Lisinopril alternatives: What can I take instead of lisinopril?

In this article:

• What can I take in place of lisinopril?
• Top 5 lisinopril alternatives
• Compare Lisinopril alternatives
• Natural alternatives to lisinopril
• How to switch to a lisinopril alternative

In this article

• What can I take in place of lisinopril?
• Top 5 lisinopril alternatives
• Compare Lisinopril alternatives
• Natural alternatives to lisinopril
• How to switch to a lisinopril alternative

Lisinopril is one of the most prescribed medications for hypertension (high blood pressure) and is often known by the brand names Prinivil (discontinued) and Zestril. Besides being an antihypertensive, lisinopril is also approved by the Food and Drug Administration (FDA) for treating heart failure and improving survival after a heart attack. Althoughde its use is widespread, lisinopril is not irreplaceable. Several lisinopril alternatives exist, providing options for times when lisinopril is contraindicated or its side effects are intolerable.

What can I take in place of lisinopril?

There are many other options available to treat high blood pressure. These alternative prescription medications include other types of angiotensin-converting enzyme inhibitors (ACE inhibitors) or other classes of blood pressure medications such as angiotensin II receptor blockers (ARBs), calcium channel blockers, and diuretics. These options may be more suitable for certain people due to their different uses, side effects, and dosages.

For children and those who have trouble swallowing, Qbrelis is the oral liquid version of lisinopril. It can be a good alternative in cases when it’s not feasible to switch to a completely new drug.

Top 5 lisinopril alternatives

1. Lotensin (benazepril)

Benazepril is an ACE inhibitor in the same class as lisinopril and works just as well to lower blood pressure. Both drugs share similar side effects, with cough, dizziness, and headache among the most common. Although benazepril doesn’t carry FDA approval for heart failure or use after a heart attack, it is available in more combination products than lisinopril. Benazepril can be found as a combination drug with hydrochlorothiazide (Lotensin HCT) and amlodipine (Lotrel), while lisinopril is only paired with hydrochlorothiazide (Prinzide, Zestoretic).

Related: Benazepril dosage

2. Diovan (valsartan)

A dry, tickling cough is a side effect that affects many people taking ACE inhibitors, often resulting in a search for alternatives. That search might land on valsartan, part of the ARB drug class that includes Cozaar (losartan), Benicar (olmesartan), and Atacand (candesartan). 

ARBs work through a slightly different pathway but provide similar cardiovascular and kidney protection. Like lisinopril, valsartan is approved for high blood pressure, heart failure, and post–heart attack treatment, which makes it a versatile substitute.

Another advantage of valsartan is the availability of combination drugs. Valsartan is often paired with HCTZ (Diovan HCT), amlodipine (Exforge), and both HCTZ and amlodipine (Exforge HCT).

3. Hydrochlorothiazide (HCTZ)

Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure by helping the kidneys remove excess salt and water. Unlike lisinopril, which can raise potassium, HCTZ may lower potassium levels. For those with high potassium levels on lisinopril, HCTZ may be a viable alternative. 

HCTZ is widely available as a low-cost generic and is often used in combination with other blood pressure drugs for added effect. Pairing it with an ACE inhibitor such as lisinopril has a proven synergistic effect, but it can also be prescribed alone or in other fixed-dose combinations.

4. Norvasc (amlodipine)

Amlodipine is a calcium channel blocker that relaxes blood vessels to lower blood pressure. Unlike lisinopril, it does not affect potassium levels or kidney function, making it a valuable alternative for patients with electrolyte imbalances. Common side effects include ankle swelling, flushing, and headache.

While amlodipine is a first-line option for hypertension, it is not approved for heart failure with reduced ejection fraction and may worsen edema in some patients. Still, its once-daily dosing, good tolerability, and availability in combination pills (such as with valsartan in Exforge) make it a practical substitute or add-on therapy.

RELATED: How does lisinopril affect your kidneys?

5. Toprol XL (metoprolol succinate)

Metoprolol succinate is a beta blocker that can lower blood pressure and decrease stress on the heart. Unlike lisinopril, it does not affect potassium levels or cause cough, but side effects can include fatigue, dizziness, and low heart rate. 

Beta blockers are not usually the first choice for uncomplicated hypertension. However, metoprolol succinate is approved for hypertension, chest pain, and heart failure, which makes it a potential lisinopril alternative. Toprol XL’s once-daily dosing is also convenient for many when a beta blocker is needed.

Compare Lisinopril alternatives
Drug name	Price without insurance	SingleCare price	Savings options
Zestril (lisinopril)	$1,434 per 90, 10 mg tablets	$7 per 90, 10 mg tablets of generic Zestril	See latest prices
Vasotec (enalapril)	$1,003 per 30, 20 mg tablets	$9 per 30, 20 mg tablets of generic Vasotec	See latest prices
Lotensin (benazepril)	$75 per 30, 10 mg tablets	$8 per 30, 10 mg tablets of generic Lotensin	See latest prices
Microzide (HCTZ)	$19 per 30, 25 mg tablets	$4 per 30, 25 mg tablets of generic Microzide	See latest prices
Zestoretic (combination lisinopril/hydrochlorothiazide)	$483 per 30, 20-12.5 mg tablets	$3 per 30, 20-12.5 mg tablets of generic Zestoretic	See latest prices
Cozaar (losartan)	$682 per 90, 100 mg tablets	$11 per 90, 100 mg tablets of generic Cozaar	See latest prices
Diovan (valsartan)	$1,135 per 90, 160 mg tablets	$29 per 90, 160 mg tablets of generic Diovan	See latest prices
Norvasc (amlodipine)	$419 per 30, 10 mg tablets	$4 per 30, 10 mg tablets of generic Norvasc	See latest prices
Cardizem CD (diltiazem extended release)	$3,128 per 90, 120 mg capsules	$6 per 30, 120 mg capsules of generic Cardizem CD	See latest prices
Toprol XL (metoprolol extended release)	$160 per 90, 25 mg tablet	$9 per 90, 25 mg tablet of generic Toprol XL	See latest prices
Cardura (doxazosin)	$674 per 90, 4 mg tablets	$16 per 90, 4 mg tablets of generic Cardura	See latest prices

Drug prices fluctuate and vary by pharmacy and location. These are the most current prices as of the time of publication. 

Natural alternatives to lisinopril

Before resorting to lisinopril or other prescription drugs for hypertension, a healthcare provider may recommend lifestyle changes, which can be used alone or combined with drug therapy: 

• Weight loss and exercise 
• Dietary salt restriction 
• More involved dietary adjustments: For example, the Dietary Approaches to Stop Hypertension clinical trial showed that a diet rich in fruits and vegetables, with low-fat dairy and low saturated and total fat, effectively lowers blood pressure (now called the DASH diet). 

Over-the-counter vitamins and supplements are often of interest, but they typically have little proof of efficacy and safety. Potassium, magnesium, fish oil, fiber, protein, and folate have all shown some promise in blood pressure reduction. Interestingly, pomegranate juice seems to lower blood pressure somewhat, possibly by inhibiting angiotensin-converting enzymes. Seek medical advice from a healthcare provider to see if any vitamin, supplement, or lifestyle change is advisable, as drug interactions may occur.

How to switch to a lisinopril alternative

You may have reached the conclusion to switch from lisinopril to an alternative blood pressure medication, but it’s important to talk this over with a healthcare professional beforehand. Adverse effects are a common reason to change, particularly cough. Certain side effects and allergic reactions require quick action, though, with angioedema (swelling of the face, lips, or throat) and high potassium levels often needing immediate medical attention.

Heart health resources and coupons

Sometimes the decision is based on added benefits. For example, drugs like Cardura (doxazosin) may help with both blood pressure and prostate symptoms. Still, it’s worth reviewing whether lisinopril is already offering other secondary benefits before making the switch. A provider can help weigh the trade-offs and recommend the safest alternative.

Cost may be another reason to compare alternatives to lisinopril. Although a relatively affordable generic drug, lisinopril can still cost almost $200 for 90, 10 mg tablets without insurance. A SingleCare prescription savings card can help you save up to 80% off on your next lisinopril refill or an alternative.