Lisinopril vs. Valsartan

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

Key Takeaways

  • Lisinopril is an ACE inhibitor and valsartan is an ARB, but both are once-daily generics that relax blood vessels to lower blood pressure.

  • Lisinopril can cause a dry, persistent cough as a class effect, while valsartan rarely does because it works through a different pathway.

  • Both drugs are also FDA-approved for heart failure and post-heart-attack care, so a doctor may switch between them if one causes side effects.

Lisinopril vs. Valsartan Drug Summary

Lisinopril

Lisinopril is an ACE inhibitor used to treat high blood pressure, heart failure, and to improve survival after a heart attack. It is taken as a single tablet once a day, usually starting at 10 mg and adjusted based on blood pressure response.

Valsartan

Valsartan is an angiotensin receptor blocker (ARB) used to treat high blood pressure, heart failure, and left ventricular dysfunction after a heart attack. It is also taken once a day, usually starting at 80 to 160 mg and adjusted as needed.

Lisinopril vs. Valsartan Side Effects

Lisinopril

Most common
Dizziness (up to 4%)
Headache (up to 4%)
Hypotension (up to 4%)
Cough (up to 3%)

Valsartan

Most common
Dizziness (up to 8%)
Viral infection (up to 3%)
Fatigue (up to 2%)
Abdominal pain (up to 2%)

Lisinopril vs. Valsartan Dosage

Lisinopril

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose Up to 80 mg once daily If needed
Dose changes 3 increases As tolerated

Valsartan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 80-160 mg once daily At the start
Maximum dose 320 mg once daily If needed
Dose changes 2 increases As tolerated

Lisinopril vs. Valsartan Indications

Lisinopril

Lisinopril is an ACE inhibitor FDA-approved to treat high blood pressure in adults and children 6 and older. It is also approved as part of combination treatment for heart failure and to help patients survive longer after a heart attack.

  • High blood pressure in adults and children 6+

  • Heart failure, as part of combination therapy

  • Improving survival after a heart attack

  • Often combined with a diuretic for extra control

Valsartan

Valsartan is an ARB FDA-approved to treat high blood pressure in adults and children 6 and older. It is also approved for heart failure to reduce hospitalization risk and to improve survival after a heart attack with reduced heart function.

  • High blood pressure in adults and children 6+

  • Heart failure, to lower hospitalization risk

  • Left ventricular dysfunction after a heart attack

  • Often combined with a diuretic for extra control

Lisinopril vs. Valsartan Pros and Cons

Lisinopril

Lisinopril is an ACE inhibitor with decades of outcomes data across blood pressure, heart failure, and post-heart-attack care. It is a well-covered, low-cost generic, though it can cause a dry cough in some people and needs careful dosing in kidney disease.

Pros

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

  • Backed by decades of real-world use and outcomes data since the late 1980s

  • Comes in more tablet strengths, which allows finer dose adjustments

  • Generic often costs roughly $5 to $10 a month with a discount coupon

Cons

  • Can cause a dry, persistent cough in some patients, a known ACE inhibitor effect

  • Carries a slightly higher angioedema risk than ARBs like valsartan

  • Usually needs a lower starting dose if kidney function is significantly reduced

  • Cannot be combined with an ARB or a renin inhibitor such as aliskiren

Valsartan

Valsartan is an ARB that works through a different pathway than lisinopril, so it rarely causes the cough or angioedema sometimes seen with ACE inhibitors. It is also a well-covered generic, though it typically has a smaller body of long-term outcomes data than lisinopril.

Pros

  • Rarely causes the dry cough associated with ACE inhibitors like lisinopril

  • Carries a lower angioedema risk than ACE inhibitors

  • No dose adjustment needed for mild to moderate kidney or liver problems

  • FDA-approved as a heart failure option for people who cannot tolerate an ACE inhibitor

Cons

  • Generic often costs roughly $10 to $20 a month with a discount coupon, more than lisinopril

  • Fewer tablet strength options than lisinopril for fine dose adjustments

  • Dizziness becomes more common at the highest approved dose of 320 mg

  • Has a shorter track record than lisinopril, which has been used since the 1980s

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