Two medicines, side by side
Ramipril vs metoprolol
Ramipril and metoprolol are both labeled for high blood pressure and heart attack and coronary artery disease. Drugs@FDA records approvals of ramipril since 1991 and of metoprolol since 1978. Pharmacies paid $0.0707 per ramipril 10 mg capsule and $0.085 per metoprolol succ ER 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Metoprolol's other strengths are brand-only: $1.20 per mL (Lopressor 10 mg/mL oral solution). In FDA's classes, ramipril is an angiotensin converting enzyme inhibitor and metoprolol a beta-adrenergic blocker.
Check it at the source: the ramipril FDA label on DailyMed (effective August 24, 2026); the metoprolol FDA label on DailyMed (effective March 3, 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 metoprolol record
Metoprolol (Lopressor) · label of March 3, 2026
Used for
From the label: indicationsTOPROL-XL, metoprolol succinate, is a beta-adrenergic blocker indicated for the treatment of: Hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. ( 1.1 ) Angina Pectoris. […]
On the market
- Earliest approval on file
- August 7, 1978
- Generic labelers
- 74 labelers
- Pharmacy cost
- $0.085 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 39
Source: FDA drug labels via openFDA (Ramipril label of August 24, 2026, Metoprolol label of March 3, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ramipril and metoprolol differ on the record?
In FDA's classes, ramipril is an angiotensin converting enzyme inhibitor and metoprolol a beta-adrenergic blocker.
How each works, in its label's words: Ramipril, “Ramipril and ramiprilat inhibit ACE in human subjects and animals.”; Metoprolol, “Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent.”
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 …”; Metoprolol, “Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately …”
Only the ramipril label carries a boxed warning.
Generics: ramipril since 2005; metoprolol since 1993 (Drugs@FDA).
| Ramipril | Metoprolol | |
|---|---|---|
| Labeled for | High blood pressure, Heart attack and coronary artery disease | High blood pressure, Angina, Heart failure, 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. | Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent. |
| 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. | Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately 3 to 7 hours. |
| Earliest approval on file (Drugs@FDA) | January 28, 1991 | August 7, 1978 |
| First generic approved | October 24, 2005 | December 21, 1993 |
| Generic labelers (NDC) | 17 labelers | 74 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0707 per capsule (Ramipril 10 mg capsule) | $0.085 per tablet (Metoprolol succ ER 100 mg tablet) |
| 12-month price change | +1% | -8% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 5 | 39 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 123,138 | 353,609 |
| 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