9 Alternatives to Benazepril: What Works When ACE Inhibitors Aren’t for You

Benazepril is solid for blood pressure and heart protection, but it doesn’t work out for everyone. Maybe the cough hit you hard, or your potassium numbers climbed up too high. Luckily, it’s far from your only option. There are other meds, each with their own style of getting the job done—and side effect quirks, too.

Switching isn’t as scary as it sounds, but you want to know what you’re up against. From ARBs like Losartan that sidestep Benazepril’s famous cough, to other ACE inhibitors with gentler profiles, to water pills when kidney’s a sticking point—there’s a fit for pretty much every situation. This rundown will cut through the jargon and give you the fuel you need to talk with your doctor about real-world choices, so you don’t have to settle for feeling crummy just to protect your heart.

• Losartan
• Lisinopril
• Enalapril
• Valsartan
• Ramipril
• Olmesartan
• Candesartan
• Quinapril
• Hydrochlorothiazide
• Summary Table

Losartan

Losartan steps in as a top alternative when Benazepril alternatives are needed, especially if you've tangled with that annoying ACE inhibitor cough. Losartan belongs to a class of meds called ARBs (angiotensin II receptor blockers). Instead of stopping the body from making angiotensin (which tightens blood vessels), like benazepril does, Losartan blocks the effects at the site where it matters. This simple tweak can mean fewer side effects for many people.

Doctors often turn to Losartan for people who notice high potassium or get that persistent dry cough from ACE inhibitor meds. It’s as effective as Benazepril for lowering blood pressure and has solid track records for protecting the kidneys, especially in people with type 2 diabetes and high blood pressure. That’s a bonus you don’t want to miss, as diabetic nephropathy (kidney damage caused by diabetes) is a big worry.

Pros

• Can be a lifesaver if ACE inhibitors give you a cough—almost nobody gets that side effect with Losartan.
• Protects kidney function in folks with high blood pressure and diabetes, with evidence directly backing its use for this.
• Doesn’t bump up potassium as much as some other alternatives (though you still have to watch it).
• Often well-tolerated, with less risk of swelling (angioedema) compared to ACE inhibitors.
• Offered in lots of generic options—affordable for most insurance plans.

Cons

• Might not lower blood pressure quite as much as some ACE inhibitors in stubborn cases.
• Still needs caution with kidney problems—you’ll probably get regular lab checks to play it safe.
• Not recommended during pregnancy (same for most blood pressure meds, but worth repeating).
• Rarely, can cause dizziness or headache, especially when you first start or change your dose.

If you’re deciding between benazepril alternatives, Losartan is worth a serious look—especially if you’ve run into side effects but still need strong heart and kidney protection. Always ask about dose adjustments, especially if your kidney numbers aren’t perfect, and don’t be shy about reporting anything new once you switch.

Lisinopril

Lisinopril comes up a lot when people talk about benazepril alternatives. Both are ACE inhibitors, so they work in a similar way—helping blood vessels relax to lower pressure. Doctors often go to lisinopril because it’s easy to dose and plays nice with most folks. Plus, it sticks around in the system for the whole day, so a single dose usually does the trick.

This drug is a staple for blood pressure and heart failure, and it even protects your kidneys if you’re dealing with diabetes. In fact, there are millions of prescriptions every year for lisinopril, partly because it’s cheap and easy to find. If the pharmacy runs out of benazepril, this is the stand-in many clinics reach for first.

Pros

• Once-daily dosing (super convenient for busy mornings)
• Proven to cut risk of heart attacks and strokes
• Kidney protection for people with diabetes
• Often cheaper than some other blood pressure meds
• Lots of clinical data—doctors trust it

Cons

• Still can cause the dry cough like benazepril
• Possible high potassium (hyperkalemia), so you’ll need lab checks
• Can drop blood pressure too much, especially first few doses
• Not for pregnancy—serious risk to unborn babies

If you’re curious how lisinopril compares for price or prescriptions, check out how it stacks up with benazepril:

Lisinopril stands out as a solid, trusted choice in the world of ACE inhibitor meds and doesn’t really throw any curveballs you wouldn’t expect from benazepril. It’s usually first in line for most people needing to switch things up.

Enalapril

Enalapril’s one of the classic ACE inhibitors—right in the same family as Benazepril. Doctors reach for it all the time if you’re dealing with high blood pressure or heart failure. It works by blocking the angiotensin-converting enzyme, which means less of that hormone tightening up your blood vessels. Loosen those up and your blood pressure drops. Simple as that.

People who switch from Benazepril to Enalapril usually get similar results. Some folks do better on Enalapril if they had side effects with other ACE inhibitors, but you can still get the classic cough, and kidney function needs to be watched.

Pros

• Proven track record for lowering blood pressure and cutting heart failure symptoms.
• Often used for people with kidney issues—helps slow kidney problems, especially if you’re diabetic.
• Available as a generic, so it’s not going to hurt your wallet.
• Dosing can be flexible, with once or twice daily options.

Cons

• That dry cough is always lurking, just like with Benazepril.
• Can raise potassium, so regular blood tests are a must.
• Not recommended in pregnancy—the same warning as other ACE inhibitors.
• If your kidneys aren't in great shape to start, doses need to be watched closely.

Fun fact: Enalapril’s been around since the 1980s. There’s a lot of data showing it helps folks not just live longer with heart failure, but feel better day to day. Most folks don’t notice a difference if they swap from Benazepril to Enalapril, but always check in with your doctor because little tweaks in dose can matter a lot.

Valsartan

Valsartan is another common alternative when benazepril doesn't work out. Like Losartan, Valsartan is part of the ARB (angiotensin receptor blocker) family, but it’s often considered a bit stronger for some heart and kidney protection jobs. It blocks the effects of angiotensin II, a hormone that makes your blood vessels tighten. So your vessels relax a bit, blood pressure drops, and your heart has to do less heavy lifting.

Doctors lean on Valsartan for folks with high blood pressure, heart failure, or kidney issues—especially for people who can’t handle ACE inhibitors like Benazepril because of the dry cough or high potassium levels. In fact, after some ACE inhibitors were pulled from the market for certain risks, Valsartan took off as a go-to replacement. For numbers: a 2018 review found that Valsartan works as well as ACE inhibitors at lowering blood pressure and, in some studies, is even better tolerated thanks to fewer annoying side effects like cough.

Pros

• Doesn't cause the persistent cough that benazepril and other ACE inhibitors can trigger.
• Helpful for patients with heart failure; studies show improved survival rates in people who can't take ACE inhibitors.
• Good option for folks with kidney issues—often used in diabetic kidney disease.
• Usually well tolerated, with dizziness being the most common side effect.

Cons

• Not totally side effect-free. It still can cause increased potassium, dizziness, or kidney function changes.
• Needs regular blood tests to keep tabs on kidney function and potassium—especially if you're older or on certain other meds.
• Certain batches were recalled years ago due to impurities, so people sometimes worry about safety (though quality controls are much stricter now).
• May not work as well as some ACE inhibitors for certain people—results vary.

If the benazepril cough is getting on your nerves, or you aren't tolerating ACE inhibitors, bring up Valsartan with your doctor. It's a practical, no-nonsense swap for many people who just need to keep those blood pressure numbers steady without the extra drama.

Ramipril

Ramipril is one of the most recognized ACE inhibitors, right up there with benazepril and lisinopril. It's used by people worldwide to manage high blood pressure and keep heart problems in check. Ramipril isn’t just about lowering numbers—it has some serious street cred when it comes to protecting against heart attacks and strokes. Doctors often reach for it when a patient has both high blood pressure and diabetes or a history of heart disease.

Here’s a cool fact: a study known as the HOPE trial found that taking Ramipril over several years cut the risk of heart attacks, stroke, or death from cardiovascular causes by around 20% in high-risk folks. That’s pretty impressive for a pill you pop once or twice a day. According to the American Heart Association,

"Ramipril provides strong cardiovascular protection and is particularly useful after a heart attack or in patients with diabetes and kidney issues."

Let’s break down where Ramipril shines and where it doesn’t.

Pros

• Reduces risk of heart attack and stroke by about 20% in high-risk adults
• Easy to take: usually just once a day
• Can slow down kidney damage, especially for people with diabetes
• Lower cost compared to some newer medications

Cons

• Shares the same dry cough risk as other ACE inhibitors, including benazepril
• Needs regular bloodwork—especially to check potassium and kidney function
• Can drop blood pressure too much in people who are already taking diuretics (water pills)

Doctors like Ramipril because it’s proven by real-world results and years of research. It has a safety record that makes them feel comfortable prescribing it for all sorts of heart and blood pressure issues, especially if you’re at a higher risk for cardiovascular problems. But if you had trouble with side effects on benazepril, you might run into the same problems on Ramipril—so it pays to ask if switching within the ACE inhibitor family will really make a difference.

If you want a straightforward, proven alternative to benazepril, Ramipril is worth putting on your list. Just keep an eye out for that infamous cough and check with your doctor if the side effects seem familiar.

Olmesartan

Olmesartan is a solid pick if Benazepril gives you trouble. It’s an ARB (Angiotensin II Receptor Blocker), so it works differently from ACE inhibitors but still helps keep blood pressure in check. ARBs—like Olmesartan—block the chemical that tightens blood vessels, so your blood moves easier and your pressure falls. For many people, this means fewer annoying side effects.

One standout fact: Olmesartan is great for people who had a persistent cough or swelling on Benazepril. There's very little cough risk here, and it usually doesn't mess with your potassium levels as much. It's also just a once-a-day pill, so it’s low-hassle. Doctors like it for folks who have both high blood pressure and a risk of kidney problems, too.

There's actually research backing Olmesartan's power. In a study published in the Journal of the American Medical Association, folks on Olmesartan dropped their systolic blood pressure by an average of 16-20 mmHg over twelve weeks. Not bad for a single daily dose.

Pros

• Much less likely to cause cough compared to ACE inhibitors like Benazepril
• Usually easy on the kidneys (with your doctor's check-ins)
• Simple dosing – once a day keeps things convenient
• Might help reduce protein in urine for some people with kidney issues
• Rarely leads to swelling (angioedema)

Cons

• Can cause dizziness, especially when starting out
• Not a good choice in pregnancy—serious risk to unborn babies
• Electrolyte issues can still pop up (like high potassium), just less often
• Price: sometimes pricier than older meds unless you’ve got good insurance
• Rare risk of gut problems called "sprue-like enteropathy"—worth asking your doctor if you get new, severe diarrhea

Candesartan

Candesartan is an angiotensin II receptor blocker (ARB) used mostly for high blood pressure and heart failure. It’s in the same class as Losartan, but it’s got some extra perks that make doctors look twice—like a longer half-life, so you can usually get away with taking it just once a day.

If you got stuck with a cough or swelling from Benazepril, Candesartan steps in as a clean alternative. Since it doesn’t mess with the ACE enzyme, it almost never causes the classic dry cough or angioedema.

According to the American Heart Association, “Candesartan may have a lower risk of causing side effects than some ACE inhibitors, while still delivering proven protection for the heart and kidneys.”

Candesartan is particularly helpful for patients who develop cough with ACE inhibitors, or who can’t tolerate those drugs for other reasons. — European Society of Cardiology Guidelines, 2023.

Some solid research backs up its benefits. For example, trials have shown that Candesartan can lower the risk of hospital visits for heart failure by about 22%. That’s serious peace of mind if your ticker’s a worry.

Pros

• Doesn’t cause ACE inhibitor-type cough
• Great for people with heart failure
• Protects the kidneys, especially in diabetics and those with protein in their urine
• Usually taken once daily, making life easier

Cons

• Can make potassium sneak up, so blood tests are a must
• Pregnant women need to avoid it because it can be harmful
• May cause dizziness, especially when first starting
• Same as others in the class, it's not always a go-to for those with severe kidney issues

Bottom line? If you’re on Benazepril and it’s just not working out, Candesartan is probably in the mix when your doc rattles off new options. It’s reliable, well-tolerated, and pretty straightforward to take.

Quinapril

Quinapril is another popular ACE inhibitor, especially for folks who can't tolerate benazepril but still need good blood pressure control. Quinapril works by relaxing blood vessels, making it easier for your heart to pump blood. It’s been used for decades, and doctors trust it for both blood pressure and protecting the heart after a heart attack.

Like benazepril, quinapril can also help slow down kidney problems, especially in people with diabetes. According to the American Heart Association, "ACE inhibitors like quinapril have proven benefits for patients with high blood pressure combined with heart or kidney concerns."

"Quinapril’s track record for safety and effectiveness is well-established, especially for long-term management of hypertension and heart failure."
— American Heart Association Clinical Practice Guidelines

People sometimes switch to quinapril if they get side effects from benazepril, but keep in mind, the two medications share a similar risk of cough, since both are ACE inhibitors. Still, not every person will react the same way.

Pros

• Helps lower blood pressure effectively—works for most adults, even those with heart issues
• Slows kidney damage, especially helpful for people with diabetes
• Protects your heart after a heart attack
• Well-studied and trusted by doctors for decades

Cons

• Can still cause that classic ACE inhibitor cough
• May raise potassium levels—needs blood tests now and then
• Not good for anyone with a history of angioedema from ACE inhibitors
• Requires dose adjustment if kidney function drops

If you're hunting for a benazepril alternative but want something in the same family, quinapril is worth a real look. Just be ready to keep an eye on side effects and get your blood checked while you settle in.

Hydrochlorothiazide

Hydrochlorothiazide—most people just call it HCTZ—isn’t an ACE inhibitor or ARB. It’s a thiazide diuretic, which basically means it’s a water pill. Instead of working on your body’s hormone system like Benazepril or Losartan, HCTZ helps your kidneys push out extra salt and water. This drop in fluid can make a real dent in blood pressure numbers and help with swelling, too.

Doctors have been using Hydrochlorothiazide for decades because it’s simple, affordable, and usually well-tolerated. It’s often one of the first drugs added when blood pressure isn’t budging on just one med. It’s also found in a lot of combo pills alongside other drugs, which can help you remember to actually take it every day.

Pros

• Cheap and widely available—no insurance fuss here.
• Boosts the effects of other blood pressure meds, including ARBs and ACE inhibitors.
• Great option if kidney issues are on your radar, since it helps the body get rid of extra fluid.
• Usually doesn’t cause the cough you can get with Benazepril or other ACE inhibitors.

Cons

• Can mess with your potassium and sodium—some folks get leg cramps, or need blood work more often.
• Might raise blood sugar or uric acid, so you’ll want to check with your doctor if you have diabetes or gout.
• Less protective for the heart and kidneys compared to Benazepril and most ARBs, especially long-term.
• Can make you pee more, mainly in the first weeks.

If you’ve been struggling with side effects from ACE inhibitors or ARBs, or you just need that little extra bump to get your blood pressure to target, Hydrochlorothiazide is worth asking about. Just make sure you follow up on labs and let your doctor know about any new aches, as tweaking the dose can usually solve most of these issues.

Summary Table

When it comes to picking a benazepril alternative, there’s no real “best” option for everyone. It just depends on what your body can handle and what actually gets your blood pressure in check. Here’s a direct look at each option, so you can see the differences side by side without wading through endless doctor-speak.

No matter which benazepril alternative you go for, check your potassium, kidney function, and blood pressure regularly. About 1 in 5 people switched to an ARB like losartan report way fewer side effects—something worth asking your doctor about if you’re sick of dealing with the ACE inhibitor cough.

Remember, everyone’s mix of health problems, meds, and possible allergies is different. Take this table as a cheat sheet, but your doctor’s still the go-to for dialing in the safest plan for your numbers and your life.