Two medicines, side by side
Lisinopril vs spironolactone
Lisinopril and spironolactone are both labeled for high blood pressure and heart failure. Drugs@FDA records approvals of lisinopril since 1987 and of spironolactone since 1960. Pharmacies paid $0.0254 per lisinopril 20 mg tablet and $0.0426 per spironolactone 25 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). In FDA's classes, lisinopril is an angiotensin converting enzyme inhibitor and spironolactone an aldosterone antagonist.
Check it at the source: the lisinopril FDA label on DailyMed (effective January 2, 2025); the spironolactone FDA label on DailyMed (effective November 28, 2025).
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
Highlights of the spironolactone record
Spironolactone (Aldactone) · label of November 28, 2025
Used for
From the label: indicationsALDACTONE is an aldosterone antagonist indicated for: • The treatment of NYHA Class III–IV heart failure and reduced ejection fraction to increase survival, manage edema, and to reduce the need for hospitalization for heart failure ( 1.1 ). • Use as an add-on therapy for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- January 21, 1960
- Generic labelers
- 38 labelers
- Pharmacy cost
- $0.0426 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 6
Source: FDA drug labels via openFDA (Lisinopril label of January 2, 2025, Spironolactone label of November 28, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do lisinopril and spironolactone differ on the record?
In FDA's classes, lisinopril is an angiotensin converting enzyme inhibitor and spironolactone an aldosterone antagonist.
How each works, in its label's words: Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”; Spironolactone, “Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent …”
Half-life, in each label's words: Lisinopril, “Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours.”; Spironolactone, “The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and …”
Only the lisinopril label carries a boxed warning.
Generics: lisinopril since 2002; spironolactone since 1980 (Drugs@FDA).
| Lisinopril | Spironolactone | |
|---|---|---|
| Labeled for | High blood pressure, Heart attack and coronary artery disease, Heart failure | Heart failure, Edema (fluid retention), High blood pressure |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | Aldosterone Antagonist |
| How it works (label) | 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. | Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted … |
| Half-life (label) | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. | The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and 6-β-hydroxy-7-α-(thiomethyl) spirolactone (HTMS) are 16.5, 13.8, and 15 hours, respectively. |
| Earliest approval on file (Drugs@FDA) | December 29, 1987 | January 21, 1960 |
| First generic approved | July 1, 2002 | May 7, 1980 |
| Generic labelers (NDC) | 36 labelers | 38 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0254 per tablet (Lisinopril 20 mg tablet) | $0.0426 per tablet (Spironolactone 25 mg tablet) |
| 12-month price change | -3% | -14% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 28 | 6 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 304,309 | 139,757 |
| 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 lisinopril
- every medicine labeled for the same conditions