Two medicines, side by side
Hydrochlorothiazide vs lisinopril
Hydrochlorothiazide and lisinopril are both labeled for high blood pressure and heart failure. Drugs@FDA records approvals of hydrochlorothiazide since 1959 and of lisinopril since 1987. Pharmacies paid $0.0115 per hydrochlorothiazide 25 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. Hydrochlorothiazide's other strengths are brand-only: $4.46 per mL (Inzirqo 10 mg/mL oral suspension). Lisinopril's other strengths are brand-only: $4.50 per mL (Qbrelis 1 mg/mL solution). In FDA's classes, hydrochlorothiazide is a thiazide diuretic and lisinopril an angiotensin converting enzyme inhibitor.
Check it at the source: the hydrochlorothiazide FDA label on DailyMed (effective June 12, 2026); the lisinopril FDA label on DailyMed (effective January 2, 2025).
Highlights of the hydrochlorothiazide record
Hydrochlorothiazide (Inzirqo) · label of June 12, 2026
Used for
From the label: indicationsHydrochlorothiazide tablets USP are indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Hydrochlorothiazide tablets USP have also been found useful in edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. […]
On the market
- Earliest approval on file
- February 12, 1959
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0115 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 7
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 (Hydrochlorothiazide label of June 12, 2026, Lisinopril label of January 2, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydrochlorothiazide and lisinopril differ on the record?
In FDA's classes, hydrochlorothiazide is a thiazide diuretic and lisinopril an angiotensin converting enzyme inhibitor.
Half-life, in each label's words: Hydrochlorothiazide, “When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 …”; Lisinopril, “Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours.”
Only the lisinopril label carries a boxed warning.
Generics: hydrochlorothiazide since 1973; lisinopril since 2002 (Drugs@FDA).
| Hydrochlorothiazide | Lisinopril | |
|---|---|---|
| Labeled for | Heart failure, High blood pressure, Edema (fluid retention) | High blood pressure, Heart attack and coronary artery disease, Heart failure |
| Pharmacologic class | Thiazide Diuretic | 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) | When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 and 14.8 hours. | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. |
| Earliest approval on file (Drugs@FDA) | February 12, 1959 | December 29, 1987 |
| First generic approved | January 12, 1973 | July 1, 2002 |
| Generic labelers (NDC) | 43 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0115 per tablet (Hydrochlorothiazide 25 mg tablet) | $0.0254 per tablet (Lisinopril 20 mg tablet) |
| 12-month price change | -7% | -3% |
| Boxed warning | No | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 7 | 28 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 144,413 | 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 hydrochlorothiazide
- every medicine labeled for the same conditions