fosinopril vs ramipril
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 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.
Monopril
Altace
Fosinopril is a medicine that lowers blood pressure. It can also help manage heart failure.
Ramipril is a medicine that lowers blood pressure. It can also help people with heart failure after a heart attack.
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 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.
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 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.
- • Cough
- • Dizziness
- • Nausea
- • Vomiting
- • Headache
- • Dizziness
- • Fatigue
- • Cough
- Fatigue 239
- Diarrhoea 232
- Dyspnoea 210
- Nausea 204
- Dizziness 179
- Dyspnoea 8,083
- Fatigue 7,877
- Nausea 7,339
- Diarrhoea 6,913
- Dizziness 6,526
Fosinopril can harm your unborn baby, even causing death. Stop taking fosinopril as soon as you know you are pregnant.
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.
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.
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.
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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 1,064 submissions while ramipril has 36,738. 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 fosinopril or ramipril.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.