Two medicines, side by side
Trandolapril vs ramipril
Trandolapril and ramipril are both labeled for high blood pressure. Drugs@FDA records approvals of trandolapril since 1996 and of ramipril since 1991. Pharmacies paid $0.157 per trandolapril 1 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. How each works, in its label's words: Trandolapril, “Mechanism of Action Trandolapril is deesterified to the diacid metabolite, trandolaprilat, which is approximately eight times more active as an inhibitor of ACE activity.”; Ramipril, “Ramipril and ramiprilat inhibit ACE in human subjects and animals.”
Check it at the source: the trandolapril FDA label on DailyMed (effective October 31, 2025); the ramipril FDA label on DailyMed (effective August 24, 2026).
Highlights of the trandolapril record
Trandolapril (Mavik) · label of October 31, 2025
FETAL TOXICITY When pregnancy is detected, discontinue trandolapril tablets as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus (See WARNINGS : Fetal Toxicity ).
Used for
From the label: indicationsHypertension Trandolapril tablets are indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive medication such as hydrochlorothiazide. […]
On the market
- Earliest approval on file
- April 26, 1996
- Generic labelers
- 5 labelers
- Pharmacy cost
- $0.157 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
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 (Trandolapril label of October 31, 2025, Ramipril label of August 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do trandolapril and ramipril differ on the record?
How each works, in its label's words: Trandolapril, “Mechanism of Action Trandolapril is deesterified to the diacid metabolite, trandolaprilat, which is approximately eight times more active as an inhibitor of ACE activity.”; Ramipril, “Ramipril and ramiprilat inhibit ACE in human subjects and animals.”
Both are in FDA's class angiotensin converting enzyme inhibitors.
Half-life, in each label's words: Trandolapril, “The elimination half-life of trandolapril is about 6 hours.”; Ramipril, “The initial rapid decline, which represents distribution of the drug into a large peripheral compartment and subsequent …”
Both labels carry a boxed warning; the records quote them.
Generics: trandolapril since 2006; ramipril since 2005 (Drugs@FDA).
| Trandolapril | Ramipril | |
|---|---|---|
| Labeled for | High blood pressure | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | Angiotensin Converting Enzyme Inhibitor | Angiotensin Converting Enzyme Inhibitor |
| How it works (label) | Mechanism of Action Trandolapril is deesterified to the diacid metabolite, trandolaprilat, which is approximately eight times more active as an inhibitor of ACE activity. | 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 elimination half-life of trandolapril is about 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) | April 26, 1996 | January 28, 1991 |
| First generic approved | December 12, 2006 | October 24, 2005 |
| Generic labelers (NDC) | 5 labelers | 17 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.157 per tablet (Trandolapril 1 mg tablet) | $0.0707 per capsule (Ramipril 10 mg capsule) |
| 12-month price change | +1% | +1% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 2,026 | 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 do the labels say about using others of their kind?
Trandolapril label, drug interactionsConcomitant Diuretic Therapy As with other ACE inhibitors, patients on diuretics, especially those on recently instituted diuretic therapy, may experience an excessive reduction of blood pressure after initiation of therapy with trandolapril tablets.
Source: FDA drug labels via openFDA
What next?
- Alternatives to trandolapril
- every medicine labeled for the same conditions