9 Alternatives to Benazepril: What Works, What Doesn’t, and Which Is Right for You

If Benazepril isn't working for you, or maybe it comes with side effects that get in the way of normal life, it’s totally fair to wonder what else is out there—nobody likes playing a guessing game with their blood pressure meds. Swapping out an ACE inhibitor like Benazepril isn't as tough as it sounds, but picking a new pill depends a lot on what’s going on with your body, any other health problems, and what you’re okay with when it comes to side effects.

You’ve got options: different classes of drugs, each working in their own way—some help relax blood vessels, others get rid of extra water, and a few slow down your heart. Don’t let the weird names or alphabet soup of drug classes scare you off. I’ll break down the best-known alternatives—plain English, no jargon, straight talk about what’s great, what isn’t, and a few tips to help your next doctor’s appointment feel a lot less awkward. Let’s get started.

• Amlodipine
• Lisinopril
• Losartan
• Valsartan
• Enalapril
• Hydrochlorothiazide
• Metoprolol
• Diltiazem
• Spironolactone
• Summary & Comparison Table

Amlodipine

This one shows up on a lot of lists when people are swapping off Benazepril alternatives. Amlodipine belongs to the calcium channel blocker group. Basically, it makes blood vessels relax by blocking those channels that let calcium into cells. With relaxed vessels, blood pressure goes down without a lot of drama. Doctors reach for amlodipine if they want to treat high blood pressure, chest pain from angina, or even when someone’s already had heart trouble.

You only need to take it once a day, which makes sticking to your routine easier for most people. Another cool fact: it’s been around for decades, so doctors know what to expect in terms of side effects. It stands out in non-black patients and older adults. If you’re also struggling with low potassium or sodium, amlodipine probably won’t make things worse, which isn’t true for some diuretics or other blood pressure pills.

Pros

• Once-daily dosing—easy for forgetful folks.
• Doesn’t usually mess up potassium or sodium。
• Great for high blood pressure and works well for chest pain too.
• Widely studied over the years.

Cons

• Can cause swollen ankles or feet (that’s called peripheral edema—ask anyone who’s had it, it’s annoying but usually not dangerous).
• Sometimes triggers a faster heart rate, which feels like your pulse skipping around.
• Not the first pick if you have diabetes—other drugs work better to protect your kidneys.

Here’s a quick stat: in a big head-to-head trial, about 1 in 8 people on amlodipine developed some amount of ankle swelling, but only a tiny percent needed to stop the drug because of it.

If you’re the type who wants a proven track record and something that doesn’t need constant tests for sodium or potassium, amlodipine could be worth asking your doctor about. Just keep an eye on those ankles and be honest if swelling starts up.

Lisinopril

Out of all the Benazepril alternatives, Lisinopril is probably the one you’ll hear about most often—especially if your doctor is an old hand at managing blood pressure. It’s another ACE inhibitor, so it works a lot like Benazepril by relaxing and widening your blood vessels to make it easier for your heart to do its job. It’s popular not just for high blood pressure, but for protecting the kidneys in people with diabetes and helping with heart failure too.

If you ever wondered why everyone seems to know at least one person on Lisinopril, it's because it’s been around for decades and the generic is cheap. Plus, dosing is simple—once a day is enough for most people.

Pros

• Works as well as Benazepril for dropping blood pressure numbers
• Protects the kidneys, especially helpful in folks with diabetes
• Reduces risk of certain heart problems after a heart attack
• Usually needs just one pill a day
• Generic is highly affordable and easy to find

Cons

• Can trigger a dry cough (like other ACE inhibitors), which drives some people nuts
• Risk of high potassium, so not the best for people with certain kidney problems
• Shouldn’t be used during pregnancy
• Rare chance of swelling or angioedema, which can get serious
• Takes a few weeks to hit full effect—don’t expect instant results

A quick tip: If you did okay on Benazepril but insurance or cost is suddenly an issue, Lisinopril usually slides in as a good substitute. Always ask your doctor if you’re making the switch, especially if you already take meds that mess with kidney function or potassium.

Losartan

Losartan is probably one of the first names that comes up when looking for an alternative to Benazepril. It’s part of the ARB (angiotensin receptor blocker) family, which means it blocks a hormone that tightens up your blood vessels—a different approach than ACE inhibitors like Benazepril, but the goal is pretty much the same: lower your blood pressure and ease the load on your heart.

The cool thing about Losartan is how well it works if you’re dealing with high blood pressure and have kidney concerns (especially if you have diabetes). It’s also a solid pick if you’ve ever had a cough from Benazepril or other ACE inhibitors—Losartan almost never causes that nagging, dry cough.

Pros

• You probably won’t get the dry cough that happens with ACE inhibitors.
• Helps protect your kidneys, especially if you have diabetes or early signs of kidney disease.
• Often only needs to be taken once a day (easy to remember).
• Safe for people who can’t handle ACE inhibitors.
• Usually works just as well for both younger and older adults.

Cons

• Can mess with your potassium levels, sometimes pushing them too high.
• Not a good choice if you’re pregnant.
• Might make kidney issues worse if your kidneys are already struggling (so doctors monitor this pretty closely).
• Some people still get dizzy, especially when first starting the medication.

If you love details, check out this quick stat on how Losartan stacks up as a Benazepril alternative for blood pressure and kidney protection:

Most folks find Losartan pretty easy to tolerate, but don’t forget—everyone responds a little differently. If your doctor suggests switching to Losartan because Benazepril is throwing you curveballs, you’re not alone. It’s one of the most common moves out there when ACE inhibitors aren’t the right fit.

Valsartan

Valsartan is an ARB—short for angiotensin II receptor blocker. It’s pretty popular for people needing an alternative to Benazepril, especially if they can’t handle ACE inhibitors because of that annoying cough. Valsartan’s job is to block a hormone that makes your blood vessels tighten up. When those vessels chill out and relax, blood pressure drops. Simple enough.

This med is mostly used for hypertension treatment, but you’ll also see it helping out with conditions like heart failure, and even after a heart attack to stop your heart from getting more beat up. It’s been around since the late 1990s, so doctors trust it, and it’s proven its worth in big studies. Compared to ACE inhibitors, it doesn’t usually make you cough, and it’s rare to get angioedema (severe swelling under the skin).

Valsartan is taken once a day, often with or without food, which keeps things low-hassle. Some folks need to add another blood pressure medication to really get numbers in check, but valsartan plays well with others.

Pros

• Usually doesn’t cause a cough—big win over ACE inhibitors.
• Safe for people who had angioedema with ACE inhibitors.
• Protects the kidneys, especially for folks with diabetes.
• Often just one daily dose—no need for awkward timing.
• Helps lower risk of heart failure hospitalization.

Cons

• Can cause dizziness, especially when starting or upping the dose.
• Not great in pregnancy—like, seriously, skip it if you’re pregnant or planning.
• Might raise potassium, so your doctor may want to check your labs.
• Not as effective for African American patients unless paired with other drugs.

Doctors often check kidney function and potassium before and during treatment. If you’re already on other meds that mess with potassium—like certain water pills or supplements—bring it up so you don’t end up with too much potassium in your system.

All in all, valsartan is a solid pick when Benazepril alternatives are on the table. Just keep tabs on your labs and speak up about any side effects—it usually works out pretty smoothly for most people.

Enalapril

If you’re looking for an ACE inhibitor that works a lot like Benazepril, Enalapril is usually the first place doctors look. Enalapril’s been around for years, and it’s considered a rock-solid choice for lowering blood pressure and helping with heart failure, especially if someone’s had recent heart trouble or high blood pressure that’s stubbornly high.

Enalapril works by blocking the angiotensin-converting enzyme, which keeps blood vessels from tightening up. That makes it easier for blood to flow and helps your heart work less. People often use it after a heart attack or if kidneys are starting to have issues from diabetes, so it’s a true multitasker in the hypertension treatment toolkit.

The dosing is flexible. Some folks take it once a day, some split it twice a day, depending how their numbers look. It’s available as a generic and is usually pretty affordable. And if you ever forget a dose, there’s no panic—missing one isn’t likely to throw your whole blood pressure out of whack.

Pros

• Well-studied and trusted for all stages of high blood pressure.
• Useful for heart failure and protecting kidneys in diabetics.
• Comes in generic, usually covered by insurance.
• Flexible dosing, so it can fit with different routines.
• Proven track record for lowering risk of stroke and heart attacks.

Cons

• Can cause a dry, nagging cough that won’t quit—this happens to about 1 in 10 people.
• Not a good pick if you’ve had swelling of lips or face (angioedema) with other ACE inhibitors.
• Might not mix well with certain diuretics or supplements that mess with potassium—may raise potassium levels too much.
• Shouldn’t be used during pregnancy, period.

Quick tip: If you’re switching from Benazepril to Enalapril, tell your doc if you’ve ever had issues with swelling or cough before. Enalapril can act up for the same reasons. Also, you’ll want to check your kidney function and potassium on a regular schedule once you start this medication—it’s a little hassle that makes a big difference for your long-term health.

Hydrochlorothiazide

Hydrochlorothiazide stands out because it’s not an ACE inhibitor, but a thiazide diuretic. Basically, it helps your body get rid of extra salt and water through urine, which lowers blood pressure. It’s one of the oldest and most prescribed blood pressure medications in the world, especially popular as an add-on when one drug just isn’t enough. If you see something called HCTZ on your prescription bottle, that’s just the shorthand for this med.

This drug works especially well for people with mild to moderate hypertension and can be a good first step if you don’t have other major health issues. Because it doesn’t mess directly with the heart or arteries, it’s seen as a pretty gentle option—unless you have kidney problems, then you’ll need extra monitoring.

Pros

• Lower cost than a lot of other Benazepril alternatives, plus it’s easy to get at nearly every pharmacy.
• Once a day dosing—no need to mess with pills all day long.
• Reduces the risk of stroke in those with high blood pressure.
• Often combined with other meds to get even better control.
• Less likely to cause pesky cough compared to ACE inhibitors like Benazepril or Lisinopril.

Cons

• Can lower potassium—so you might need labs to check your levels.
• Raises blood sugar and cholesterol slightly, which could be tricky for people with diabetes.
• Might cause more urination, so if you have to pee a lot, that could get annoying.
• Not the best pick for those with gout or regular kidney trouble.
• Rarely, can make skin more sensitive to sunlight—bring the sunscreen.

If you’re curious how common side effects are, here’s what the numbers look like in real life:

Bottom line—Hydrochlorothiazide is a classic for a reason, but even classics have quirks. Worth talking to your doctor about if cost, convenience, and track record matter to you.

Metoprolol

Metoprolol is a beta blocker—a totally different kind of blood pressure medicine compared to Benazepril alternatives like ACE inhibitors or ARBs. Instead of relaxing blood vessels, metoprolol mostly works by slowing down your heart rate and making each beat less forceful. This drop in pressure is what helps keep your heart from working too hard, which can be a game changer if you’ve had a heart attack or deal with AFib, angina, or even migraines.

The cool thing about metoprolol? It’s been around for decades, so docs really know how it acts in the real world. Two main flavors exist: metoprolol tartrate (short-acting, usually taken twice daily) and metoprolol succinate (long-acting, good for once-daily dosing). The long-acting type (succinate) is the one doctors reach for more often when treating high blood pressure since it keeps your numbers steady with just one pill a day.

Pros

• Reduces risk of another heart attack if you’ve already had one.
• Great for controlling heart rhythm in AFib patients.
• Helps with certain cases of chest pain (angina) and even migraine prevention.
• Well-studied and affordable, often available as a generic.

Cons

• Can cause fatigue, slower heart rate, and sometimes dizziness—especially when you first start.
• Not the top choice if you have asthma or certain lung conditions (can make wheezing worse).
• May cause cold hands and feet, and in rare cases, make depression feel worse.
• Can mask symptoms of low blood sugar in people with diabetes.

One quick tip: If you ever need to stop metoprolol, don’t just quit cold turkey. Work with your doctor to ease off it slowly—sudden stopping could spike your blood pressure and heart rate, which nobody wants. For folks searching for antihypertensive drugs that double up with heart benefits, metoprolol definitely lands near the top of the list.

Diltiazem

Diltiazem isn’t just another option on the list—it’s a go-to calcium channel blocker, much like amlodipine but with its own twist. If you’re looking for a Benazepril alternative because your blood pressure’s still too high or you’ve got a racing heart, diltiazem could be a good fit. This drug mainly targets both your heart rate and how hard your heart has to work. That means it’s not only used for high blood pressure, but also for angina (chest pain) and specific rhythm issues like atrial fibrillation.

Here’s something cool: because diltiazem slows your heart and relaxes vessels at the same time, doctors sometimes pick it for people who can’t take beta-blockers. If you have asthma or a really low resting heart rate, this might come up in your doctor’s office.

Pros

• Helps control both blood pressure and heart rate—two birds, one stone.
• Usually doesn’t mess with your potassium or kidney function.
• Can be used if you have certain heart rhythm issues—some other meds can’t handle both jobs.
• Long-acting versions mean fewer doses a day for most people.

Cons

• Can cause swelling in hands or feet (peripheral edema)—sometimes annoying, sometimes not.
• Might make you feel tired, dizzy, or even lightheaded if your blood pressure drops too much.
• Can interact with other drugs, especially if you’re already on meds for heart rhythm or cholesterol.
• If you have a slow heart rate already, diltiazem isn’t for you—could make it worse.

Here’s a quick table that breaks down how diltiazem stacks up as a Benazepril alternative:

People switching from ACE inhibitors, like Benazepril, sometimes feel a bit less cough or angioedema risk on diltiazem. But as always, watch for swelling or weird fatigue. If you’re juggling several meds, make sure your doctor checks for drug interactions—diltiazem likes to mingle.

Spironolactone

Spironolactone isn’t your average blood pressure pill—it works as an aldosterone antagonist, which basically means it blocks a hormone that makes your body hold onto salt and water. When you block aldosterone, the kidneys kick out extra sodium and water, and your body hangs onto potassium instead. This makes spironolactone a solid option for folks dealing with hypertension, especially when standard meds don’t do the trick or if someone also has problems with things like heart failure or swelling.

Spironolactone is sometimes called a “potassium-sparing diuretic.” Unlike other water pills that can drain your potassium levels, this one actually bumps them up. Doctors often turn to spironolactone when they want to lower blood pressure and reduce swelling—especially if there’s a history of heart issues. Notably, it’s probably the go-to pick if someone also struggles with resistant hypertension (high blood pressure that doesn’t respond to at least three meds).

Pros

• Helpful for resistant hypertension—when other meds aren’t enough.
• Reduces fluid buildup, so it’s also used in heart failure and conditions like liver cirrhosis.
• Often boosts potassium, which can be a good thing if you tend to run low.
• Proven record in treating certain hormonal issues, like PCOS and hyperaldosteronism.
• Good add-on when standard blood pressure medications aren’t cutting it.

Cons

• Can cause high potassium (hyperkalemia)—worth checking with blood tests now and then, especially if you have kidney issues.
• Not everyone likes the hormonal side effects: enlargement or tenderness of breasts (especially in men), changes in periods for women, or decreased libido.
• Might make you pee more at first, but your body often adjusts.
• Needs regular check-ins to monitor electrolytes and kidney function.
• Headaches, dizziness, and sometimes tummy troubles (nausea, diarrhea) crop up for some people.

Here’s a quick look at how spironolactone compares to standard diuretics when it comes to potassium levels:

If you’re running out of patience with regular ACE inhibitor substitute meds, or you’ve got heart, kidney, or hormone issues on top of high blood pressure, spironolactone’s worth a conversation. Just be ready to get your blood checked more often—it’s not the kind of pill you want to take and just forget about. But for the right person, it can make a real difference.

Summary & Comparison Table

Making sense of blood pressure meds gets a lot easier when you can see the big picture all at once. Swapping out Benazepril? Good news: it's not just one-size-fits-all. These meds have their own strengths, side effects, and reasons your doctor might steer you toward—or away from—each one.

Here’s a head-to-head look at the main options many doctors reach for. If you're stuck picking between a calcium channel blocker or an ARB, for example, this makes it clearer. It’s also a quick way to spot options that match best with issues like diabetes, kidney problems, or needing something with once-a-day dosing. Scan for what matters most in your day-to-day (no one likes running to the pharmacy twice a week or getting hit with relentless swelling).

When you’re deciding which Benazepril alternative makes sense, think about what else is going on with your health. For example, if you’re stubbornly high on blood pressure and can’t handle cough, an ARB like Losartan or Valsartan could be a smart move. Swelling after starting a calcium channel blocker like Amlodipine? Not rare—the numbers show up to 10% of folks will get some ankle puffiness. If you’re worried about extra bathroom trips, steer clear of Hydrochlorothiazide unless your doc says it’s absolutely needed.

Always ask your doctor for lab checks when starting something new. Some meds can sneakily change kidney function or potassium levels, especially if you have any other medical conditions. As you can see, you’ve got choices—the best blood pressure medication is the one you’ll actually take that keeps your hypertension in check without wrecking your week.