Two medicines, side by side
Captopril vs ramipril
Captopril and ramipril are both labeled for high blood pressure. Drugs@FDA records approvals of captopril since 1981 and of ramipril since 1991. Pharmacies paid $0.228 per captopril 12.5 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.
Check it at the source: the captopril FDA label on DailyMed (effective February 6, 2026); the ramipril FDA label on DailyMed (effective August 24, 2026).
Highlights of the captopril record
Captopril (Capoten) · label of February 6, 2026
FETAL TOXICITY When pregnancy is detected, discontinue captopril tablets as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. See WARNINGS: Fetal Toxicity
Used for
From the label: indicationsHypertension Captopril tablets are indicated for the treatment of hypertension. In using captopril tablets, consideration should be given to the risk of neutropenia/agranulocytosis (see WARNINGS ). Captopril tablets may be used as initial therapy for patients with normal renal function, in whom the risk is relatively low. […]
On the market
- Earliest approval on file
- April 6, 1981
- Generic labelers
- 13 labelers
- Pharmacy cost
- $0.228 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
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 (Captopril label of February 6, 2026, Ramipril label of August 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do captopril and ramipril differ on the record?
Both are in FDA's class angiotensin converting enzyme inhibitors.
Half-life, in each label's words: Captopril, “The apparent elimination half-life for total radioactivity in blood is probably less than 3 hours.”; Ramipril, “The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent …”
Both labels carry a boxed warning; the records quote them.
Generics: captopril since 1995; ramipril since 2005 (Drugs@FDA).
| Captopril | Ramipril | |
|---|---|---|
| Labeled for | High blood pressure, Heart failure, Chronic kidney disease | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | 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 apparent elimination half-life for total radioactivity in blood is probably less than 3 hours. | 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) | April 6, 1981 | January 28, 1991 |
| First generic approved | March 31, 1995 | October 24, 2005 |
| Generic labelers (NDC) | 13 labelers | 17 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.228 per tablet (Captopril 12.5 mg tablet) | $0.0707 per capsule (Ramipril 10 mg capsule) |
| 12-month price change | -28% | +1% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 9,557 | 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 captopril
- every medicine labeled for the same conditions