Two medicines, side by side
Olmesartan vs ramipril
Olmesartan and ramipril are both labeled for high blood pressure. Drugs@FDA records approvals of olmesartan since 2002 and of ramipril since 1991. Pharmacies paid $0.0805 per olmesartan medoxomil 20 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, olmesartan is an angiotensin 2 receptor blocker and ramipril an angiotensin converting enzyme inhibitor.
Check it at the source: the olmesartan FDA label on DailyMed (effective September 23, 2025); the ramipril FDA label on DailyMed (effective August 24, 2026).
Highlights of the olmesartan record
Olmesartan (Benicar) · label of September 23, 2025
FETAL TOXICITY When pregnancy is detected, discontinue Benicar as soon as possible ( 5.1 , 8.1 ). Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus ( 5.1 , 8.1 ). WARNING: FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue Benicar as soon as possible ( 5.1 , 8.1 ).
Used for
From the label: indicationsBenicar is indicated for the treatment of hypertension in adults and children six years of age and older, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. […]
On the market
- Earliest approval on file
- April 25, 2002
- Generic labelers
- 30 labelers
- Pharmacy cost
- $0.0805 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
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 (Olmesartan label of September 23, 2025, Ramipril label of August 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do olmesartan and ramipril differ on the record?
In FDA's classes, olmesartan is an angiotensin 2 receptor blocker and ramipril an angiotensin converting enzyme inhibitor.
How each works, in its label's words: Olmesartan, “Angiotensin II is 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: Olmesartan, “Olmesartan appears to be eliminated in a biphasic manner with a terminal elimination half-life of approximately 13 …”; 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: olmesartan since 2016; ramipril since 2005 (Drugs@FDA).
| Olmesartan | Ramipril | |
|---|---|---|
| Labeled for | High blood pressure | 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 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) | Olmesartan appears to be eliminated in a biphasic manner with a terminal elimination half-life of approximately 13 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) | April 25, 2002 | January 28, 1991 |
| First generic approved | October 26, 2016 | October 24, 2005 |
| Generic labelers (NDC) | 30 labelers | 17 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0805 per tablet (Olmesartan medoxomil 20 mg tablet) | $0.0707 per capsule (Ramipril 10 mg capsule) |
| 12-month price change | +1% | +1% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 35,743 | 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 olmesartan
- every medicine labeled for the same conditions