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fosinopril vs ramipril

Side-by-side comparison of fosinopril and ramipril Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
fosinopril ACE Inhibitor
ramipril ACE Inhibitor
Type
fosinopril Prescription
ramipril Prescription
Summary
fosinopril

Fosinopril is a medicine that lowers blood pressure. It can also help manage heart failure.

ramipril

Ramipril is a medicine that lowers blood pressure. It can also help people with heart failure after a heart attack.

What It Treats
fosinopril

Fosinopril is used to treat high blood pressure. It can be used alone or with a water pill (diuretic). Fosinopril also helps manage heart failure when used with other medicines.

ramipril

Ramipril is used to treat high blood pressure. It can be used alone or with other blood pressure medicines. It is also used in patients who have signs of heart failure after a heart attack. Ramipril can lower the risk of death and hospitalization in these patients.

How It Works
fosinopril

Fosinopril belongs to a class of drugs called ACE inhibitors. It works by blocking a substance in your body that tightens blood vessels. This helps your blood vessels relax and lowers your blood pressure.

ramipril

Ramipril belongs to a class of drugs called ACE inhibitors. It works by blocking a substance in your body that tightens blood vessels. This helps your blood vessels relax and lowers your blood pressure.

Common Side Effects
fosinopril
  • Cough
  • Dizziness
  • Nausea
  • Vomiting
ramipril
  • Headache
  • Dizziness
  • Fatigue
  • Cough
FAERS Reports
fosinopril
  • Tiredness 239
  • Diarrhea 232
  • Difficulty breathing 210
  • Feeling sick to your stomach 205
  • Medicine not working 182
ramipril
  • Difficulty breathing 8,083
  • Tiredness 7,876
  • Feeling sick to your stomach 7,337
  • Loose stools 6,914
  • Feeling lightheaded 6,526
Serious Warnings
fosinopril

Fosinopril can harm your unborn baby, even causing death. Stop taking fosinopril as soon as you know you are pregnant.

ramipril

This drug can cause serious harm or death to an unborn baby. If you are pregnant or plan to become pregnant, tell your doctor right away. Stop taking ramipril as soon as you know you are pregnant.

Pregnancy
fosinopril

Do not take fosinopril if you are pregnant. It can cause serious harm or death to your unborn baby. Talk to your doctor about other blood pressure medicines if you are breastfeeding.

ramipril

Do not take ramipril if you are pregnant. It can harm your unborn baby. It is not recommended to use ramipril if you are breastfeeding.

Also Compare — Nearby Drugs

How to Read This fosinopril vs ramipril Comparison

fosinopril is classified in the ACE Inhibitor drug class, while ramipril 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, fosinopril has 1,068 submissions while ramipril has 36,736. 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 substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between fosinopril and ramipril — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.