enalapril vs perindopril
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 perindopril. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Vasotec
Aceon
Enalapril (Vasotec) is a medicine that lowers blood pressure and helps treat heart failure. It belongs to a class of drugs called ACE inhibitors.
Perindopril (Aceon) is a drug that lowers blood pressure. It can also help reduce the risk of heart problems in people with stable coronary artery disease.
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.
Perindopril treats high blood pressure (hypertension). It can be used alone or with other blood pressure medicines. Perindopril also helps lower the risk of heart-related death or heart attack in people who have stable coronary artery disease. It can be used with other treatments for coronary artery disease.
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.
Perindopril belongs to a class of drugs called ACE inhibitors. It works by relaxing your blood vessels, which lowers blood pressure. This makes it easier for your heart to pump blood.
- • Headache
- • Dizziness
- • Fatigue
- • Cough
- • Cough
- • Dizziness
- • Back pain
- Diarrhoea 2,807
- Dyspnoea 2,659
- Nausea 2,574
- Fatigue 2,377
- Drug Interaction 2,336
No adverse event reports.
This drug can harm your unborn baby. Stop taking enalapril as soon as you know you are pregnant.
If you become pregnant, stop taking perindopril right away. This medicine can cause serious harm or death to an unborn baby.
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 perindopril if you are pregnant. It can cause harm to your unborn baby, especially during the second and third trimesters. It is not known if perindopril passes into breast milk, so talk to your doctor before breastfeeding.
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How to Read This enalapril vs perindopril Comparison
enalapril is classified in the ACE Inhibitor drug class, while perindopril 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 perindopril has 0. 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 perindopril.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.