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
Benazepril
Losartan vs. Benazepril Dosage
Losartan
Benazepril
| 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 |
| 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
| 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
| 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
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