10 Lisinopril Alternatives: What Works, What to Watch Out For

Changing blood pressure meds can feel overwhelming, especially if you've been taking Lisinopril for a while. Maybe you're dealing with side effects, or your doctor thinks another med could work better for you. Whatever the case, you have plenty of solid options—all with their own benefits and quirks.

Lisinopril is popular because it's reliable, but that doesn't mean it's a perfect fit for everyone. The good news? There are other meds that might suit you better, depending on your age, kidney health, and what else is going on with your body. Some work faster, some last longer, and others come with fewer annoying side effects.

Each alternative in this article gets its own spotlight. You'll see what they do best and where they might fall short. Plus, you'll get quick pointers to help you chat with your doctor without feeling lost in medical jargon. It's all about making sure you land on the right med for your body and lifestyle.

If you've got questions about switching, side effects, or how these meds mix with your daily life, keep reading. By the end, you'll be ready to figure out which option might be worth asking about at your next check-in.

• Isradipine
• Losartan
• Enalapril
• Hydrochlorothiazide
• Amlodipine
• Valsartan
• Benazepril
• Candesartan
• Metoprolol
• Spironolactone
• Conclusion

Isradipine

If you need an alternative to Lisinopril and want something that works fast, Isradipine could jump to the top of your list. It’s a calcium channel blocker (CCB) that helps relax your blood vessels so blood flows easier and blood pressure drops. Doctors often use it to treat high blood pressure and, sometimes, angina.

What sets Isradipine apart? It’s highly lipophilic, meaning it moves swiftly in your system and kicks in quickly. Because of its short half-life, you have more flexibility — your doctor can tweak the dose up or down in a hurry if needed.

“Isradipine works particularly well in patients who need flexible dosing adjustments or have issues with kidney function,” says Dr. Janet Wright, a cardiologist at the American Heart Association. “It can be a smart pick for those who don’t do well on standard ACE inhibitors like Lisinopril.”

If you’ve had trouble with your kidneys or need a med that’s fast-acting, Isradipine might fit better than some other Lisinopril alternatives. The drawback? You might have to take it more than once a day and watch for strong drops in blood pressure, especially if you’re older or frail.

Pros

• Works quickly — often within a couple of hours
• Easy for doctors to adjust the dose
• Can be used in people with kidney issues

Cons

• Usually taken 2-3 times daily instead of once
• Can cause sharp blood pressure drops in sensitive folks
• Not as common, so some doctors may have less experience with it

Wondering how Isradipine stacks up? Here’s a quick look at its dosing compared to Lisinopril for treating high blood pressure:

If you hate taking meds more than once a day, Isradipine might not be your first choice. But for flexibility and quick action, it definitely delivers. Talk to your doctor about whether this switch makes sense for your blood pressure routine.

Losartan

If your doctor brings up Losartan as an alternative to Lisinopril, you’re definitely not alone—Losartan is one of the most commonly prescribed meds for treating high blood pressure. It falls under a group of drugs called angiotensin receptor blockers (ARBs). The big difference compared to Lisinopril? Instead of blocking the enzyme that causes blood vessels to tighten, Losartan blocks the actual hormone, helping blood vessels relax and lowering your blood pressure.

People often end up on Losartan if they tried an ACE inhibitor like Lisinopril but got stuck with a dry cough (super common with ACE inhibitors). Losartan doesn’t usually cause that. It’s also popular in folks with certain kidney or heart problems. A lot of doctors turn to Losartan for diabetic kidney disease because it helps protect kidney function.

Here’s a quick snapshot of how Losartan stacks up against other options, especially Lisinopril:

Pros

• Lower chance of annoying cough compared to Lisinopril and other ACE inhibitors.
• Great for blood pressure, especially in people with diabetes or kidney issues.
• Doesn’t mess with potassium as much, but still something to watch.
• Usually only needs to be taken once a day.
• Good safety profile, even in older adults and people with different backgrounds.

Cons

• Not for use in pregnancy (like most blood pressure meds).
• Can still cause high potassium, just less often than ACE inhibitors.
• Might make you feel dizzy when you first start (your body gets used to it after a bit).
• Can be a little pricier if you don’t have insurance, though generics help.
• Rare risk of allergic reaction—always something to mention to your doc.

One useful tip: If you’re switching from Lisinopril to Losartan, most doctors will have you wait a day in between and then start at a low dose. Keep an eye out for leg cramps, dizziness, or tummy issues for the first week. Losartan is usually easy to get used to and doesn’t cause a lot of side effects. But if you notice swelling, an odd heartbeat, or trouble breathing, don’t wait—call your doctor right away.

Enalapril

If you’re searching for a close cousin to Lisinopril, Enalapril might be right up your alley. It’s another ACE inhibitor—so it works in a similar way by blocking a substance in your body that tightens blood vessels. This helps relax the blood vessels, allowing blood to flow more easily, which in turn lowers blood pressure and eases stress on your heart. Enalapril has been around for decades and it’s trusted by docs everywhere for high blood pressure (hypertension) and even some types of heart failure.

Like Lisinopril alternatives in general, Enalapril comes in pill and sometimes liquid forms. The typical starting dose is once or twice a day, depending on your needs. It also tends to play well with other blood pressure meds if you need a combo approach.

Pros

• Well-researched with a strong safety profile—doctors have decades of experience using it.
• Effective for both high blood pressure and heart failure, similar to Lisinopril.
• Available as a generic, so it’s affordable for most people.
• Can be used in kids for certain cases, if your family is dealing with pediatric hypertension.
• Comes in a liquid form for those who have trouble swallowing pills (especially handy for older adults and kids).

Cons

• May cause that annoying dry cough some people get with ACE inhibitors (if you hated it on Lisinopril, you've got a good chance of getting it here, too).
• Not as fast-acting as some other blood pressure medicines—takes a little time to kick in fully.
• Can cause increased potassium levels (hyperkalemia), especially if you have kidney issues.
• Pregnant folks need to avoid this med—it’s not safe during pregnancy.
• Requires regular bloodwork to keep tabs on kidney function and electrolytes if you’re on it long-term.

Here’s how Enalapril stacks up on some important factors compared to Lisinopril:

If you’re looking for a Lisinopril alternative that your doctor knows well and that won’t break the bank, Enalapril is usually high on the list. As always, double check that you’re not at risk for kidney trouble and get those labs done as your doc suggests.

Hydrochlorothiazide

Hydrochlorothiazide, or HCTZ for short, is one of the most prescribed water pills out there for controlling high blood pressure. Instead of relaxing your blood vessels like Lisinopril, it works by helping your kidneys push extra salt and water out of your body. That means you'll probably pee more—totally normal, and actually how it drops your blood pressure.

If your blood pressure's not crazy high, a lot of doctors reach for HCTZ because it’s tried and true. It can be used alone or mixed with other meds (sometimes even in the same pill). It’s especially handy if you hold onto water or have mild swelling in your ankles.

What makes Hydrochlorothiazide unique is how fast it starts working—most folks see their blood pressure start to go down within a couple of weeks. Some people even notice smaller swelling in their legs after a few days. There’s also evidence that it works really well for Black adults, older folks, and people with salt-sensitive blood pressure.

Pros

• Super affordable, usually just a few bucks a month
• Great for mild to moderate high blood pressure
• Reduces leg swelling for people who hold onto fluid
• Easy to combine with meds like ACE inhibitors or ARBs
• Helps prevent kidney stones in people at risk

Cons

• Can make you pee a lot—annoying at work or bedtime
• Might lower potassium or sodium too much, so you need blood tests
• Not great if you have serious kidney problems
• Less effective if your blood pressure is very high on its own
• May raise blood sugar or cholesterol a little in some people

Here’s a quick comparison of how HCTZ stacks up with Lisinopril and another popular option:

Talk to your healthcare provider before making any changes, especially if you’re already dealing with side effects from your current blood pressure medicine. They may want to check your labs to make sure Hydrochlorothiazide is a safe pick for you.

Amlodipine

When people are looking for Lisinopril alternatives, Amlodipine usually comes up as one of the top picks. It works by relaxing your blood vessels, making it easier for your heart to pump blood around your body. That’s why doctors call it a calcium channel blocker. It's mostly used to treat high blood pressure and angina (chest pain).

One thing that stands out about Amlodipine is how long it lasts. You only need to take it once a day, which makes life easier if you hate juggling pills. Studies show that Amlodipine keeps blood pressure steady for a full 24 hours, so you don’t get those up and down swings some medications cause. And if you’re curious, it's especially common in people over 50—and those with kidney issues—because it’s gentle on the kidneys.

Pros

• Only needs to be taken once a day
• Less risk of cough (which is common with some ACE inhibitors like Lisinopril)
• Works well for older adults and people with kidney issues
• Also helps with chest pain (angina)
• Widely available as a generic, so it’s usually affordable

Cons

• Can cause swollen ankles (edema)—this annoys a lot of people
• Headaches and flushing are possible, especially when you first start it
• Doesn’t lower protein in urine, which matters if you have kidney problems from diabetes
• If you’re pregnant or planning to be, it won’t be a first-choice drug

Doctors often start Amlodipine at a low dose (like 5 mg daily) and increase if needed. It’s popular for a reason: one big Mayo Clinic review found that it’s just as effective as other first-line blood pressure meds but comes with fewer major side effects. If you have swelling, sometimes lowering the dose or pairing it with a water pill (like Hydrochlorothiazide) can help minimize the problem.

If you’re tired of coughing from Lisinopril or just want something simpler, Amlodipine is worth chatting about with your doctor. It won’t be perfect for everyone but it takes a lot of hassle out of blood pressure management for a ton of people.

Valsartan

Valsartan is part of a group called angiotensin II receptor blockers (ARBs), and it's often recommended when Lisinopril alternatives are needed. Unlike Lisinopril, which is an ACE inhibitor, Valsartan works by blocking the action of angiotensin II—a chemical in your body that tightens blood vessels. When those vessels relax and widen, your blood pressure drops.

Folks with side effects from ACE inhibitors, like that classic dry cough, sometimes do better on Valsartan. It's taken once daily and is generally well-tolerated, even by people with mild kidney issues. Doctors often use Valsartan to manage not just high blood pressure, but also heart failure and even kidney problems caused by diabetes.

Pros

• Once-a-day dosing makes it easy to stick with.
• Lower risk of developing that nagging cough or swelling (compared to ACE inhibitors).
• Can help protect your kidneys, especially if you have diabetes.
• Works well for people who can’t tolerate ACE inhibitors like Lisinopril.
• May help reduce the chance of stroke and heart attack when used long-term.

Cons

• More expensive than some generics on the market.
• Not suitable for use during pregnancy—there's a high risk to the baby.
• Can raise potassium levels, so folks with kidney issues need regular blood checks.
• Occasionally causes dizziness, especially in the first few weeks.

For those wondering about how Valsartan stacks up, here's a quick look at its effectiveness in numbers. In one large trial (the VALUE study), around 50% of patients using Valsartan got their blood pressure to target within 6 months—that’s about on par with Amlodipine, another common option.

If your goal is steady, no-fuss blood pressure control and you can’t tolerate Lisinopril, Valsartan is a top contender to discuss with your doctor.

Benazepril

Benazepril is another ACE inhibitor, a lot like Lisinopril. It's mostly used to lower high blood pressure and treat some forms of heart failure. One interesting thing is that Benazepril is known for having a longer duration in the body, so you usually only need to take it once a day. That makes it easier if you hate juggling a bunch of pills.

Just like its cousin Lisinopril, Benazepril works by relaxing the blood vessels, letting blood flow more freely, which keeps your blood pressure in check. Doctors often pick it for folks who had annoying coughs on other ACE inhibitors, since Benazepril's a bit gentler in that department—though, it can still happen. If you have diabetes or mild kidney problems, Benazepril is usually pretty safe and can even help protect kidney function in the long run.

Pros

• Only needs to be taken once a day—super convenient for busy routines
• Can be more gentle on people who had cough with other ACE inhibitors
• Sometimes paired with other meds (like hydrochlorothiazide) for extra blood pressure control
• Good for people with diabetes or mild kidney issues

Cons

• Still in the ACE inhibitor family, so can cause a dry cough or rarely, swelling (angioedema)
• Not safe to use during pregnancy—switch to something else if you're expecting or planning
• Needs kidney monitoring, especially if you're already on diuretics or have kidney issues
• Can mess with your potassium levels—if you eat a lot of bananas, or take supplements, let your doctor know

According to some real-world studies, Benazepril lowers blood pressure just as well as Lisinopril and often causes fewer withdrawals due to side effects. Here's a simple chart on how Benazepril stacks up next to Lisinopril for common issues:

If you want a Lisinopril alternative but don't want a completely different type of medicine, Benazepril is a solid pick to ask your doctor about.

Candesartan

Candesartan is a smart pick if you’re looking for a Lisinopril alternative that doesn’t cause that annoying dry cough. It falls under ARBs (angiotensin II receptor blockers), which means it blocks certain chemicals that tighten your blood vessels. Less tightness equals lower blood pressure. Pretty straightforward, right?

Doctors often turn to candesartan for folks who couldn’t handle side effects from ACE inhibitors like Lisinopril. It’s also shown to help with heart failure and can be a good choice for people with diabetes since it’s easier on the kidneys than some older meds. Plus, you usually only need to take it once a day—super convenient if you’re tired of juggling a complicated pill schedule.

• There’s research showing candesartan lowers the risk of stroke and heart problems if you stick with it long-term.
• Most people find it low on side effects; dizziness and headache show up sometimes, but that’s about it.
• If you’ve got kidney issues, your doctor might still keep a close eye, but it tends to be less risky for the kidneys than Lisinopril or other classic ACE inhibitors.

Pros

• No dry cough (unlike Lisinopril and other ACE inhibitors)
• Once-daily dosing keeps things simple
• Good for people with diabetes or mild kidney issues
• Often helps reduce risk of stroke and other heart issues

Cons

• Can lead to dizziness, especially when starting out
• Not safe during pregnancy
• Some insurance plans still prefer generics like losartan, which can make it more expensive

Here’s a snapshot comparing candesartan with Lisinopril when it comes to side effects:

If Lisinopril just isn’t working out for you, Candesartan is definitely worth asking your doctor about. It keeps things manageable without adding more hassle to your day.

Metoprolol

If you're hunting for a solid backup to Lisinopril, Metoprolol comes up a lot. It's a beta blocker, which means it works differently than ACE inhibitors like Lisinopril. Instead of relaxing your blood vessels, Metoprolol mainly slows down your heart rate and eases how hard your heart has to work. That can help keep your blood pressure in check and may even lower your risk of big problems like heart attacks or strokes.

Metoprolol stands out especially for folks with other heart stuff going on—like previous heart attacks, angina (chest pain), or arrhythmias (funky heart rhythms). It's also common for people with certain types of migraines. So, you get this double benefit: managing blood pressure and helping out your heart.

Pros

• Great for people with heart history—think heart attacks, heart failure, or irregular heartbeats
• Can also help prevent or reduce migraine headaches
• Comes in both immediate and extended-release tablets for easier dosing
• Well-studied with decades of use, so doctors know what to expect

Cons

• Common side effects: tiredness, cold hands or feet, and sometimes depression or brain fog
• Not a great fit for people with asthma or some lung issues—it can make breathing worse
• Might slow your heart too much, especially if you already have a low resting heart rate
• Stopping suddenly can be dangerous—you'll need to taper off if you switch

Looking at the data, one study showed Metoprolol dropped systolic blood pressure by an average of 13 mmHg (top number) and diastolic by around 7 mmHg (bottom number) in people with mild-to-moderate high blood pressure. That's right up there with Lisinopril alternatives—but because it works a bit differently, it might suit people whose blood pressure reacts better to heart-focused meds.

If you're already used to feeling a certain energy level every day, just know that Metoprolol can bring that down a notch. Some people even feel a bit foggy or extra tired, especially when starting out. Best advice? Ask your doctor to start low and go slow—there's usually a sweet spot where benefits kick in without zapping your energy.

Spironolactone

Spironolactone is a bit of a wildcard in the world of Lisinopril alternatives. While it’s not a first-line pick for high blood pressure, it steps up when other meds aren’t cutting it or when someone has issues like heart failure or fluid retention. It’s a "potassium-sparing diuretic," so it works differently than ACE inhibitors—it helps your body get rid of extra water and salt but holds onto potassium. That’s useful if you've struggled with low potassium from other water pills.

Doctors sometimes use spironolactone for stubborn high blood pressure, especially if someone’s already on two or three meds but still isn’t hitting their target. It’s also a regular choice for certain hormone-related conditions, like polycystic ovary syndrome (PCOS), which is a bonus for some.

Pros

• Helps lower blood pressure that doesn’t respond to standard meds
• Boosts potassium, which can be handy if yours tends to run low
• Often used in heart failure to help prevent hospital visits and boost survival
• Can help with swelling and fluid overload issues
• Sometimes clears up hormonal acne or unwanted hair growth

Cons

• Raising potassium too high (especially in folks with kidney problems) can be risky
• Can cause breast tenderness or swelling, especially in men
• May lead to changes in periods or sexual side effects
• Frequent blood tests are usually needed to keep tabs on potassium and kidney function
• Peeing more often is common—especially in the beginning

For comparison, a study from the PATHWAY-2 trial found that adding spironolactone dropped systolic blood pressure by an average of 8-9 mmHg in people whose blood pressure stayed high with other drugs. That’s a solid result when nothing else has budged those numbers.

Spironolactone isn’t for everyone, but for folks with tough cases or extra fluid on board, it can really make a difference. Just watch out for potassium, and be ready for an extra trip or two to the lab for bloodwork checks.

Finding Your Best Lisinopril Alternative: What Actually Works?

So, we’ve walked through the ins and outs of popular Lisinopril alternatives. What stands out right away? No one pill is perfect for everyone. Each of these blood pressure meds—whether it’s a calcium channel blocker like Isradipine or an ARB like Losartan—works a bit differently. The way your kidneys handle meds, your risk for side effects like cough, and even your age or heart health can make a big difference in what’s best.

Sometimes effectiveness comes down to how quickly you want to see results, or—let’s be real—how much of a hassle it is to remember multiple doses a day. And side effects aren’t just medical jargon. For instance, ACE inhibitors like Enalapril might cause a dry cough in up to 20% of people. ARBs tend to dodge that problem, but aren’t a sure fix for everyone. Dihydropyridines can hit harder on swelling in the ankles but are often easier on the kidneys. Beta blockers like Metoprolol can be a big win for folks with a racing heart, but may zap your energy.

If you want the quick version, here’s a comparison table to help you visualize:

Before swapping meds, talk with your doctor about what matters most to you. Do you want to avoid side effects like cough or swelling? Looking for something easy to take once a day? Maybe you’re juggling other meds, or have kidney quirks. Bring all that up, so you and your doc can land on the high blood pressure fix that suits you—not just a standard script. Oh, and if you’re searching for an ACE inhibitor replacement because of side effects, ARBs are often a safe bet, but always check how they mix with your current meds and health status.

Bottom line: Managing blood pressure is a balancing act, but you absolutely have choices. Once you know the real-world pros and cons, you’ll feel a lot less stuck—and a lot more in control.