Two medicines, side by side
Fosinopril vs lisinopril
Fosinopril and lisinopril are both labeled for high blood pressure and heart failure. Drugs@FDA records approvals of fosinopril since 1991 and of lisinopril since 1987. Pharmacies paid $0.154 per fosinopril sodium 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).
Check it at the source: the fosinopril FDA label on DailyMed (effective October 10, 2025); the lisinopril FDA label on DailyMed (effective January 2, 2025).
Highlights of the fosinopril record
Fosinopril (Monopril) · label of October 10, 2025
FETAL TOXICITY When pregnancy is detected, discontinue fosinopril sodium tablets 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: indicationsFosinopril sodium tablets are indicated for the treatment of hypertension. They may be used alone or in combination with thiazide diuretics. Fosinopril sodium tablets are indicated in the management of heart failure as adjunctive therapy when added to conventional therapy including diuretics with or without digitalis (see DOSAGE AND ADMINISTRATION ). […]
On the market
- Earliest approval on file
- May 16, 1991
- Generic labelers
- 7 labelers
- Pharmacy cost
- $0.154 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
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 (Fosinopril label of October 10, 2025, Lisinopril label of January 2, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do fosinopril and lisinopril differ on the record?
Both are in FDA's class angiotensin converting enzyme inhibitors.
Half-life, in each label's words: Fosinopril, “In healthy subjects, the terminal elimination half-life (t 1/2 ) of an intravenous dose of radiolabeled fosinoprilat is …”; Lisinopril, “Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: fosinopril since 2003; lisinopril since 2002 (Drugs@FDA).
| Fosinopril | 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) | n/a | 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) | In healthy subjects, the terminal elimination half-life (t 1/2 ) of an intravenous dose of radiolabeled fosinoprilat is approximately 12 hours. | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. |
| Earliest approval on file (Drugs@FDA) | May 16, 1991 | December 29, 1987 |
| First generic approved | November 25, 2003 | July 1, 2002 |
| Generic labelers (NDC) | 7 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.154 per tablet (Fosinopril sodium 10 mg tablet) | $0.0254 per tablet (Lisinopril 20 mg tablet) |
| 12-month price change | -5% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 3 | 28 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 4,243 | 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 fosinopril
- every medicine labeled for the same conditions