Two medicines, side by side
Enalapril vs perindopril
Enalapril and perindopril are both labeled for high blood pressure. Drugs@FDA records approvals of enalapril since 1985 and of perindopril since 1993. Pharmacies paid $0.0664 per enalapril maleate 10 mg tablet and $0.495 per perindopril erbumine 4 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. 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.”; Perindopril, “Perindopril erbumine is a pro-drug for perindoprilat, which inhibits ACE in human subjects and animals.”
Check it at the source: the enalapril FDA label on DailyMed (effective January 23, 2026); the perindopril FDA label on DailyMed (effective March 13, 2024).
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 perindopril record
Perindopril (Aceon) · label of March 13, 2024
FETAL TOXICITY When pregnancy is detected, discontinue perindopril erbumine as soon as possible [see Warnings and Precautions (5.4) ]. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.4) ]. WARNING: FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue perindopril erbumine as soon as possible [see Warnings and Precautions (5.4) ].
Used for
From the label: indicationsPerindopril erbumine tablets are indicated for the treatment of patients with essential hypertension. (1.1) Perindopril erbumine tablets are indicated for treatment of patients with stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction. (1.2) 1.1 Hypertension Perindopril erbumine tablets are indicated for the treatment of patients with essential hypertension. […]
On the market
- Earliest approval on file
- December 30, 1993
- Generic labelers
- 1 labeler
- Pharmacy cost
- $0.495 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Enalapril label of January 23, 2026, Perindopril label of March 13, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do enalapril and perindopril 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.”; Perindopril, “Perindopril erbumine is a pro-drug for perindoprilat, which inhibits 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.”; Perindopril, “The mean half-life of perindopril associated with most of its elimination is approximately 0.8 to 1 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: enalapril since 2000; perindopril since 2009 (Drugs@FDA).
| Enalapril | Perindopril | |
|---|---|---|
| Labeled for | High blood pressure, Heart failure | High blood pressure, Heart attack and coronary artery disease |
| 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. | Perindopril erbumine is a pro-drug for perindoprilat, which inhibits ACE in human subjects and animals. The mechanism through which perindoprilat lowers blood pressure is believed to be primarily inhibition of ACE activity. |
| Half-life (label) | The effective half-life for accumulation of enalaprilat following multiple doses of enalapril maleate is 11 hours. | The mean half-life of perindopril associated with most of its elimination is approximately 0.8 to 1 hours. |
| Earliest approval on file (Drugs@FDA) | December 24, 1985 | December 30, 1993 |
| First generic approved | August 22, 2000 | November 10, 2009 |
| Generic labelers (NDC) | 28 labelers | 1 labeler |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0664 per tablet (Enalapril maleate 10 mg tablet) | $0.495 per tablet (Perindopril erbumine 4 mg tablet) |
| 12-month price change | -12% | -2% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 17 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 60,702 | 5,567 |
| 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