Two medicines, side by side
Telmisartan vs lisinopril
Telmisartan and lisinopril are both labeled for high blood pressure and heart attack and coronary artery disease. Drugs@FDA records approvals of telmisartan since 1998 and of lisinopril since 1987. Pharmacies paid $0.106 per telmisartan 20 mg tablet and $0.0254 per lisinopril 20 mg tablet (NADAC, October 7, 2026). Lisinopril's other strengths are brand-only: $4.50 per mL (Qbrelis 1 mg/mL solution). In FDA's classes, telmisartan is an angiotensin 2 receptor blocker and lisinopril an angiotensin converting enzyme inhibitor.
Check it at the source: the telmisartan FDA label on DailyMed (effective May 29, 2026); the lisinopril FDA label on DailyMed (effective January 2, 2025).
Highlights of the telmisartan record
Telmisartan (Micardis) · label of May 29, 2026
FETAL TOXICITY When pregnancy is detected, discontinue telmisartan as soon as possible [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)]. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)]. WARNING: FETAL TOXICITY See full prescribing information for complete boxed warnings.
Used for
From the label: indicationsTelmisartanis an angiotensin II receptor blocker (ARB) indicated for: Treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions(1.1) 1.1 Hypertension Telmisartan is indicated for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- November 10, 1998
- Generic labelers
- 28 labelers
- Pharmacy cost
- $0.106 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Highlights of the lisinopril record
Lisinopril (Zestril) · label of January 2, 2025
FETAL TOXICITY When pregnancy is detected, discontinue ZESTRIL as soon as possible [see Warnings and Precautions ( 5.1 )]. 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 Zestril as soon as possible.
Used for
From the label: indicationsZestril is an angiotensin converting enzyme (ACE) inhibitor indicated for: Treatment of hypertension in adults and pediatric patients 6 years of age and older ( 1.1 ) Adjunct therapy for heart failure ( 1.2 ) Treatment of Acute Myocardial Infarction ( 1.3 ) 1.1 Hypertension Zestril is indicated for the treatment of hypertension in adult patients and pediatric patients 6 years of age and older to lower blood pressure. […]
On the market
- Earliest approval on file
- December 29, 1987
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.0254 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 28
Source: FDA drug labels via openFDA (Telmisartan label of May 29, 2026, Lisinopril label of January 2, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do telmisartan and lisinopril differ on the record?
In FDA's classes, telmisartan is an angiotensin 2 receptor blocker and lisinopril an angiotensin converting enzyme inhibitor.
How each works, in its label's words: Telmisartan, “Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II).”; Lisinopril, “Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals.”
Half-life, in each label's words: Telmisartan, “Telmisartan shows bi-exponential decay kinetics with a terminal elimination half-life of approximately 24 hours.”; Lisinopril, “Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: telmisartan since 2014; lisinopril since 2002 (Drugs@FDA).
| Telmisartan | Lisinopril | |
|---|---|---|
| Labeled for | High blood pressure, Heart attack and coronary artery disease | High blood pressure, Heart attack and coronary artery disease, Heart failure |
| 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). | Lisinopril inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. |
| Half-life (label) | Telmisartan shows bi-exponential decay kinetics with a terminal elimination half-life of approximately 24 hours. | Upon multiple dosing, lisinopril exhibits an effective half-life of 12 hours. |
| Earliest approval on file (Drugs@FDA) | November 10, 1998 | December 29, 1987 |
| First generic approved | January 8, 2014 | July 1, 2002 |
| Generic labelers (NDC) | 28 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.106 per tablet (Telmisartan 20 mg tablet) | $0.0254 per tablet (Lisinopril 20 mg tablet) |
| 12-month price change | -4% | -3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 3 | 28 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 17,745 | 304,309 |
| 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 telmisartan
- every medicine labeled for the same conditions