Two medicines, side by side
Propranolol vs ramipril
Propranolol and ramipril are both labeled for high blood pressure. Drugs@FDA records approvals of propranolol since 1967 and of ramipril since 1991. Pharmacies paid $0.0493 per propranolol 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, propranolol is a beta-adrenergic blocker and ramipril an angiotensin converting enzyme inhibitor.
Check it at the source: the propranolol FDA label on DailyMed (effective January 15, 2026); the ramipril FDA label on DailyMed (effective August 24, 2026).
Highlights of the propranolol record
Propranolol (Inderal) · label of January 15, 2026
Used for
From the label: indicationsHypertension Propranolol hydrochloride tablets are indicated in the management of hypertension. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Propranolol hydrochloride tablets are not indicated in the management of hypertensive emergencies. […]
On the market
- Earliest approval on file
- November 13, 1967
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.0493 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 4
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 (Propranolol label of January 15, 2026, Ramipril label of August 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do propranolol and ramipril differ on the record?
In FDA's classes, propranolol is a beta-adrenergic blocker and ramipril an angiotensin converting enzyme inhibitor.
How each works, in its label's words: Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”; Ramipril, “Ramipril and ramiprilat inhibit ACE in human subjects and animals.”
Half-life, in each label's words: Propranolol, “The plasma half-life of propranolol is from 3 to 6 hours.”; Ramipril, “The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent …”
Only the ramipril label carries a boxed warning.
Generics: propranolol since 1985; ramipril since 2005 (Drugs@FDA).
| Propranolol | Ramipril | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Atrial fibrillation, Migraine | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | beta-Adrenergic Blocker | Angiotensin Converting Enzyme Inhibitor |
| How it works (label) | Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established. | 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 plasma half-life of propranolol is from 3 to 6 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) | November 13, 1967 | January 28, 1991 |
| First generic approved | July 30, 1985 | October 24, 2005 |
| Generic labelers (NDC) | 42 labelers | 17 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0493 per tablet (Propranolol 20 mg tablet) | $0.0707 per capsule (Ramipril 10 mg capsule) |
| 12-month price change | -17% | +1% |
| Boxed warning | No | Yes |
| Shortage now | In shortage | No current entry |
| Recalls recorded | 4 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 71,660 | 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 propranolol
- every medicine labeled for the same conditions