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

Most common
Edema (up to 10.8%)
Palpitations (up to 4.5%)
Dizziness (up to 3.4%)
Flushing (up to 2.6%)

Benazepril

Most common
Headache (up to 6%)
Dizziness (up to 4%)
Somnolence (up to 2%)
Postural dizziness (up to 2%)

Amlodipine vs. Benazepril Dosage

Amlodipine

Dosage
Dosage Table
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

Dosage
Dosage Table
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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