Two medicines, side by side
Irbesartan vs ramipril
Irbesartan and ramipril are both labeled for high blood pressure. Drugs@FDA records approvals of irbesartan since 1997 and of ramipril since 1991. Pharmacies paid $0.107 per irbesartan 150 mg tablet and $0.0707 per ramipril 10 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, irbesartan is an angiotensin 2 receptor blocker and ramipril an angiotensin converting enzyme inhibitor.
Check it at the source: the irbesartan FDA label on DailyMed (effective August 6, 2026); the ramipril FDA label on DailyMed (effective August 24, 2026).
Highlights of the irbesartan record
Irbesartan (Avapro) · label of August 6, 2026
FETAL TOXICITY
When pregnancy is detected, discontinue irbesartan tablets 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 warning.
Used for
From the label: indicationsIrbesartan is 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 ) Treatment of diabetic nephropathy in hypertensive patients with type 2 diabetes, an elevated serum creatinine, and proteinuria. […]
On the market
- Earliest approval on file
- September 30, 1997
- Generic labelers
- 23 labelers
- Pharmacy cost
- $0.107 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Highlights of the ramipril record
Ramipril (Altace) · label of August 24, 2026
FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue ramipril as soon as possible ( 5.6 ). Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus ( 5.6 ). WARNING: FETAL TOXICITY When pregnancy is detected, discontinue ramipril as soon as possible ( 5.6 ). Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus ( 5.6 ).
Used for
From the label: indicationsRamipril capsules are an angiotensin converting enzyme (ACE) inhibitor indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. It may be used alone or in combination with thiazide diuretics ( 1.1 ). […]
On the market
- Earliest approval on file
- January 28, 1991
- Generic labelers
- 17 labelers
- Pharmacy cost
- $0.0707 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Irbesartan label of August 6, 2026, Ramipril label of August 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do irbesartan and ramipril differ on the record?
In FDA's classes, irbesartan is an angiotensin 2 receptor blocker and ramipril an angiotensin converting enzyme inhibitor.
How each works, in its label's words: Irbesartan, “Angiotensin II is a potent vasoconstrictor formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II).”; Ramipril, “Ramipril and ramiprilat inhibit ACE in human subjects and animals.”
Half-life, in each label's words: Irbesartan, “The terminal elimination half-life of irbesartan averages 11 to 15 hours.”; Ramipril, “The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent …”
Both labels carry a boxed warning; the records quote them.
Generics: irbesartan since 2012; ramipril since 2005 (Drugs@FDA).
| Irbesartan | Ramipril | |
|---|---|---|
| Labeled for | High blood pressure, Chronic kidney disease | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | Angiotensin 2 Receptor Blocker | Angiotensin Converting Enzyme Inhibitor |
| How it works (label) | Angiotensin II is a potent vasoconstrictor formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). | Ramipril and ramiprilat inhibit ACE in human subjects and animals. Angiotensin converting enzyme is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. |
| Half-life (label) | The terminal elimination half-life of irbesartan averages 11 to 15 hours. | The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent binding to both plasma and tissue ACE, has a half-life of 2 to 4 hours. |
| Earliest approval on file (Drugs@FDA) | September 30, 1997 | January 28, 1991 |
| First generic approved | March 30, 2012 | October 24, 2005 |
| Generic labelers (NDC) | 23 labelers | 17 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.107 per tablet (Irbesartan 150 mg tablet) | $0.0707 per capsule (Ramipril 10 mg capsule) |
| 12-month price change | -8% | +1% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 10 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 44,400 | 123,138 |
| 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 irbesartan
- every medicine labeled for the same conditions