Key takeaways:
Angiotensin-converting enzyme (ACE) inhibitors and beta blockers are two different classes of medications. They are both used for cardiovascular conditions, such as high blood pressure and heart failure.
Lisinopril (Zestril, Qbrelis) isn’t a beta blocker. It’s an ACE inhibitor. Common beta blockers include metoprolol (Lopressor, Toprol XL, Kapspargo Sprinkle) and atenolol (Tenormin).
ACE inhibitors lower blood pressure by relaxing blood vessels in the body. Beta blockers lower heart rate, which can lead to lower blood pressure.
If needed, you can take an ACE inhibitor and a beta blocker together. A healthcare professional can help determine whether one or both of these blood pressure medications are right for you.
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There are many classes of blood pressure medications. Two common groups are angiotensin-converting enzyme (ACE) inhibitors and beta blockers. And many people take medication from both classes at the same time.
If you’re taking multiple blood pressure medications, it can be tough to remember which is which. We’ll help you keep them straight. Below, we’ll answer common questions people have when comparing ACE inhibitors versus beta blockers.
Is lisinopril a beta blocker?
No, lisinopril (Zestril, Qbrelis) is not a beta blocker. It’s an ACE inhibitor. And it’s the most commonly prescribed blood pressure medication.
What is lisinopril used for?
Lisinopril is FDA approved for:
Hypertension (high blood pressure)
Heart failure
To lower the risk of death after a heart attack
Qbrelis is a brand-name oral liquid version of lisinopril. This medication is approved for the same uses as lisinopril tablets.
What are ACE inhibitors?
ACE inhibitors are a class of cardiovascular medications. They’re used for managing high blood pressure and heart failure. They’re also one of the key medications prescribed after a person has a heart attack. Certain people living with diabetes take ACE inhibitors to help protect their kidneys.
What are beta blockers?
Oral beta blockers are a class of medications that lower heart rate and blood pressure. Beta blockers aren’t first-choice medications for managing high blood pressure. But they can be helpful if other treatments aren’t working well enough. And for people living with heart failure, certain beta blockers can help lower the risk of death from the condition.
How do ACE inhibitors and beta blockers work?
ACE inhibitors block an enzyme (protein) in your body that creates a chemical called angiotensin II. This chemical causes your blood vessels to narrow, which can raise your blood pressure. By lowering the amount of angiotensin II in the body, ACE inhibitors help relax your blood vessels. This, in turn, lowers blood pressure and improves blood flow.
Beta blockers work differently. They target beta receptors (binding sites) in the heart. Normally, when those receptors are activated, the heart pumps faster and harder. This leads to a faster heart rate and higher blood pressure. By blocking beta receptors, beta blockers help lower your heart rate and blood pressure.
Selective vs. nonselective beta blockers
Beta blockers can be separated into two main groups: cardioselective, or “selective,” and nonselective beta blockers.
Selective beta blockers primarily target beta-1 receptors. These binding sites are mainly found in the heart and kidneys.
Nonselective beta blockers target beta-1 and beta-2 receptors. Beta-2 receptors are located throughout the body, including in the lungs. When nonselective beta blockers attach to beta-2 receptors, it can cause trouble breathing as a side effect. Because of this, healthcare professionals typically avoid prescribing nonselective beta blockers to people with lung conditions, such as asthma.
Which ACE inhibitors and beta blockers exist?
There are several ACE inhibitors and beta blockers on the U.S. market. Typical dosages and approved uses vary depending on the medication you’re taking.
Generic ACE inhibitor names end in “-pril.” Examples include:
Benazepril (Lotensin)
Enalapril (Vasotec)
Lisinopril
Ramipril (Vostally)
Generic beta blocker names end in “-lol.” Examples of selective beta blockers include:
Atenolol (Tenormin)
Metoprolol tartrate (Lopressor)
Metoprolol succinate (Toprol XL, Kapspargo Sprinkle)
Nebivolol (Bystolic)
Examples of nonselective beta blockers include:
Carvedilol (Coreg)
Propranolol (Inderal LA, Innopran XL, Hemangeol)
Sotalol (Betapace, Sorine, Sotylize)
What conditions do ACE inhibitors and beta blockers treat?
ACE inhibitors and beta blockers treat some of the same conditions. But there are several differences.
The table below highlights conditions that each class treats. Keep in mind that not every medication in each class treats all these conditions. Your prescriber and pharmacist can tell you which conditions your ACE inhibitor or beta blocker is FDA approved for.
| Conditions both classes treat | Additional conditions ACE inhibitors treat | Additional conditions beta blockers treat |
|---|---|---|
|
|
Propranolol has these additional uses:
|
What are the side effects of ACE inhibitors and beta blockers?
All blood pressure medications can cause dizziness when you first start them. And they all carry a risk of hypotension (low blood pressure). But broadly, since ACE inhibitors and beta blockers work differently, their side effects are also different.
Common and rare side effects for each medication class are listed in the table below.
| ACE inhibitor side effects | Beta blocker side effects | |
|---|---|---|
| Common or mild |
|
|
| Rare but serious |
|
|
Can you combine an ACE inhibitor and a beta blocker?
Yes, it’s safe to combine an ACE inhibitor and a beta blocker. In fact, the combination is often recommended to manage certain conditions, such as heart failure. Just keep in mind that not everyone needs to take both. Your prescriber can let you know if you could benefit from taking both an ACE inhibitor and a beta blocker.
How to save on ACE inhibitors and beta blockers
There are ways to save on ACE inhibitors and beta blockers. Many options are available as lower-cost generics or have copay savings opportunities. GoodRx can help make your prescription more affordable.
For example, anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of brand-name Toprol XL at an exclusive cash price.
Frequently asked questions
Unless a healthcare professional has told you otherwise, you don’t need to drink extra fluids with lisinopril. Just make sure you’re drinking enough to stay hydrated. A good rule to follow is to drink when you feel thirsty. If you’re dehydrated, lisinopril could put extra strain on your kidneys.
If you’re living with heart failure, ask your prescriber how much water you should drink. Some people may need to limit fluids to help manage the condition.
Lisinopril doesn’t typically cause weight gain. Some studies have actually found that people taking it lost a small amount (up to 3 lbs) of body weight. Keep in mind that other common blood pressure medications, such as beta blockers, can cause weight gain.
If you’ve rapidly gained weight (more than 2 lbs or 3 lbs in a day or more than 5 lbs in a week), contact your prescriber right away. This can be a symptom of worsening heart failure.
Ask a healthcare professional before taking lisinopril with potassium supplements, such as potassium chloride (Klor-Con). Lisinopril can raise your potassium levels. Combining it with potassium supplements could cause these levels to become dangerously high.
Your prescriber can tell you if you need to take both lisinopril and a potassium supplement. If you do, they may recommend more frequent blood tests to watch your potassium levels.
Unless a healthcare professional has told you otherwise, you don’t need to drink extra fluids with lisinopril. Just make sure you’re drinking enough to stay hydrated. A good rule to follow is to drink when you feel thirsty. If you’re dehydrated, lisinopril could put extra strain on your kidneys.
If you’re living with heart failure, ask your prescriber how much water you should drink. Some people may need to limit fluids to help manage the condition.
Lisinopril doesn’t typically cause weight gain. Some studies have actually found that people taking it lost a small amount (up to 3 lbs) of body weight. Keep in mind that other common blood pressure medications, such as beta blockers, can cause weight gain.
If you’ve rapidly gained weight (more than 2 lbs or 3 lbs in a day or more than 5 lbs in a week), contact your prescriber right away. This can be a symptom of worsening heart failure.
Ask a healthcare professional before taking lisinopril with potassium supplements, such as potassium chloride (Klor-Con). Lisinopril can raise your potassium levels. Combining it with potassium supplements could cause these levels to become dangerously high.
Your prescriber can tell you if you need to take both lisinopril and a potassium supplement. If you do, they may recommend more frequent blood tests to watch your potassium levels.
The bottom line
Lisinopril (Zestril, Qbrelis) isn’t a beta blocker. It’s an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors and beta blockers are two popular types of heart medications. Both can help manage cardiovascular conditions, such as high blood pressure and heart failure.
ACE inhibitors lower blood pressure by relaxing blood vessels and improving blood flow. Beta blockers work by slowing your heart rate, which can help lower blood pressure. It’s safe to combine an ACE inhibitor and a beta blocker. But not everyone needs to take both.
Why trust our experts?
References
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