Lisinopril vs Benazepril – Comparison of Uses & Side Effects

Lisinopril

It is the generic name of a drug that belongs to a group of drugs called angiotensin-converting enzyme inhibitors.

The US Food and Drug Administration originally approved this medication in 1987.

Mechanism of Action

This medication works by relaxing blood vessels to make the heart pump better and lower blood pressure.

It can be found under the following brand names: Prinivil, Qbrelis, Zestril.

Uses

It is used to treat diabetic congestive heart failure, high blood pressure, and nephropathy.

High blood pressure, also referred as hypertension, is defined as having a sustained blood pressure of 140/90 mmHg or above.

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.”

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

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

Also, this angiotensin-converting enzyme inhibitor is used immediately after a heart attack to reduce the chance of having another heart attack.

Drug Interactions

This angiotensin-converting enzyme inhibitor may negatively interact with other medications, especially:

  • ibuprofen (Advil);
  • aliskiren (Tekturna);
  • naproxen sodium (Aleve);
  • celecoxib (Celebrex);
  • indomethacin (Indocin);
  • triamterene (Dyrenium);
  • ketoprofen (Orudis);
  • amiloride (Midamor);
  • oxaprozin (Daypro);
  • telmisartan (Micardis);
  • torsemide (Demadex);
  • lithium (Eskalith);
  • Xanax;
  • ketorolac (Toradol);
  • nabumetone (Relafen);
  • piroxicam (Feldene);
  • naproxen (Naprosyn).

Dosage

The usual initial recommended dosage is 5mg a day. A few weeks later, the dosage can be increased until the patient reaches the optimal dose.

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The peak effect of this angiotensin-converting enzyme inhibitor can be observed in 6 to 8 hours. Its effect lasts for an average duration of 24 hours.

Note – this medication is not recommended for children less than 6 years of age.

Alcohol

Drinking alcohol can increase the blood pressure lowering effect of this angiotensin-converting enzyme inhibitor and can also make you feel dizzier and more likely to faint.

Pregnancy & Breastfeeding

Avoid this angiotensin-converting enzyme inhibitor as soon as possible once the pregnancy is detected. Moreover, it should be avoided by nursing women.

Side Effects and Precautions

Common side effects may include:

  • chest pain;
  • a cough;
  • nausea;
  • dizziness;
  • weakness;
  • headaches.

Less common side effects may include:

  • a feeling like you might pass out;
  • swelling of your feet or ankles;
  • clay-colored stools;
  • irregular heartbeats;
  • loss of movement;
  • feeling short of breath;
  • fever;
  • a sore throat;
  • dark urine;
  • upper stomach pain;
  • loss of appetite;
  • jaundice (yellowing of the skin or eyes);
  • tired feeling.

Benazepril

Image credit – https://commons.wikimedia.org/wiki/File:001850277lg_Benazepril_hydrochloride_20_MG_Hydrochlorothiazide_25_MG_Oral_Tablet.jpg

It is the generic name of a drug that belongs to the class of drugs called angiotensin-converting enzyme inhibitors. This medication can found under the brand name of Lotensin.

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

Mechanism of Action

It works by relaxing the blood vessels.

Uses

This prescription medication is used to treat mild to moderately high blood pressure.

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

Alcohol

Avoid drinking alcoholic beverages while taking this angiotensin-converting enzyme inhibitor since alcohol lowers your blood pressure and could also increase the risk of side effects.

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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.

Side Effects and Precautions

Common side effects may include:

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

Less common side effects may include:

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

Pregnancy & Breastfeeding

This angiotensin-converting enzyme inhibitor should be avoided during breastfeeding because it passes into breast milk and may affect the infant in a negative way.

It 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.

Contraindications

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

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

Drug Interactions

It may negatively interact with other medications, especially:

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

Bottom Line – Lisinopril vs Benazepril               

Lisinopril (brand names – Prinivil, Qbrelis, Zestril) is a medication which is prescribed to patients with high blood pressure. In addition, the medication is given to people with kidney problems without hypertension as a preventive measure.

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

According to a 2016 study, an increase in all-cause mortality combined with a limited effect on reducing systolic and diastolic blood pressure made lisinopril the worst choice among the angiotensin-converting enzyme inhibitors evaluated.

Regarding their price, the average retail price for 30 tablets of lisinopril 10mg is $5, while the average retail price for 30 tablets of benazepril 20mg is $6.

References

https://www.ncbi.nlm.nih.gov/pubmed/1663163
https://www.sciencedirect.com/science/article/abs/pii/S0022286007003006
https://journals.lww.com/jhypertension/Citation/1993/12050/Comparative_

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