Benicar vs. Other Blood Pressure Meds: How Olmesartan Stacks Up

Quick Facts

• Benicar (Olmesartan) is an ARB used to treat hypertension.
• Key alternatives include Losartan, Valsartan, Telmisartan, Amlodipine, Lisinopril and Hydrochlorothiazide.
• Effectiveness is similar across ARBs; side‑effect profiles differ.
• Cost varies - generic ARBs are usually cheaper than brand‑name Benicar.
• Choosing the right drug depends on kidney health, pregnancy plans and tolerance.

When treating hypertension, Benicar (Olmesartan) is an angiotensin II receptor blocker (ARB) that helps relax blood vessels and lower blood pressure. It’s marketed in Australia as a 20mg or 40mg tablet, but the active ingredient is available generically under the name olmesartan medoxomil. Below we compare Benicar with the most common alternatives so you can see where it shines and where other options might fit better.

How ARBs Work (and Why They Matter)

ARBs block the binding of angiotensin II to the AT‑1 receptor, preventing the hormone from narrowing blood vessels. The result is smoother blood flow and a drop in systolic and diastolic pressure. Because they act downstream of ACE inhibitors, ARBs tend to cause fewer cough and taste‑disturbance side effects.

Major Alternatives

Losartan is another ARB, often chosen for its low cost and 24‑hour efficacy. It’s the first ARB approved in Australia and comes in 25mg, 50mg and 100mg tablets.

Valsartan is an ARB that has strong evidence for heart‑failure benefit. Typical doses range from 80mg to 320mg per day.

Telmisartan is an ARB with a longer half‑life, useful for once‑daily dosing. It’s sold in 40mg and 80mg tablets.

Amlodipine is a calcium‑channel blocker (CCB) that relaxes the muscle of blood‑vessel walls. Doses are usually 5mg or 10mg.

Lisinopril is an ACE inhibitor that reduces angiotensin‑converting enzyme activity. It’s taken at 5mg to 40mg daily.

Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure by reducing fluid volume. Standard dose is 12.5mg to 25mg.

Side‑Effect Snapshot

All antihypertensives have trade‑offs. Here’s a quick look at the most common complaints:

• ARBs (Benicar, Losartan, Valsartan, Telmisartan): dizziness, elevated potassium, rare angio‑edema.
• ACE inhibitors (Lisinopril): persistent dry cough, higher risk of angio‑edema.
• CCBs (Amlodipine): ankle swelling, flushing, gum overgrowth.
• Thiazides (Hydrochlorothiazide): increased urination, low potassium, gout flare‑ups.

Cost Comparison (Australian Market, 2025)

How to Pick the Right Drug for You

Think of the choice as a checklist rather than a lottery. Score each option against your own health profile:

1. Kidney function: ARBs and ACE inhibitors protect kidneys in diabetes, but they can raise potassium. If you have chronic kidney disease, a lower‑dose ARB or an ACE may be appropriate, but monitor labs closely.
2. Pregnancy plans: ACE inhibitors and ARBs are contraindicated in pregnancy. If you might become pregnant, a CCB like amlodipine or a thiazide is safer.
3. Side‑effect tolerance: If a dry cough pins you down, avoid ACE inhibitors. If ankle swelling bothers you, skip CCBs.
4. Cost sensitivity: Generic Losartan, Valsartan, or Telmisartan are often cheaper than brand‑name Benicar. Pharmacy discount cards can shave another $5‑$10 off.
5. Cardiovascular risk: Patients with heart failure benefit from ARBs with proven mortality reduction (Valsartan, Telmisartan). For isolated hypertension, any of the listed agents work.

Pros and Cons of Benicar vs. Each Alternative

Benicar vs. Losartan

• Pros: Once‑daily dosing, strong BP control, low cough risk.
• Cons: Higher brand price; Losartan generic is cheaper.

Benicar vs. Valsartan

• Pros: Similar efficacy; Valsartan has extra heart‑failure data.
• Cons: Valsartan can be more expensive at higher doses.

Benicar vs. Telmisartan

• Pros: Telmisartan’s longer half‑life may suit patients who miss doses.
• Cons: Telmisartan can cause back pain in a small subset.

Benicar vs. Amlodipine (CCB)

• Pros: ARBs don’t cause peripheral edema.
• Cons: CCBs work faster for acute spikes, and are cheaper.

Benicar vs. Lisinopril (ACE)

• Pros: No dry cough, better for patients with ACE‑induced cough.
• Cons: ACE inhibitors have stronger evidence for post‑myocardial‑infarction remodeling.

Benicar vs. Hydrochlorothiazide (Diuretic)

• Pros: ARBs avoid electrolyte loss and gout flare‑ups.
• Cons: Diuretics are the cheapest option and work well in combination therapy.

When Benicar Might Be the Best Choice

If you need a solid, once‑daily ARB without the cough that often comes with ACE inhibitors, and you’re not on a strict budget, Benicar is a fine pick. It’s also helpful if you’ve tried Losartan or Valsartan and still have borderline BP; the slight potency increase at 40mg can tip the scale.

Potential Pitfalls to Watch

• Elevated potassium (hyperkalaemia) - especially if you’re on potassium‑sparing diuretics.
• Rare cases of sprue‑like enteropathy (persistent diarrhea). If symptoms persist >2 weeks, see a doctor.
• Interactions with NSAIDs - may blunt BP‑lowering effect and worsen kidney function.

Real‑World Example

John, a 58‑year‑old accountant from Perth, was on Losartan 50mg but his BP lingered at 148/92mmHg. His doctor switched him to Benicar 20mg, and within a month his reading fell to 132/84mmHg without any new side effects. The only change was a modest price increase, which John covered using his private health fund.

Bottom Line

Benicar holds its own against the big names, but cost and individual tolerance often decide the winner. By weighing kidney health, pregnancy plans, side‑effect tolerance, and price, you can land on the medication that keeps your numbers in the safe zone.

Frequently Asked Questions

Can I take Benicar and a thiazide diuretic together?

Yes, combining an ARB like Benicar with a thiazide (e.g., hydrochlorothiazide) is common practice. The duo improves BP control and can offset the potassium‑raising effect of the ARB.

Is Benicar safe for people with diabetes?

ARBs, including Benicar, are actually preferred for diabetic patients because they protect kidney function and reduce proteinuria. Regular blood‑sugar and kidney‑function monitoring is still essential.

What should I do if I develop a persistent cough on Benicar?

A cough is rare with ARBs but can happen due to increased bradykinin. Switch to an ACE inhibitor is usually the other way round; with a cough, talk to your doctor about moving to a CCB or a different ARB.

How quickly does Benicar start working?

Blood‑pressure reduction can be seen within 2weeks, with the full effect typically reached after 4‑6weeks of consistent dosing.

Is there a Benicar alternatives list for patients who can’t afford the brand?

Yes. Generic olmesartan, Losartan, Valsartan and Telmisartan are widely available at lower prices. Discuss with your pharmacist about bulk‑pack options or PBS (Pharmaceutical Benefits Scheme) eligibility.