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ACE Inhibitors: Summary of Recommendations

ACE inhibitors (ACEIs) are used by tens of millions of Americans to treat high blood pressure and heart failure, to prevent repeat heart attacks, to reverse thickening of the heart due to high blood pressure, and to prevent the decline of kidney function in people with high blood pressure and/or diabetes.

The monthly cost for ACEIs varies from less than $10 to more than $100. This report gives you information that could save you hundreds of dollars a year if you are currently taking a brand-name ACEI.

ACEIs are effective, life-saving medicines with more than 20 years of widespread safe use. They help lower the risk of both fatal and non-fatal heart attacks and strokes, and kidney failure. And they improve quality of life. This report compares the effectiveness, safety, and cost of the 10 ACEIs.

 We have selected the following five ACEIs as Consumer Reports Best Buy Drugs based primarily on the evidence for their effectiveness, but also on dosing convenience and cost in treating the following conditions:
  • For high blood pressure: benazepril, enalapril, and lisinopril
  • For heart failure: captopril, and enalapril
  • After a heart attack: lisinopril
  • For diabetics: ramipril
  • For people with kidney disease: benazepril, and ramipril

All of these medicines are low-cost or moderately-priced generics. All have been proven to be just as effective or superior to other ACEIs in treating the general population.

Studies have proven ramipril particularly effective in treating people who have diabetes and other heart disease risk factors, and in the prevention of kidney function decline in diabetics.

Note: The ACEIs can lower blood pressure. But studies indicate they should not be used as the initial “first-step” treatment for most people with high blood pressure who do not have heart disease, diabetes, or kidney disease. ACEIs are best used in combination with other blood pressure medicines.

ACE Inhibitors: Drug Comparison

Note: If the price box contains a , that indicates the dose of that drug is available for a low monthly cost through programs offered by large chain stores. For example, Kroger, Sam's Club, Target, and Walmart offer a month's supply of selected generic drugs for $4 or a three-month supply for $10. Other chain stores, such as Costco, CVS, Kmart, and Walgreens, offer similar programs. Some programs have restrictions or membership fees, so check the details carefully for restrictions and to make sure your drug is covered.

Generic name, dosage strength and form Brand NameA Frequency of Use (per day)B Total daily dose Average Monthly CostC Best Buy Indication Compare Prices
  Benazepril 10 mg tablet Lotensin One 10 mg $76  
Benazepril 10 mg tablet Generic One 10 mg $8 High blood pressure, for people with kidney disease
  Benazepril 20 mg tablet Lotensin One 20 mg $69  
Benazepril 20 mg tablet Generic One 20 mg $8 High blood pressure, for people with kidney disease
  Benazepril 40 mg tablet Lotensin One 40 mg $69  
Benazepril 40 mg tablet Generic One 40 mg $7 High blood pressure, for people with kidney disease
Captopril 12.5 mg tablet Generic Three 37.5 mg $21 Heart failure
Captopril 25 mg tablet Generic Three 75 mg $19 Heart failure
Captopril 50 mg tablet Generic Three 150 mg $57 Heart failure
Captopril 100 mg tablet Generic Three 300 mg $54 Heart failure
  Enalapril 5 mg tablet Vasotec One 5 mg $91  
Enalapril 5 mg tablet Generic One 5 mg $8 High blood pressure, heart failure
  Enalapril 10 mg tablet Vasotec One 10 mg $96  
Enalapril 10 mg tablet Generic One 10 mg $8 High blood pressure, heart failure
  Enalapril 20 mg tablet Vasotec One 20 mg $134  
Enalapril 20 mg tablet Generic One 20 mg $15 High blood pressure, heart failure
  Fosinopril 10 mg tablet Generic One 10 mg $29  
  Fosinopril 20 mg tablet Generic One 20 mg $26  
  Fosinopril 40 mg tablet Generic One 40 mg $29  
  Lisinopril 5 mg tablet Prinivil One 5 mg $41  
  Lisinopril 5 mg tablet Zestril One 5 mg $53  
Lisinopril 5 mg tablet Generic One 5 mg $7 Heart attack, high blood pressure
  Lisinopril 10 mg tablet Prinivil One 10 mg $46  
  Lisinopril 10 mg tablet Zestril One 10 mg $57  
Lisinopril 10 mg tablet Generic One 10 mg $6 Heart attack, high blood pressure
  Lisinopril 20 mg tablet Prinivil One 20 mg $48  
  Lisinopril 20 mg tablet Zestril One 20 mg $57  
Lisinopril 20 mg tablet Generic One 20 mg $7 Heart attack, high blood pressure
Lisinopril 30 mg tablet Generic One 30 mg $18 Heart attack, high blood pressure
  Lisinopril 40 mg tablet Zestril One 40 mg $85  
Lisinopril 40 mg tablet Generic One 40 mg $17 Heart attack, high blood pressure
  Moexipril 7.5 mg tablet Univasc One 7.5 mg $74  
  Moexipril 7.5 mg tablet Generic One 7.5 mg $32  
  Moexipril 15 mg tablet Univasc One 15 mg $89  
  Moexipril 15 mg tablet Generic One 15 mg $32  
  Perindopril 2 mg tablet Aceon One 2 mg $92  
  Perindopril 2 mg tablet Generic One 2 mg $51  
  Perindopril 4 mg tablet Aceon One 4 mg $99  
  Perindopril 4 mg tablet Generic One 2 mg $54  
  Perindopril 8 mg tablet Aceon One 8 mg $111  
  Perindopril 8 mg tablet Generic One 2 mg $63  
  Quinapril 10 mg tablet Accupril One 10 mg $70  
  Quinapril 10 mg tablet Generic One 10 mg $24  
  Quinapril 20 mg tablet Accupril One 20 mg $69  
  Quinapril 20 mg tablet Generic One 20 mg $23  
  Quinapril 40 mg tablet Accupril One 40 mg $70  
  Quinapril 40 mg tablet Generic One 40 mg $24  
Ramipril 1.25 mg capsule Generic One 1.25 mg $36 For people with diabetes or kidney disease
  Ramipril 2.5 mg capsule Altace One 2.5 mg $87  
Ramipril 2.5 mg capsule Generic One 2.5 mg $36 For people with diabetes or kidney disease
  Ramipril 5 mg capsule Altace One 5 mg $90  
Ramipril 5 mg capsule Generic One 5 mg $36 For people with diabetes or kidney disease
  Ramipril 10 mg capsule Altace One 10 mg $101  
Ramipril 10 mg capsule Generic One 10 mg $39 For people with diabetes or kidney disease
  Trandolapril 1 mg tablet Mavik One 1 mg $53  
  Trandolapril 1 mg tablet Generic One 1 mg $35  
  Trandolapril 2 mg tablet Mavik One 2 mg $52  
  Trandolapril 2 mg tablet Generic One 2 mg $35  
  Trandolapril 4 mg tablet Mavik One 4 mg $58  
  Trandolapril 4 mg tablet Generic One 4 mg $32  
A. "Generic" indicates that this drug is sold under its generic name. For example, in this table, the first drug listed is available as both generic benazepril and as brand-name Lotensin. Both have the same active ingredient. When column 2 says "generic," the price listed is for the generic version at the specified dose.

B. Depending on your health conditions, symptoms and response to the medicine, your doctor may adjust your dose to be either higher or lower than what we've stated in this price chart.

C. Prices reflect nationwide retail average for January 2011, rounded to the nearest dollar. Information derived by Consumer Reports Health Best Buy Drugs from data provided by Wolters Kluwer Pharma Solutions, which is not involved in our analysis or recommendations.