Two medicines, side by side
Ramipril vs losartan
Ramipril and losartan are both labeled for high blood pressure. Drugs@FDA records approvals of ramipril since 1991 and of losartan since 1995. Pharmacies paid $0.0707 per ramipril 10 mg capsule and $0.0327 per losartan potassium 50 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 losartan an angiotensin 2 receptor blocker.
Check it at the source: the ramipril FDA label on DailyMed (effective August 24, 2026); the losartan FDA label on DailyMed (effective January 20, 2026).
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 losartan record
Losartan (Cozaar) · label of January 20, 2026
FETAL TOXICITY When pregnancy is detected, discontinue COZAAR as soon as possible. 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 COZAAR as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
Used for
From the label: indicationsCOZAAR is an angiotensin II receptor blocker (ARB) indicated for: Treatment of hypertension, to lower blood pressure in adults and children greater than 6 years old. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. ( 1.1 ) Reduction of the risk of stroke in patients with hypertension and left ventricular hypertrophy. […]
On the market
- Earliest approval on file
- April 14, 1995
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0327 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 77
Source: FDA drug labels via openFDA (Ramipril label of August 24, 2026, Losartan label of January 20, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ramipril and losartan differ on the record?
In FDA's classes, ramipril is an angiotensin converting enzyme inhibitor and losartan an angiotensin 2 receptor blocker.
How each works, in its label's words: Ramipril, “Ramipril and ramiprilat inhibit ACE in human subjects and animals.”; Losartan, “Angiotensin II [formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II)] is a potent vasoconstrictor, the primary vasoactive hormone of the …”
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 …”; Losartan, “The terminal half-life of losartan is about 2 hours and of the metabolite is about 6-9 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: ramipril since 2005; losartan since 2010 (Drugs@FDA).
| Ramipril | Losartan | |
|---|---|---|
| Labeled for | High blood pressure, Heart attack and coronary artery disease | High blood pressure, Chronic kidney disease, Stroke prevention |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | Angiotensin 2 Receptor 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. | Angiotensin II [formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II)] is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system, and an important component … |
| 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 terminal half-life of losartan is about 2 hours and of the metabolite is about 6-9 hours. |
| Earliest approval on file (Drugs@FDA) | January 28, 1991 | April 14, 1995 |
| First generic approved | October 24, 2005 | April 6, 2010 |
| Generic labelers (NDC) | 17 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0707 per capsule (Ramipril 10 mg capsule) | $0.0327 per tablet (Losartan potassium 50 mg tablet) |
| 12-month price change | +1% | +2% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 77 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 123,138 | 200,566 |
| 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