Two medicines, side by side
Ramipril vs atenolol
Ramipril and atenolol are both labeled for high blood pressure and heart attack and coronary artery disease. Drugs@FDA records approvals of ramipril since 1991 and of atenolol since 1981. Pharmacies paid $0.0707 per ramipril 10 mg capsule and $0.0217 per atenolol 25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, ramipril is an angiotensin converting enzyme inhibitor and atenolol a beta-adrenergic blocker.
Check it at the source: the ramipril FDA label on DailyMed (effective August 24, 2026); the atenolol FDA label on DailyMed (effective September 18, 2025).
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
Highlights of the atenolol record
Atenolol (Tenormin) · label of September 18, 2025
Used for
From the label: indicationsHypertension TENORMIN is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including atenolol. […]
On the market
- Earliest approval on file
- August 19, 1981
- Generic labelers
- 35 labelers
- Pharmacy cost
- $0.0217 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 4
Source: FDA drug labels via openFDA (Ramipril label of August 24, 2026, Atenolol label of September 18, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ramipril and atenolol differ on the record?
In FDA's classes, ramipril is an angiotensin converting enzyme inhibitor and atenolol a beta-adrenergic blocker.
Half-life, in each label's words: Ramipril, “The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent …”; Atenolol, “The elimination half-life of oral TENORMIN is approximately 6 to 7 hours, and there is no alteration of the kinetic …”
Only the ramipril label carries a boxed warning.
Generics: ramipril since 2005; atenolol since 1988 (Drugs@FDA).
| Ramipril | Atenolol | |
|---|---|---|
| Labeled for | High blood pressure, Heart attack and coronary artery disease | High blood pressure, Angina, Heart attack and coronary artery disease |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | beta-Adrenergic Blocker |
| How it works (label) | 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. | n/a |
| Half-life (label) | 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. | The elimination half-life of oral TENORMIN is approximately 6 to 7 hours, and there is no alteration of the kinetic profile of the drug by chronic administration. |
| Earliest approval on file (Drugs@FDA) | January 28, 1991 | August 19, 1981 |
| First generic approved | October 24, 2005 | July 15, 1988 |
| Generic labelers (NDC) | 17 labelers | 35 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0707 per capsule (Ramipril 10 mg capsule) | $0.0217 per tablet (Atenolol 25 mg tablet) |
| 12-month price change | +1% | -3% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 123,138 | 132,491 |
| 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 ramipril
- every medicine labeled for the same conditions