Two medicines, side by side
Enalapril vs telmisartan
Enalapril and telmisartan are both labeled for high blood pressure. Drugs@FDA records approvals of enalapril since 1985 and of telmisartan since 1998. Pharmacies paid $0.0664 per enalapril maleate 10 mg tablet and $0.106 per telmisartan 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, enalapril is an angiotensin converting enzyme inhibitor and telmisartan an angiotensin 2 receptor blocker.
Check it at the source: the enalapril FDA label on DailyMed (effective January 23, 2026); the telmisartan FDA label on DailyMed (effective May 29, 2026).
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 telmisartan record
Telmisartan (Micardis) · label of May 29, 2026
FETAL TOXICITY When pregnancy is detected, discontinue telmisartan as soon as possible [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)]. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)]. WARNING: FETAL TOXICITY See full prescribing information for complete boxed warnings.
Used for
From the label: indicationsTelmisartanis an angiotensin II receptor blocker (ARB) indicated for: Treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions(1.1) 1.1 Hypertension Telmisartan is indicated for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- November 10, 1998
- Generic labelers
- 28 labelers
- Pharmacy cost
- $0.106 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Source: FDA drug labels via openFDA (Enalapril label of January 23, 2026, Telmisartan label of May 29, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do enalapril and telmisartan differ on the record?
In FDA's classes, enalapril is an angiotensin converting enzyme inhibitor and telmisartan an angiotensin 2 receptor blocker.
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.”; Telmisartan, “Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II).”
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.”; Telmisartan, “Telmisartan shows bi-exponential decay kinetics with a terminal elimination half-life of approximately 24 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: enalapril since 2000; telmisartan since 2014 (Drugs@FDA).
| Enalapril | Telmisartan | |
|---|---|---|
| Labeled for | High blood pressure, Heart failure | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | Angiotensin 2 Receptor Blocker |
| How it works (label) | Mechanism of Action Enalapril, after hydrolysis to enalaprilat, inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. | Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). |
| Half-life (label) | The effective half-life for accumulation of enalaprilat following multiple doses of enalapril maleate is 11 hours. | Telmisartan shows bi-exponential decay kinetics with a terminal elimination half-life of approximately 24 hours. |
| Earliest approval on file (Drugs@FDA) | December 24, 1985 | November 10, 1998 |
| First generic approved | August 22, 2000 | January 8, 2014 |
| Generic labelers (NDC) | 28 labelers | 28 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0664 per tablet (Enalapril maleate 10 mg tablet) | $0.106 per tablet (Telmisartan 20 mg tablet) |
| 12-month price change | -12% | -4% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 17 | 3 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 60,702 | 17,745 |
| 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