Losartan vs. Benazepril

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

Key Takeaways

  • Losartan is an ARB and benazepril is an ACE inhibitor, and both lower blood pressure through the same hormone pathway but at different points, and both must be stopped as soon as pregnancy is confirmed.

  • Losartan carries added FDA approvals for cutting stroke risk in hypertension with left ventricular hypertrophy and for slowing diabetic kidney disease, while benazepril's approval covers hypertension only.

  • ACE inhibitors like benazepril can cause a dry cough in some patients, a side effect that losartan does not share because it works through a different mechanism.

Losartan vs. Benazepril Drug Summary

Losartan

Losartan is an angiotensin receptor blocker (ARB) used to treat high blood pressure, cut stroke risk in people with hypertension and an enlarged heart muscle, and slow kidney damage from type 2 diabetes. It's taken as a once-daily tablet, usually starting at 50 mg.

Benazepril

Benazepril is an ACE inhibitor used to treat high blood pressure by relaxing blood vessels so the heart works less hard. It's taken as a once-daily tablet, usually starting at 10 mg and raised in steps up to a maximum of 80 mg if needed.

Losartan vs. Benazepril Side Effects

Losartan

Most common
Upper respiratory infection (up to 8%)
Dizziness (up to 3%)
Nasal congestion (up to 2%)
Back pain (up to 2%)

Benazepril

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

Losartan vs. Benazepril Dosage

Losartan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg once daily At the start
Maximum dose 100 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 0.6 mg/kg once daily If needed
Dose changes 6 increases As tolerated

Losartan vs. Benazepril Indications

Losartan

Losartan blocks angiotensin II receptors to relax blood vessels and lower blood pressure. Beyond hypertension, it's FDA-approved to cut stroke risk in people with hypertension and left ventricular hypertrophy, and to slow kidney disease progression in type 2 diabetes with proteinuria.

  • Treating high blood pressure in adults and children 6 and older

  • Reducing stroke risk in hypertension with left ventricular hypertrophy (benefit not shown in Black patients)

  • Slowing diabetic kidney disease in type 2 diabetes with proteinuria

Benazepril

Benazepril blocks the ACE enzyme so the body makes less angiotensin II, relaxing blood vessels and lowering blood pressure. Its FDA approval covers hypertension only, without the added stroke-risk or kidney-disease indications carried by losartan.

  • Treating high blood pressure in adults

  • Treating high blood pressure in children 6 years and older

  • Not indicated for stroke-risk reduction or diabetic kidney disease

Losartan vs. Benazepril Pros and Cons

Losartan

Losartan is an ARB with a well-documented side-effect profile and broader FDA approval than a plain blood pressure pill, covering stroke-risk reduction and diabetic kidney disease alongside hypertension. It's often the choice when a patient can't tolerate the dry cough that ACE inhibitors like benazepril sometimes cause.

Pros

  • Does not cause the dry cough that leads some patients to stop ACE inhibitors like benazepril

  • Carries added FDA approvals for reducing stroke risk in hypertension with left ventricular hypertrophy and for slowing diabetic kidney disease

  • Often a suitable option for patients who developed cough or swelling reactions on an ACE inhibitor

Cons

  • The stroke-risk-reduction benefit has not been shown in Black patients

  • Has fewer decades of real-world outcomes data than benazepril, which has been available since 1991

  • Is converted by the liver into its active form, adding drug-interaction considerations that a direct-acting ACE inhibitor does not have

Benazepril

Benazepril is an ACE inhibitor with a long track record and effective blood pressure control, though its FDA approval covers hypertension only. It carries a real, if modest, risk of dry cough and dizziness that leads some patients to switch to an ARB instead.

Pros

  • Longer track record, with FDA approval since 1991 versus losartan's 1995

  • Acts directly on the ACE enzyme without needing conversion to an active metabolite first

  • Available in more tablet strengths (5, 10, 20, 40, 80 mg), allowing finer dose titration

Cons

  • Carries a real risk of dry cough, sometimes leading patients to stop the medication

  • Slightly higher rates of dizziness and postural dizziness than losartan in trials

  • Less effective at lowering blood pressure as a standalone drug in Black patients

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.