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ACE inhibitors: the complete list, ranked by safety record

All 9 ace inhibitors we track, ranked by our independent FDA recall-safety score. Unlike a plain list, every drug here carries its safety record, what it treats, whether a generic exists, and how long it stays in your body.

ACE inhibitors are blood-pressure medications. Doctors prescribe them for high blood pressure and heart failure, and to protect the heart and kidneys in people with related conditions.

How they work: They block the angiotensin-converting enzyme, which normally turns angiotensin I into angiotensin II — a chemical that tightens blood vessels. With less angiotensin II, vessels relax and widen, so blood flows more easily and pressure drops.

What everyone taking one should know

Three risks run across the whole class: a dry, persistent cough (in roughly 1 to 10 percent of users, with no treatment other than reconsidering the drug); angioedema — sudden, serious swelling of the face, tongue, or throat that can block the airway; and fetal harm, since these drugs can injure or kill a developing baby and are not used in pregnancy. Swelling of the face or throat or trouble breathing is a medical emergency.

By the pharmaranks editorial teamReviewed against the FDA (Established Pharmacologic Class & openFDA), MedlinePlus sourcesHow we research
ACE inhibitors ranked by FDA recall-safety score
DrugSafetyGeneric?
enalapril maleateboxed warning72/100Brand only
fosinopril sodiumboxed warning72/100Brand only
lisinoprilboxed warning
Half-life: about 12 hours
72/100Yes
benazepril hydrochlorideboxed warning70/100Brand only
trandolaprilboxed warning70/100Brand only
captoprilboxed warningunratedYes
perindopril erbumineboxed warningunratedBrand only
quinapril hydrochlorideboxed warningunratedBrand only
ramiprilboxed warningunratedBrand only

Ranked by our independent recall-safety score (higher is better), which reflects the FDA recall and enforcement record — not effectiveness. A higher score is not medical advice to switch; which drug is right for you is a prescriber’s decision. 4 are unrated (too little regulatory history to score) and sort last.

Sources

Other drug classes: NSAIDs · Statins · Benzodiazepines · Opioids · Beta blockers · SSRIs · SNRIs · ARBs · Proton pump inhibitors · Calcium channel blockers · Macrolide antibiotics.

The list is built from the FDA’s Established Pharmacologic Class tags, so it reflects the drugs in this class that we track (one row per active ingredient). Safety scores come from the FDA recall and enforcement record. This is general reference information, not medical advice — do not start, stop or switch a medication based on it; talk to your prescriber or pharmacist.