Lisinopril vs. Benazepril

See how Lisinopril and Benazepril compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lisinopril and benazepril are both ACE inhibitors that relax blood vessels and share side effects like headache, dizziness, cough, and elevated potassium.

  • Lisinopril is also approved for heart failure and to improve survival after a heart attack, while benazepril's FDA approval covers hypertension only.

  • Both are once-daily oral tablets that typically start around 5 to 10 mg, with doses adjusted upward based on blood pressure response.

Lisinopril vs. Benazepril Drug Summary

Lisinopril

Lisinopril is an ACE inhibitor that relaxes blood vessels to lower blood pressure and ease strain on the heart. It's FDA-approved for hypertension, heart failure, and to improve survival after a heart attack, and it's taken as a tablet once a day.

Benazepril

Benazepril is an ACE inhibitor that works the same way, relaxing blood vessels to bring blood pressure down. It's FDA-approved specifically for hypertension in adults and children, and it's also taken as a once-daily tablet.

Lisinopril vs. Benazepril Side Effects

Lisinopril

Most common
Headache (up to 3.8%)
Dizziness (up to 3.5%)
Cough (up to 2.5%)
Fatigue (up to 1%)

Benazepril

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

Lisinopril vs. Benazepril Dosage

Lisinopril

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose Up to 80 mg once daily If needed
Dose changes 3 increases As tolerated

Benazepril

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose 0.6 mg/kg once daily If needed
Dose changes 6 increases As tolerated

Lisinopril vs. Benazepril Indications

Lisinopril

Lisinopril is FDA-approved to treat high blood pressure in adults and children 6 years and older, to help manage heart failure, and to improve survival after a heart attack. Lowering blood pressure with lisinopril also reduces the risk of stroke over time.

  • Hypertension in adults and children 6 years and older

  • Heart failure, usually combined with other therapies

  • To improve survival after a heart attack (within 24 hours of onset)

  • Can be combined with a diuretic like hydrochlorothiazide for added control

Benazepril

Benazepril is FDA-approved only to treat high blood pressure, in adults and in children 6 years and older. It is not approved for heart failure or for use after a heart attack, unlike some other ACE inhibitors such as lisinopril.

  • Hypertension in adults

  • Hypertension in children 6 years and older

  • Often paired with a diuretic for added blood pressure control

  • Not approved for heart failure or post-heart-attack care

Lisinopril vs. Benazepril Pros and Cons

Lisinopril

Lisinopril's FDA approval extends beyond blood pressure control to heart failure and post-heart-attack care, broader than benazepril's. It is not a prodrug, so it works the same regardless of liver function, though it is cleared solely by the kidneys.

Pros

  • FDA-approved for heart failure and to improve survival after a heart attack, not just hypertension

  • Not a prodrug — it's active right away, so liver function doesn't affect how it works

  • One of the longest-used and most-studied ACE inhibitors, on the market since 1988

  • Widely available as a low-cost generic at nearly every pharmacy

Cons

  • Cleared entirely by the kidneys, so dose must be lowered in significant kidney impairment

  • Cough leading to stopping treatment is reported more often in Black patients than other groups

  • No specific weight-based pediatric dosing chart, just a flat dose range for ages 6 and up

Benazepril

Benazepril's FDA approval is limited to hypertension, and it requires liver conversion to become active since it is a prodrug. Its elimination through both the liver and kidneys can be an advantage for some patients with reduced kidney function.

Pros

  • Cleared through both the liver and kidneys, which can help some patients with reduced kidney function

  • Has established weight-based dosing for children, not just a flat pediatric dose

  • Low rate of treatment discontinuation specifically due to cough (about 0.5%)

  • FDA-approved option for hypertension since 1991, with decades of use

Cons

  • Only FDA-approved for hypertension, without heart failure or post-heart-attack indications

  • A prodrug that needs liver conversion to become active, which may matter with significant liver disease

  • Somnolence and postural dizziness are each reported in up to 2% of patients

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