Atenolol vs. Benazepril
See how Atenolol and Benazepril compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Atenolol is a beta-blocker approved for hypertension, angina, and stable heart attack recovery, while benazepril is an ACE inhibitor approved only for hypertension.
Both are taken once daily by mouth, but atenolol follows a simple three-step titration while benazepril offers more dose strengths for fine-tuning blood pressure control.
Atenolol must not be stopped abruptly and needs caution in lung disease, while benazepril carries a boxed warning for fetal harm and a rare risk of angioedema.
Atenolol vs. Benazepril Drug Summary
Atenolol
Atenolol is a beta-1 selective beta-blocker used to treat high blood pressure, angina, and to aid recovery after a stable heart attack. It comes as an oral tablet taken once daily.
Benazepril
Benazepril is an ACE inhibitor used specifically to lower blood pressure in hypertension. It comes as an oral tablet taken once daily.
Atenolol vs. Benazepril Side Effects
Atenolol
Benazepril
Atenolol vs. Benazepril Dosage
Atenolol
Benazepril
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 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 | 0.6 mg/kg once daily | If needed |
| Dose changes | 5 increases | As tolerated |
Atenolol
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 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 | 0.6 mg/kg once daily | If needed |
| Dose changes | 5 increases | As tolerated |
Atenolol vs. Benazepril Indications
Atenolol
Atenolol is FDA-approved for hypertension, angina pectoris, and to improve outcomes after a hemodynamically stable heart attack. Doctors also prescribe it off-label to prevent migraines and to reduce tremor.
Hypertension
Angina pectoris
Acute myocardial infarction (stable)
Benazepril
Benazepril is FDA-approved solely to lower blood pressure in hypertension. Dosing data for children as young as 6 suggest it can be used in that age group, though it is not approved under age 6.
Hypertension in adults
Hypertension in children 6 and older
May be used alone or added to other blood pressure medications
Atenolol vs. Benazepril Pros and Cons
Atenolol
Atenolol has decades of clinical use and covers angina and post-heart-attack care in addition to hypertension, giving it broader FDA-approved uses than benazepril. It requires careful tapering and closer monitoring in people with lung disease, slow heart rate, or kidney impairment.
Pros
Also treats angina and helps with recovery after a heart attack
Long-standing safety record, approved since 1981
Used off-label for migraine prevention and essential tremor
Simple once-daily dosing with a straightforward titration
Cons
Cannot be stopped abruptly without doctor guidance - risk of rebound angina or heart attack
Not suitable for people with asthma, COPD, bradycardia, or certain heart block
May mask warning signs of low blood sugar or an overactive thyroid
Needs dose adjustment in people with kidney impairment
Benazepril
Benazepril is approved specifically for hypertension and tends to cause fewer of the fatigue-type side effects associated with beta-blockers like atenolol. It carries a boxed warning against use during pregnancy and a rare but serious risk of angioedema.
Pros
Approved for use in children as young as 6 with hypertension
Lower risk of fatigue, cold extremities, and mood-related side effects seen with beta-blockers
Wide range of tablet strengths for fine-tuning the dose
Does not require heart-rate monitoring like a beta-blocker
Cons
Carries a boxed warning for fetal harm - must be stopped immediately if pregnancy occurs
Risk of angioedema, a rare but potentially life-threatening swelling reaction
Less effective as monotherapy in Black patients
Higher rate of treatment discontinuation due to side effects than placebo
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