressure control
Multiple dose strengths allow for gradual titration
Cons
Boxed warning for fetal injury and death; stop if pregnant
Risk of angioedema, including rare fatal reactions
Less effective as monotherapy in Black patients
About 5% of patients stop due to side effects vs 3% on placebo
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