enalapril vs fosinopril
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
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
- Diarrhoea 2,807
- Dyspnoea 2,659
- Nausea 2,574
- Fatigue 2,377
- Drug Interaction 2,336
- Fatigue 239
- Diarrhoea 232
- Dyspnoea 210
- Nausea 204
- Dizziness 179
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.
Also Compare, Nearby Drugs
Compare enalapril with
Compare fosinopril with
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 12,753 submissions while fosinopril has 1,064. 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 represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for enalapril or fosinopril.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.