Valsartan vs. Benazepril

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

Key Takeaways

  • Valsartan is an ARB approved for high blood pressure, heart failure, and post-heart-attack care, while benazepril, an ACE inhibitor, is FDA-approved only for hypertension.

  • Both are once-daily tablets, but valsartan starts at 80 mg with two dose steps, while benazepril starts at 5 mg with more titration options up to 80 mg.

  • Valsartan does not cause the dry cough linked to ACE inhibitors, but its reported rates of headache and dizziness are higher than benazepril's.

Valsartan vs. Benazepril Drug Summary

Valsartan

Valsartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure, heart failure, and to reduce cardiovascular death after a heart attack. It comes as a tablet taken once daily, usually starting at 80 mg.

Benazepril

Benazepril is an ACE inhibitor used to treat high blood pressure in adults and children six and older. It comes as a tablet taken once daily, starting at 5 mg and increasing gradually up to 80 mg if needed.

Valsartan vs. Benazepril Side Effects

Valsartan

Most common
headache (up to 14%)
dizziness (up to 14%)
viral infection (up to 3%)
fatigue (up to 2%)

Benazepril

Most common
headache (up to 6%)
dizziness (up to 4%)
somnolence (up to 2%)
postural dizziness (up to 2%)

Valsartan vs. Benazepril Dosage

Valsartan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 80 mg once daily At the start
Maximum dose Up to 320 mg 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

Valsartan vs. Benazepril Indications

Valsartan

Valsartan treats high blood pressure in adults and children one year and older. It's also approved for heart failure, to cut hospital stays, and after a heart attack to lower cardiovascular death risk in people with a weakened heart.

  • Hypertension in adults and children 1 year and older

  • Heart failure (NYHA class II-IV) to reduce hospitalization

  • Post-heart-attack care to lower cardiovascular death risk

  • Can be combined with other blood pressure medications

Benazepril

Benazepril treats high blood pressure in adults and children six years and older. It's often paired with a diuretic or another blood pressure drug when one medication alone doesn't control pressure fully.

  • Hypertension in adults

  • Hypertension in children 6 years and older

  • Often combined with a diuretic for added control

  • Can be paired with other antihypertensive drugs

Valsartan vs. Benazepril Pros and Cons

Valsartan

Valsartan is an ARB with proven benefits beyond blood pressure control, backed by large heart failure and post-heart-attack trials. It generally causes less cough than ACE inhibitors but has a shorter track record than older ACE inhibitors like benazepril.

Pros

  • FDA-approved for heart failure and to reduce death after a heart attack, not just high blood pressure

  • Approved for children as young as 1 year old for hypertension

  • Does not cause the dry cough common with ACE inhibitors like benazepril

  • Simple three-step titration schedule reaching a max dose within 4 weeks

Cons

  • Higher reported rates of headache and dizziness than benazepril in clinical trials

  • Fewer years on the market than benazepril, which has been available since 1991

  • Still carries an angioedema warning, though the risk is generally lower than with ACE inhibitors

Benazepril

Benazepril is a well-established ACE inhibitor with decades of real-world use and a flexible range of tablet strengths. It's limited to hypertension treatment and carries the class-wide angioedema and cough risks typical of ACE inhibitors.

Pros

  • Five adult tablet strengths (5 to 80 mg) allow finer dose adjustments

  • Long-established safety record with FDA approval since 1991

  • Approved for children 6 years and older with hypertension

  • Lower reported rates of headache and dizziness than valsartan in trials

Cons

  • Boxed warning for angioedema, including reactions that have been fatal

  • The class-typical dry cough leads about 0.5% of patients to stop treatment

  • Only FDA-approved for hypertension, not heart failure or post-heart-attack care

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