Two medicines, side by side
Enalapril vs lisinopril
Enalapril and lisinopril are both labeled for high blood pressure and heart failure. Drugs@FDA records approvals of enalapril since 1985 and of lisinopril since 1987. Pharmacies paid $0.0664 per enalapril maleate 10 mg tablet and $0.0254 per lisinopril 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Lisinopril's other strengths are brand-only: $4.50 per mL (Qbrelis 1 mg/mL solution). How each works, in its label's words: Enalapril, “Mechanism of Action Enalapril, after hydrolysis to enalaprilat, inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”; Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”
Check it at the source: the enalapril FDA label on DailyMed (effective January 23, 2026); the lisinopril FDA label on DailyMed (effective January 2, 2025).
Highlights of the enalapril record
Enalapril (Vasotec) · label of January 23, 2026
FETAL TOXICITY See full prescribing information for complete boxed warning.
When pregnancy is detected, discontinue VASOTEC ® 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 VASOTEC is indicated for the treatment of hypertension. VASOTEC is effective alone or in combination with other antihypertensive agents, especially thiazide-type diuretics. The blood pressure lowering effects of VASOTEC and thiazides are approximately additive. Heart Failure VASOTEC is indicated for the treatment of symptomatic congestive heart failure, usually in combination with diuretics and digitalis. […]
On the market
- Earliest approval on file
- December 24, 1985
- Generic labelers
- 28 labelers
- Pharmacy cost
- $0.0664 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 17
Highlights of the lisinopril record
Lisinopril (Zestril) · label of January 2, 2025
FETAL TOXICITY When pregnancy is detected, discontinue ZESTRIL as soon as possible [see Warnings and Precautions ( 5.1 )]. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.1)]. WARNING: FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue Zestril as soon as possible.
Used for
From the label: indicationsZestril is an angiotensin converting enzyme (ACE) inhibitor indicated for: Treatment of hypertension in adults and pediatric patients 6 years of age and older ( 1.1 ) Adjunct therapy for heart failure ( 1.2 ) Treatment of Acute Myocardial Infarction ( 1.3 ) 1.1 Hypertension Zestril is indicated for the treatment of hypertension in adult patients and pediatric patients 6 years of age and older to lower blood pressure. […]
On the market
- Earliest approval on file
- December 29, 1987
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.0254 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 28
Source: FDA drug labels via openFDA (Enalapril label of January 23, 2026, Lisinopril label of January 2, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do enalapril and lisinopril differ on the record?
How each works, in its label's words: Enalapril, “Mechanism of Action Enalapril, after hydrolysis to enalaprilat, inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”; Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”
Both are in FDA's class angiotensin converting enzyme inhibitors.
Half-life, in each label's words: Enalapril, “The effective half-life for accumulation of enalaprilat following multiple doses of enalapril maleate is 11 hours.”; Lisinopril, “Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: enalapril since 2000; lisinopril since 2002 (Drugs@FDA).
| Enalapril | Lisinopril | |
|---|---|---|
| Labeled for | High blood pressure, Heart failure | High blood pressure, Heart attack and coronary artery disease, Heart failure |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | Angiotensin Converting Enzyme Inhibitor |
| How it works (label) | Mechanism of Action Enalapril, after hydrolysis to enalaprilat, inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. | Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. |
| Half-life (label) | The effective half-life for accumulation of enalaprilat following multiple doses of enalapril maleate is 11 hours. | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. |
| Earliest approval on file (Drugs@FDA) | December 24, 1985 | December 29, 1987 |
| First generic approved | August 22, 2000 | July 1, 2002 |
| Generic labelers (NDC) | 28 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0664 per tablet (Enalapril maleate 10 mg tablet) | $0.0254 per tablet (Lisinopril 20 mg tablet) |
| 12-month price change | -12% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 17 | 28 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 60,702 | 304,309 |
| 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 enalapril
- every medicine labeled for the same conditions