Benazepril vs Enalapril - Comparison of Side Effects & Uses

Benazepril

This drug belongs to the class of medications called angiotensin-converting enzyme inhibitors. It can found under the brand name of Lotensin.

It works by relaxing the blood vessels. This reduces the amount of work the heart has to do to pump blood, ultimately, lowering the blood pressure.

The US Food and Drug Administration originally approved it in 1991.

Uses

It is used to treat mild to moderately high blood pressure.

High blood pressure, also referred as hypertension, is defined as having a sustained blood pressure of 140/90 mmHg or above. Hypertension is the main cause of death and disability in the US.

Persistent hypertension can increase your risk of a number of serious and potentially life-threatening conditions, like:

  • peripheral arterial disease;
  • heart disease;
  • vascular dementia;
  • heart attacks;
  • kidney disease;
  • strokes;
  • aortic aneurysms;
  • heart failure.

Most people with hypertension have no signs or symptoms, even if blood pressure readings reach very high levels. That is the main reason why high blood pressure is also referred to as the “silent killer.”

According to statistics, 1 out of every 5 people with hypertension is not aware of having this major risk factor for heart attacks and strokes.

This medication may also be used to treat chronic renal failure and congestive heart failure, and to prevent kidney damage in diabetics.

Dosage

The usual recommended dose is  20 to 40 mg per day in 1 or 2 divided doses. The maximum recommended dose is 80 mg per day. Take this medication by mouth with or without food.

Side Effects and Precautions

Common side effects may include:

  • nausea;
  • vomiting;
  • headaches;
  • impotence;
  • constipation;
  • sore or swollen throat;
  • fatigue;
  • drowsiness;
  • a persistent cough;
  • chest pain.

Rare side effects may include:

  • little or no urinating;
  • a feeling like you might pass out;
  • jaundice (yellowing of the skin or eyes);
  • tingly feeling;
  • dark urine;
  • loss of movement;
  • irregular heartbeats;
  • loss of appetite;
  • weakness;
  • stomach pain (upper right side).

To make sure that this angiotensin-converting enzyme inhibitor is safe for you, tell your healthcare provider if you have:

  • liver disease;
  • kidney disease (or if you are on dialysis);
  • if you have had an organ transplant;
  • any history of heart disease.

Alcohol

Avoid drinking alcoholic beverages while taking this medication since alcohol lowers your blood pressure and could also increase the risk of side effects.

Pregnancy & Breastfeeding

This medication can cause serious harm to an unborn baby if used during pregnancy. Hence, it is essential to prevent pregnancy while taking this angiotensin-converting enzyme inhibitor.

Also, the medication should be avoided during breastfeeding because it passes into breast milk and may affect the infant in a negative way.

Drug Interactions

It may negatively interact with other medications, especially:

  • birth control pills that contain drospirenone (Angeliq);
  • Amiloride (Midamor);
  • lithium (Eskalith, Lithobid, Lithonate);
  • Spironolactone (Aldactone);
  • any prescription or over-the-counter medication that raises blood pressure;
  • Triamterene (Dyrenium);
  • hydrocodone;
  • insulin or oral diabetes medicines;
  • non-steroidal anti-inflammatory drugs (NSAIDs);
  • Valsartan (Diovan);
  • cyclobenzaprine;
  • Losartan (Cozaar).

Enalapril

It is the generic name of a medication that belongs to a group of drugs called angiotensin-converting enzyme inhibitors. It can be found under the following brand names –  Epaned or Vasotec.

This medication works by blocking a chemical which tightens blood vessels, relaxing them. This leads to a decreased blood pressure as well as an improvement in heart function.

Uses

This prescription medication is used to treat heart failure and high blood pressure.

Dosage

For congestive heart failure, the usual recommended dose is 2.5 mg. The dosage can be increased up to 40 mg.

For hypertension, the initial recommended dose is 5 mg once per day. The dosage can be increased to 40 mg per day, taken in two divided doses.

The effect of this angiotensin-converting enzyme inhibitor lasts for an average duration of 12-24 hours.

Side Effects and Precautions

Common side effects may include:

  • feeling light-headed;
  • feeling tired;
  • a cough;
  • dizziness.

Rare side effects may include:

  • slow heartbeats;
  • a light-headed feeling like you might pass out;
  • jaundice (yellowing of the skin or eyes);
  • fluttering in your chest;
  • pounding heartbeats;
  • chills;
  • fever;
  • little or no urination;
  • unusual bleeding;
  • burning pain in the hands or feet;
  • loss of movement;
  • easy bruising;
  • irregular heartbeats;
  • chest pain;
  • tingly feeling;
  • nausea.

To make sure that this angiotensin-converting enzyme inhibitor is safe for you, tell your healthcare provider if you have:

  • a history of blood clot or stroke;
  • kidney disease (or if you are on dialysis);
  • an electrolyte imbalance;
  • liver disease;
  • heart disease or congestive heart failure.

Pregnancy & Breastfeeding

You should not take enalapril if you are breastfeeding a baby since the medication may be excreted in the breast milk and can negatively affect the infant.

It falls into category D. This means that this angiotensin-converting enzyme inhibitor may be given to a pregnant woman only if her doctor believes that its benefits to the pregnant woman outweigh any possible risks to the unborn baby.

Alcohol

You should avoid the consumption of alcohol while taking this angiotensin-converting enzyme inhibitor as it may cause headaches, dizziness, and changes in heart rate.

Drug Interactions

It may negatively interact with other medications, especially:

  • methyldopa;
  • diuretics, or “water pills;”
  • prazosin (Minipress);
  • spironolactone (Aldactone);
  • lithium;
  • non-steroidal anti-inflammatory drugs, like – ibuprofen (Advil) or aspirin (Ecotrin);
  • injectable gold (sodium aurothiomalate);
  • potassium supplements;
  • digoxin (Lanoxin);
  • hydralazine;
  • calcium channel blocking drugs, like – verapamil (Calan) and amlodipine (Norvasc);
  • nitrates, like – isosorbide dinitrate, nitroglycerin, and isosorbide mononitrate.

Bottom Line – Benazepril vs Enalapril

Benazepril (brand name – Lotensin) is an ACE inhibitor that is used to treat high blood pressure (hypertension).

Enalapril (brand names – Epaned or Vasotec) is an ACE inhibitor that is used to treat congestive heart failure and high blood pressure.

References

http://www.nejm.org/doi/full/10.1056/NEJMoa0806182
https://www.ncbi.nlm.nih.gov/pubmed/19081317
http://www.nejm.org/doi/full/10.1056/NEJMoa053107

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