Blood Pressure Medication Comparison Tool
Find the Best Alternative for You
Answer a few questions to see which blood pressure medications might work best for your situation.
Based on your responses, these medications may be the best alternatives to Hypernil (lisinopril).
Losartan
RecommendedARB (Angiotensin II receptor blocker)
Losartan is often the first alternative for people who develop a cough from lisinopril. It works on the same pathway but doesn't cause the dry, persistent cough associated with ACE inhibitors. This makes it a great option if cough is your main issue.
Amlodipine
Strong alternativeCalcium channel blocker
Amlodipine is especially effective for people of African or Caribbean descent. It's also a good choice if you have kidney issues or want a medication that won't raise potassium levels. This is ideal if you want to avoid potassium-related complications.
Hydrochlorothiazide
Cost-effective optionDiuretic
HCTZ is the most affordable option and works well for people over 65 or with fluid retention. However, it lowers potassium levels and may cause increased urination. This is a good choice if cost is a primary concern and you can manage the side effects.
Before making any changes
Never stop or switch blood pressure medications without your doctor's supervision. Your doctor can safely adjust your dosage and monitor your response. They'll help you choose the best option for your specific health situation.
High blood pressure doesn’t care if you’re busy, tired, or frustrated with side effects. If you’re taking Hypernil - which is just a brand name for lisinopril - and you’re wondering if there’s something better, you’re not alone. Thousands of people switch from lisinopril every year, not because it doesn’t work, but because it doesn’t work for them. Maybe your cough won’t go away. Maybe your potassium levels are too high. Or maybe you just want a pill that doesn’t make you feel like you’re walking through fog all day.
What is Hypernil (Lisinopril)?
Lisinopril is an ACE inhibitor used to treat high blood pressure, heart failure, and to improve survival after a heart attack. It was first approved in the U.S. in 1987 and has since become one of the most prescribed blood pressure medications worldwide. Hypernil is simply a branded version sold in New Zealand and Australia. The active ingredient? Lisinopril. Same as the generic. Same as what your doctor prescribes under a different label.
Lisinopril works by blocking an enzyme called angiotensin-converting enzyme (ACE). That enzyme normally tells your body to tighten blood vessels. Block it, and your vessels relax. Blood pressure drops. Simple. Effective. Cheap.
But here’s the catch: it’s not perfect. About 1 in 10 people on lisinopril develop a dry, hacking cough. Some get dizzy. A few develop angioedema - swelling of the face or throat - which is rare but dangerous. And if you have kidney issues, your doctor has to monitor your potassium and creatinine levels closely.
Why People Look for Alternatives
People don’t switch meds because they’re bored. They switch because something’s wrong.
- Your cough won’t stop - even after three months.
- You’re always tired, even when you sleep well.
- Your doctor says your potassium is too high - again.
- You had a reaction and now you’re scared to take it.
- You’re paying $15 a month for Hypernil and wonder if a generic alternative could do the same job.
These aren’t minor complaints. They’re reasons to explore other options. And the good news? There are several well-studied, equally effective alternatives.
ARBs: The Most Common Swap
If lisinopril gives you a cough, your doctor will likely suggest an ARB - angiotensin II receptor blocker. These work on the same pathway as ACE inhibitors but don’t trigger the same cough. Why? Because they block a different part of the system.
Common ARBs include:
- Losartan - often the first choice. Studies show it lowers blood pressure just as well as lisinopril, with fewer coughs.
- Valsartan - used for heart failure too. Often prescribed after a heart attack.
- Olmesartan - stronger effect per milligram. Good for people who need more pressure control.
A 2023 meta-analysis of over 120,000 patients found that ARBs caused cough in only 2% of users - compared to 10% with lisinopril. That’s a big difference if you’re the one choking at 3 a.m.
ARBs also have a lower risk of angioedema. And like lisinopril, they’re available as generics. Losartan costs about $4 a month in New Zealand. Same as lisinopril.
Calcium Channel Blockers: A Different Approach
Not everyone responds to drugs that target the renin-angiotensin system. That’s where calcium channel blockers (CCBs) come in.
These meds - like amlodipine, diltiazem, and nifedipine - work by relaxing the muscles in your blood vessel walls. They don’t touch ACE or angiotensin. They just let your vessels open wider.
Why choose a CCB?
- No cough. Ever.
- Great for older adults and people of African or Caribbean descent - studies show they work better in these groups than ACE inhibitors.
- Can help with chest pain (angina) too.
Amlodipine is the most common. It’s taken once a day. Side effects? Swollen ankles or flushing. Not fun, but usually mild. And unlike lisinopril, it doesn’t raise potassium. That’s a win if you have kidney disease.
Diuretics: The Old Reliable
Think of diuretics as your body’s natural drain. They help your kidneys flush out extra salt and water. That reduces blood volume. Pressure drops.
The most common diuretic for high blood pressure is hydrochlorothiazide (HCTZ). It’s been around since the 1950s. Still works. Still cheap.
Many doctors combine HCTZ with lisinopril or an ARB. But some people take it alone - especially if they’re over 65 or have fluid retention.
Downsides? You might need to pee more. You could get low potassium (unlike lisinopril, which raises it). Some people feel a bit dehydrated. But if you drink enough water and get your levels checked, it’s a solid, low-cost option.
Beta Blockers: Not First-Line Anymore
Once the go-to for high blood pressure, beta blockers like atenolol and metoprolol are now used less often for pure hypertension.
Why? Because large studies - like the ALLHAT trial - showed they’re less effective at preventing strokes than ACE inhibitors or diuretics. They’re still used if you have:
- Heart failure
- After a heart attack
- Fast heart rate or arrhythmias
They can cause fatigue, cold hands, or weight gain. Not ideal for someone just trying to control blood pressure without side effects.
Comparison Table: Lisinopril vs Top Alternatives
| Medication | Type | Common Side Effects | Cough Risk | Potassium Effect | Cost (NZD/month) |
|---|---|---|---|---|---|
| Lisinopril (Hypernil) | ACE Inhibitor | Dizziness, fatigue, cough, high potassium | High (up to 10%) | Increases | $4-$15 |
| Losartan | ARB | Dizziness, back pain, fatigue | Low (2%) | Increases | $4-$10 |
| Amlodipine | Calcium Channel Blocker | Swollen ankles, flushing, dizziness | None | Neutral | $5-$12 |
| Hydrochlorothiazide | Diuretic | Increased urination, low potassium, dehydration | None | Decreases | $3-$8 |
| Atenolol | Beta Blocker | Fatigue, cold hands, weight gain | None | Neutral | $5-$10 |
When to Stick With Lisinopril
Just because there are alternatives doesn’t mean you should switch. Lisinopril is still a top choice for many.
Stick with it if:
- You have no cough or dizziness
- You’re diabetic with protein in your urine - lisinopril protects your kidneys better than most other drugs
- You’re post-heart attack and your doctor says it reduces your risk of another one
- You’ve been on it for years and your blood pressure is stable
There’s no reason to fix what isn’t broken. But if something is broken - your sleep, your energy, your peace of mind - then it’s time to talk.
What Your Doctor Needs to Know
Switching meds isn’t just about swapping pills. It’s about matching the drug to your body, your health history, and your lifestyle.
Before you ask for a change, prepare these points:
- Exactly what side effects you’re having - and when they started
- Any other conditions - diabetes, kidney disease, asthma, gout
- What you’re willing to tolerate - e.g., “I can handle a little swelling but not a cough”
- Cost concerns - ask if a generic version is available
Your doctor might not bring up alternatives unless you do. Don’t be shy. You’re the one living with the side effects.
What Not to Do
Don’t stop lisinopril cold turkey. Suddenly stopping can cause your blood pressure to spike - sometimes dangerously. Always taper under medical supervision.
Don’t switch to OTC supplements like garlic pills or magnesium without talking to your doctor. Some can interact with blood pressure meds or worsen kidney function.
And don’t believe online forums that say one drug is “the best.” What works for someone else might not work for you. Your genetics, your diet, your kidneys - they all matter.
Bottom Line
Hypernil (lisinopril) is a good drug. But it’s not the only good drug. If you’re struggling with side effects, there are safer, just-as-effective options. ARBs like losartan are the most common swap. Calcium channel blockers like amlodipine are great if you want no cough and no potassium issues. Diuretics like HCTZ are simple, cheap, and still reliable.
The goal isn’t to find the “best” pill. It’s to find the one that lets you live your life - without coughing, dizzy spells, or constant worry.
Talk to your doctor. Bring this list. Ask for alternatives. You deserve a treatment that fits you - not the other way around.
Is Hypernil the same as lisinopril?
Yes. Hypernil is a brand name for lisinopril, the generic drug. Both contain the exact same active ingredient and work the same way. The only differences are the packaging, the price, and the manufacturer. In most cases, switching to generic lisinopril saves money without changing effectiveness.
Why does lisinopril cause a cough?
Lisinopril blocks ACE, which breaks down a substance called bradykinin. When bradykinin builds up, it irritates the airways and triggers a dry, persistent cough. This doesn’t happen with ARBs like losartan because they work differently - they don’t affect bradykinin levels.
Can I switch from lisinopril to losartan on my own?
No. Never stop or switch blood pressure medications without medical supervision. Even though both are ACE/ARB drugs, your body adjusts to the dose and mechanism. A sudden switch can cause blood pressure spikes or drops. Your doctor will guide you through a safe transition, often overlapping doses for a few days.
Which alternative is cheapest?
Hydrochlorothiazide (HCTZ) is usually the cheapest, often under $5 a month in New Zealand. Generic lisinopril and losartan are also very affordable, typically $4-$10. Brand-name versions like Hypernil cost more - sometimes double - for no added benefit.
Do any of these alternatives help with weight loss?
None of these drugs are designed for weight loss. But diuretics like HCTZ can cause temporary water weight loss, which some people mistake for fat loss. That’s not sustainable. For real weight loss, focus on diet, movement, and sleep - not medication changes.
Can I take lisinopril with potassium supplements?
No - not without your doctor’s approval. Lisinopril can raise potassium levels, and adding supplements can push them into dangerous territory. High potassium can cause irregular heartbeat or even cardiac arrest. Always get your levels checked before taking any potassium supplement.