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
Valsartan
Lisinopril vs. Valsartan Dosage
Lisinopril
Valsartan
| 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 |
| 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
| 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
| 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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