Benazepril Equivalent for Lisinopril 40mg Daily
The equivalent dose of benazepril for lisinopril 40mg once daily is benazepril 80mg once daily, based on the established 2:1 conversion ratio. 1
Conversion Ratio and Dosing
- The American College of Cardiology recommends a 2:1 conversion ratio between benazepril and lisinopril, meaning 40mg of benazepril equals 20mg of lisinopril. 1
- Therefore, to match lisinopril 40mg daily, you would need benazepril 80mg once daily. 1
Important Dosing Limitation
- However, the maximum recommended daily dose for benazepril is 40mg, which creates a practical ceiling for this conversion. 1
- Since lisinopril 40mg represents the maximum dose for both medications 1, and benazepril's maximum is also 40mg 2, you cannot achieve a true equivalent conversion when starting from lisinopril 40mg.
- In practice, benazepril 40mg once daily is the highest dose you can prescribe, though this represents only half the theoretical equivalent of lisinopril 40mg. 1
Clinical Approach
- If converting from lisinopril 40mg to benazepril, start with benazepril 40mg once daily (the maximum allowable dose). 2, 1
- Monitor blood pressure within 1-2 weeks after conversion to assess adequacy of control. 1
- Check renal function and potassium levels within 1-2 weeks, as both ACE inhibitors affect these parameters. 1
- If blood pressure control is inadequate on benazepril 40mg alone, consider adding a thiazide diuretic (such as hydrochlorothiazide 12.5-25mg) rather than attempting to exceed the maximum benazepril dose. 2
Monitoring Requirements
- Watch for hypotension, especially in volume-depleted patients or those on concurrent diuretics. 1
- Monitor for hyperkalemia, particularly in patients with renal dysfunction or those taking potassium supplements or potassium-sparing diuretics. 1
- Assess for common ACE inhibitor side effects including cough and, rarely, angioedema. 3