Two medicines, side by side
Bisoprolol vs ramipril
Bisoprolol and ramipril are both labeled for high blood pressure. Drugs@FDA records approvals of bisoprolol since 1992 and of ramipril since 1991. Pharmacies paid $0.114 per bisoprolol fumarate 5 mg tablet and $0.0707 per ramipril 10 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, bisoprolol is a beta-adrenergic blocker and ramipril an angiotensin converting enzyme inhibitor.
Check it at the source: the bisoprolol FDA label on DailyMed (effective March 11, 2026); the ramipril FDA label on DailyMed (effective August 24, 2026).
Highlights of the bisoprolol record
Bisoprolol (Zebeta) · label of March 11, 2026
Used for
From the label: indicationsBisoprolol fumarate tablets are indicated in the management of hypertension. It may be used alone or in combination with other antihypertensive agents.
On the market
- Earliest approval on file
- July 31, 1992
- Generic labelers
- 24 labelers
- Pharmacy cost
- $0.114 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the ramipril record
Ramipril (Altace) · label of August 24, 2026
FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue ramipril as soon as possible ( 5.6 ). Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus ( 5.6 ). WARNING: FETAL TOXICITY When pregnancy is detected, discontinue ramipril as soon as possible ( 5.6 ). Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus ( 5.6 ).
Used for
From the label: indicationsRamipril capsules are an angiotensin converting enzyme (ACE) inhibitor indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. It may be used alone or in combination with thiazide diuretics ( 1.1 ). […]
On the market
- Earliest approval on file
- January 28, 1991
- Generic labelers
- 17 labelers
- Pharmacy cost
- $0.0707 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Bisoprolol label of March 11, 2026, Ramipril label of August 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do bisoprolol and ramipril differ on the record?
In FDA's classes, bisoprolol is a beta-adrenergic blocker and ramipril an angiotensin converting enzyme inhibitor.
Half-life, in each label's words: Bisoprolol, “The plasma elimination half-life is 9 to 12 hours and is slightly longer in elderly patients, in part because of …”; Ramipril, “The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent …”
Only the ramipril label carries a boxed warning.
Generics: bisoprolol since 2000; ramipril since 2005 (Drugs@FDA).
| Bisoprolol | Ramipril | |
|---|---|---|
| Labeled for | High blood pressure | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | beta-Adrenergic Blocker | Angiotensin Converting Enzyme Inhibitor |
| How it works (label) | n/a | Ramipril and ramiprilat inhibit ACE in human subjects and animals. Angiotensin converting enzyme is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. |
| Half-life (label) | The plasma elimination half-life is 9 to 12 hours and is slightly longer in elderly patients, in part because of decreased renal function in that population. | The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent binding to both plasma and tissue ACE, has a half-life of 2 to 4 hours. |
| Earliest approval on file (Drugs@FDA) | July 31, 1992 | January 28, 1991 |
| First generic approved | November 16, 2000 | October 24, 2005 |
| Generic labelers (NDC) | 24 labelers | 17 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.114 per tablet (Bisoprolol fumarate 5 mg tablet) | $0.0707 per capsule (Ramipril 10 mg capsule) |
| 12-month price change | -39% | +1% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 135,060 | 123,138 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to bisoprolol
- every medicine labeled for the same conditions