Two medicines, side by side
Lisinopril vs trandolapril
Lisinopril and trandolapril are both labeled for high blood pressure. Drugs@FDA records approvals of lisinopril since 1987 and of trandolapril since 1996. Pharmacies paid $0.0254 per lisinopril 20 mg tablet and $0.157 per trandolapril 1 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). How each works, in its label's words: Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”; Trandolapril, “Mechanism of Action Trandolapril is deesterified to the diacid metabolite, trandolaprilat, which is approximately eight times more active as an inhibitor of ACE activity.”
Check it at the source: the lisinopril FDA label on DailyMed (effective January 2, 2025); the trandolapril FDA label on DailyMed (effective October 31, 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 trandolapril record
Trandolapril (Mavik) · label of October 31, 2025
FETAL TOXICITY When pregnancy is detected, discontinue trandolapril tablets as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus (See WARNINGS : Fetal Toxicity ).
Used for
From the label: indicationsHypertension Trandolapril tablets are indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive medication such as hydrochlorothiazide. […]
On the market
- Earliest approval on file
- April 26, 1996
- Generic labelers
- 5 labelers
- Pharmacy cost
- $0.157 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Lisinopril label of January 2, 2025, Trandolapril label of October 31, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do lisinopril and trandolapril differ on the record?
How each works, in its label's words: Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”; Trandolapril, “Mechanism of Action Trandolapril is deesterified to the diacid metabolite, trandolaprilat, which is approximately eight times more active as an inhibitor of ACE activity.”
Both are in FDA's class angiotensin converting enzyme inhibitors.
Half-life, in each label's words: Lisinopril, “Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours.”; Trandolapril, “The elimination half-life of trandolapril is about 6 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: lisinopril since 2002; trandolapril since 2006 (Drugs@FDA).
| Lisinopril | Trandolapril | |
|---|---|---|
| Labeled for | High blood pressure, Heart attack and coronary artery disease, Heart failure | High blood pressure |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | Angiotensin Converting Enzyme Inhibitor |
| 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. | Mechanism of Action Trandolapril is deesterified to the diacid metabolite, trandolaprilat, which is approximately eight times more active as an inhibitor of ACE activity. |
| Half-life (label) | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. | The elimination half-life of trandolapril is about 6 hours. |
| Earliest approval on file (Drugs@FDA) | December 29, 1987 | April 26, 1996 |
| First generic approved | July 1, 2002 | December 12, 2006 |
| Generic labelers (NDC) | 36 labelers | 5 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0254 per tablet (Lisinopril 20 mg tablet) | $0.157 per tablet (Trandolapril 1 mg tablet) |
| 12-month price change | -3% | +1% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 28 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 304,309 | 2,026 |
| 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 do the labels say about using others of their kind?
Trandolapril label, drug interactionsConcomitant Diuretic Therapy As with other ACE inhibitors, patients on diuretics, especially those on recently instituted diuretic therapy, may experience an excessive reduction of blood pressure after initiation of therapy with trandolapril tablets.
Source: FDA drug labels via openFDA
What next?
- Alternatives to lisinopril
- every medicine labeled for the same conditions