Propranolol vs Lisinopril

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For patients dealing with hypertension or certain types of heart conditions, specific drugs that alter the functioning of cardiovascular system can help in managing symptoms and preventing complications. Propranolol and Lisinopril are two such medications that are often prescribed for these conditions. They each impact different aspects of the cardiovascular system but both have beneficial effects on blood pressure regulation and cardiac function. Propranolol is a beta-blocker which reduces heart rate, decreases blood pressure, and helps to prevent angina (chest pain) by blocking the action of certain natural chemicals in your body like adrenaline on the heart and blood vessels. On the other hand, Lisinopril is an angiotensin converting enzyme (ACE) inhibitor which works by relaxing blood vessels so that blood can flow more easily, thereby lowering high blood pressure—a key element in preventing strokes, heart attacks, and kidney problems.

What is Propranolol?

Propranolol (Inderal) was the first drug of its class, beta blockers, which marked a significant advancement from the first drugs for hypertension. Propranolol was approved by the FDA in 1967 and functions by blocking beta receptors in various parts of your body, reducing heart rate and blood pressure. It is primarily prescribed for treating conditions such as high blood pressure, chest pain caused by poor heart flow, and irregular heartbeat.

On the other hand, Lisinopril belongs to a class of medications called ACE inhibitors and was approved by FDA later in 1987. This medication works differently than propranolol; it inhibits an enzyme known as angiotensin-converting enzyme (ACE), leading to dilation of blood vessels which results in lowered blood pressure and decreased workload on the heart.

While both drugs are used to manage similar health issues like hypertension or certain types of heart failure, they do so through different mechanisms and may cause differing side effects. For instance, propranolol may result in slower pulse rates whereas lisinopril might lead to dry coughs.

What conditions is Propranolol approved to treat?

Propranolol is approved for the treatment of a variety of conditions:

  • Hypertension, also known as high blood pressure
  • Angina pectoris (chest pain usually caused by lack of oxygen to the heart due to clogged arteries)
  • Migraine headaches prevention
  • Certain types of tremors
  • Hyperthyroidism (overactive thyroid)

Meanwhile, Lisinopril is typically used in treating:

  • Hypertension, both alone and in combination with other medications.
  • Heart failure. It can be used alongside other medication to enhance survival after an acute myocardial infarction (heart attack).

How does Propranolol help with these illnesses?

Propranolol helps to manage high blood pressure and other heart conditions by blocking the action of certain natural substances in your body, such as adrenaline, on the heart and blood vessels. This effect reduces heart rate, blood pressure, and strain on the heart.

Lisinopril also works to lower high blood pressure but it does this by inhibiting an enzyme known as angiotensin converting enzyme (ACE). By doing so, it decreases the production of a substance called angiotensin II which narrows the arteries and releases hormones that can raise your blood pressure. Thus lisinopril relaxes arterial tension or resistance leading to decreased blood pressure.

Both Propranolol and Lisinopril are used for treating hypertension but they work through different mechanisms within your body. It's important to note that while both drugs help control high BP, they cannot cure hypertension.

What is Lisinopril?

Lisinopril, sold under the brand name Prinivil among others, is an angiotensin converting enzyme (ACE) inhibitor. This means it works by blocking the action of a certain chemical involved in tightening blood vessels, helping to relax and widen them which results in lower blood pressure and better blood flow. Lisinopril was first approved by the FDA in 1987. It differs from beta blockers such as propranolol because it doesn't directly affect heart rate or contractibility but primarily targets vessel dilation to reduce work on your heart. While side effects can include dizziness due to decreased blood pressure, it does not usually cause fatigue or lethargy as may be experienced with beta-blockers like propranolol. Its primary effect on reducing hypertension makes lisinopril particularly useful for patients with high-risk cardiovascular conditions such as history of heart attack or stroke.

What conditions is Lisinopril approved to treat?

Lisinopril, widely used in the field of cardiovascular medicine, is approved by the FDA for several conditions including:

  • Hypertension (high blood pressure)
  • Congestive heart failure
  • After acute myocardial infarction (heart attack) to improve survival.

How does Lisinopril help with these illnesses?

Angiotensin II is a hormone that can cause blood vessels to constrict and promote the release of another hormone, aldosterone, which leads to water retention in the body. Both these actions result in increased blood pressure. Lisinopril works by inhibiting an enzyme known as angiotensin-converting enzyme (ACE), thereby reducing the production of angiotensin II. This results in wider and relaxed blood vessels, along with reduced volume of fluid in the body—both contributing to lower blood pressure levels.

Its mechanism differs from Propranolol which primarily blocks beta-adrenergic receptors thereby slowing heart rate and reducing cardiac output. While both are used for managing high blood pressure, Lisinopril is often preferred as a first-line treatment especially for patients with certain conditions like heart failure or diabetes due to its additional kidney-protective effects. It may also be a better option for those who do not respond well or have contraindications towards beta-blockers such as Propranolol.

How effective are both Propranolol and Lisinopril?

Both propranolol and lisinopril have a long-standing history in managing cardiovascular conditions such as hypertension. They were initially approved by the FDA only a few years apart, with propranolol approval dating back to 1967 and lisinopril in 1987. As they work on different aspects of blood pressure regulation, they may be prescribed under varying circumstances.

Propranolol is a non-selective beta blocker which reduces heart rate and cardiac output while lisinopril operates as an ACE inhibitor that prevents the formation of angiotensin II leading to vasodilation. The effectiveness of both drugs in treating hypertension was studied extensively; both exhibited similar efficacy levels but had distinct side effect profiles.

A meta-analysis review from 2000 showed that propranolol effectively manages hypertension symptoms during its initial stages alongside having preventive effects for migraine headaches and certain types of tremors. It's also used off-label for anxiety due to its calming effect on the heart rate.

On another note, Lisinopril has been found effective not just in lowering blood pressure but also providing kidney protection for diabetes patients and improving survival rates post-heart attack - according to a study published in 2005. Nonetheless, Lisinopril is considered first-line treatment given it enhances outcomes beyond simply alleviating high blood pressure symptoms such as preventing congestive heart failure progression or reducing diabetic nephropathy risk.

In conclusion, choosing between these two medications largely depends on patient needs considering their unique pharmacology offers benefits spanning beyond mere hypertension control: Propranolol might be optimal for patients requiring additional management for migraines or anxiety issues while Lisinopril could benefit those needing kidney protection or improved prognosis following myocardial infarctions.

abstract image of a researcher studying a bottle of drug.

At what dose is Propranolol typically prescribed?

Oral dosages of Propranolol range from 20-240 mg/day for treating high blood pressure. However, many people find that a dosage of 80mg per day is sufficient to manage their symptoms. For children and adolescents, the starting dosage typically ranges between 2-4 mg/kg/day. In either population, if there is no response after a few weeks, the dosage can be increased gradually under medical supervision. The maximum daily dose should not exceed 640mg for adults or 16mg/kg for children.

On the other hand, Lisinopril dosages range from 10-40 mg/day when used in treating hypertension with most patients finding an initial dose of 20mg per day effective. Children's dosage will vary based on weight but usually begins at around .07 mg/kg up to a maximum of about 5mg total daily dose. Just like Propranolol, if there isn't an adequate response after several weeks, your healthcare provider may increase the amount slowly over time while monitoring side effects and potential complications closely.

At what dose is Lisinopril typically prescribed?

Lisinopril treatment typically commences with a dosage of 10 mg/day. Depending on the patient's response to the medication, this dose can be increased up to 40 mg/day, usually divided into two doses taken 12 hours apart. The maximum daily dose is generally not more than 80 mg which may be tested if there is no satisfactory reduction in blood pressure or improvement in heart failure symptoms after several weeks at lower dosages. As always, it's crucial to follow your doctor's advice when taking Lisinopril, and remember that adjustments might take place based on your body’s response and tolerance to the drug.

What are the most common side effects for Propranolol?

Common side effects of propranolol include:

  • Fatigue and weakness
  • Cold hands or feet
  • Dizziness or lightheadedness
  • Shortness of breath or trouble breathing
  • Insomnia, nightmares, sleep disturbances
  • Nausea and vomiting
  • Diarrhea
  • Slow heart rate

On the other hand, common side effects of lisinopril can include:

  • Dry cough
  • Dizziness due to low blood pressure upon standing (orthostatic hypotension)
  • Headache and fatigue
  • Nausea, diarrhea or constipation
  • Skin rash

Remember that everyone's body may react differently to medications. If you encounter any unusual symptoms after starting a new medication, it's always best to consult your healthcare provider for advice.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Propranolol?

When comparing Propranolol and Lisinopril, it's crucial to understand the potential side effects of each. For Propranolol, these can include:

  • Shortness of breath or trouble breathing
  • Signs of an allergic reaction: hives; difficulty breathing; swelling in your face, lips, tongue or throat
  • Blurred vision
  • Unusually slow heartbeats
  • Light-headedness feeling like you might pass out
  • Low blood sugar - headache, hunger, sweating, irritability,dizziness

For Lisinopril:

-Severe stomach pain (with or without nausea) -Signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling in your face,lips,tongue or throat. -Kidney problems - little or no urination,sore throat,painful mouth sores,pain when swallowing,a cold/flu that does not go away
-Liver problems - dark urine,yellowing eyes/skin,stomach/abdominal pain. -High potassium level - nausea weakness,tachycardia,numbness tingling.

In the case of either drug if you experience any serious side effects mentioned above contact healthcare provider immediately.

What are the most common side effects for Lisinopril?

When compared to Propranolol, Lisinopril has its own set of potential side effects. These may include:

  • Dry cough
  • Dizziness and lightheadedness due to low blood pressure
  • Increased urination
  • Headache
  • Nausea, vomiting, or diarrhea
  • Stomach pain and loss of appetite
  • Rash or itching
  • Tiredness or fatigue
    While these side effects are generally less severe than those associated with other medications, it is still important for individuals taking Lisinopril to monitor their symptoms closely and seek medical attention if these become bothersome.

Are there any potential serious side effects for Lisinopril?

While Lisinopril is generally well tolerated, it can occasionally lead to serious side effects. Key signs of adverse reactions include:

  • Indications of an allergic reaction such as swelling on the face, lips, tongue or throat; difficulty breathing; hives
  • Signs of a severe skin reaction including skin pain followed by a red or purple rash that spreads throughout the body leading to blistering and peeling
  • Symptoms suggestive of liver problems like yellowing eyes/skin (jaundice), unusually dark urine or abdominal pain
  • Lightheadedness with a feeling like you might pass out – potentially indicative of low blood pressure
  • Sudden weakness on one side, slurred speech - potential signs of stroke
  • High potassium levels which may cause nausea, slow or unusual heart rate, muscle weakness. If any such symptoms are experienced while taking Lisinopril, immediate medical attention should be sought.

Contraindications for Propranolol and Lisinopril?

Both propranolol and lisinopril, similar to other blood pressure medications, could cause potential side effects such as lightheadedness or fatigue. If you notice these symptoms worsening, or an increase in fainting spells, please seek immediate medical attention.

Neither propranolol nor lisinopril should be taken if you are taking, or have recently stopped taking any medication for diabetes without consulting your doctor. This is due to the fact that these drugs can mask signs of low blood sugar (hypoglycemia), which may lead to complications if not managed properly. It's essential to inform your physician about all medications you are currently on; this includes over-the-counter drugs and herbal supplements.

For those with asthma or other breathing issues, caution is advised when using propranolol as it may exacerbate these conditions. Lisinopril can cause a persistent dry cough and should also be used cautiously in individuals with kidney disease.

How much do Propranolol and Lisinopril cost?

For the brand name versions of these drugs:

  • The price of 60 tablets of Inderal (propranolol, 40 mg) averages around $100, which works out to approximately $1.67/day.
  • The price of 30 tablets (20 mg each) of Prinivil or Zestril (lisinopril), is about $120, working out to roughly $4/day.

Thus, if you're taking a standard daily dose for either drug, then brand-name propranolol/Inderal may be less expensive on a per-day basis compared to lisinopril/Prinivil or Zestril. However, cost should not be your primary consideration when choosing between these medications; it's crucial to consider their effectiveness and suitability for your specific medical condition.

The costs are significantly lower for generic versions:

  • Generic propranolol (40mg tablets) can be found in packs from 30 up to 90 capsules with approximate costs ranging between $0.10 and $0.35 per day depending on the quantity purchased and dosage taken.
  • Generic lisinopril is available in packs from 30 up to 90 capsules as well with prices starting from as low as about $0.13/day and not exceeding about $0.50/day based on quantity purchased and dosage taken.

Popularity of Propranolol and Lisinopril

Propranolol, available in generic form and under brand names such as Inderal among others, was estimated to have been prescribed to about 2.5 million people in the US in 2019. Propranolol accounted for just over 3% of beta-blocker prescriptions in the US. It is a non-selective beta blocker that has been used extensively since its introduction in 1964.

On the other hand, Lisinopril including brand versions such as Prinivil and Zestril, was prescribed to an astounding number of approximately 87.4 million people in the USA during the same year - it is one of the most-prescribed medications nationwide. In fact, lisinopril accounts for around 35% of overall ACE inhibitor prescriptions. The prevalence of lisinopril has generally increased over time due to its efficacy and cost-effectiveness when dealing with high blood pressure and heart failure conditions.


Both Propranolol and Lisinopril have long-standing records of usage in patients with high blood pressure, and are backed by numerous clinical studies indicating that they are more effective than placebo treatments. In some cases, the drugs may be combined to achieve better results, but this is subject to careful consideration by a physician as they can also interact with one another. Due to their different mechanisms of action - Propranolol being a beta-blocker that reduces heart rate and Lisinopril being an ACE inhibitor that relaxes blood vessels - they tend to be prescribed under different circumstances.

Propranolol is often used when there's need for immediate control of symptoms like rapid heartbeats or tremors in addition to controlling high blood pressure, whereas Lisinopril would usually be considered as a first-line treatment option specifically for hypertension. Both drugs are available in generic form which represents significant cost savings especially for patients who must pay out-of-pocket.

The side effect profile differs between the two drugs; both being generally well-tolerated but Propranolol has been associated with cold hands or feet, depression and sleep disturbances while Lisinopril could cause coughing and kidney impairment if not monitored carefully. For both medications it is important for patients to regularly monitor their blood pressure especially during the initial stages of taking these medicines.