enalapril vs fosinopril
Side-by-side comparison of enalapril and fosinopril Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Vasotec
Monopril
Enalapril (Vasotec) is a medicine that lowers blood pressure and helps treat heart failure. It belongs to a class of drugs called ACE inhibitors.
Fosinopril is a medicine that lowers blood pressure. It can also help manage heart failure.
Enalapril is used to treat high blood pressure. It can be used alone or with other blood pressure medicines, like water pills. Enalapril also treats symptomatic congestive heart failure, usually with other medicines. It can also help clinically stable patients with left ventricular dysfunction.
Fosinopril is used to treat high blood pressure. It can be used alone or with a water pill (diuretic). Fosinopril also helps manage heart failure when used with other medicines.
Enalapril blocks a substance in your body that tightens blood vessels. This helps your blood vessels relax and widens them. As a result, blood pressure is lowered, and blood can flow more easily.
Fosinopril belongs to a class of drugs called ACE inhibitors. It works by blocking a substance in your body that tightens blood vessels. This helps your blood vessels relax and lowers your blood pressure.
- • Headache
- • Dizziness
- • Fatigue
- • Cough
- • Cough
- • Dizziness
- • Nausea
- • Vomiting
- Diarrhea 2,806
- Difficulty breathing 2,659
- Feeling sick to your stomach 2,571
- Medicine not working 2,548
- Tiredness 2,374
- Tiredness 239
- Diarrhea 232
- Difficulty breathing 210
- Feeling sick to your stomach 205
- Medicine not working 182
This drug can harm your unborn baby. Stop taking enalapril as soon as you know you are pregnant.
Fosinopril can harm your unborn baby, even causing death. Stop taking fosinopril as soon as you know you are pregnant.
Do not take enalapril if you are pregnant because it can cause harm or death to the developing fetus. Talk to your doctor about safe alternatives if you are breastfeeding.
Do not take fosinopril if you are pregnant. It can cause serious harm or death to your unborn baby. Talk to your doctor about other blood pressure medicines if you are breastfeeding.
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How to Read This enalapril vs fosinopril Comparison
enalapril is classified in the ACE Inhibitor drug class, while fosinopril sits within the ACE Inhibitor class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, enalapril has 12,958 submissions while fosinopril has 1,068. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between enalapril and fosinopril — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.