Ramipril vs Lisinopril: what is the difference?

How they differ

Ramipril and lisinopril are ACE inhibitors, two of the most widely prescribed blood pressure medicines, and both descend from a peptide found in the venom of a Brazilian pit viper. The main chemical difference is that ramipril is a prodrug: it is an ethyl ester that the liver must cut to make ramiprilat, the active form, while lisinopril is active as swallowed. Lisinopril is also unusual in its class for not being processed by the liver at all, and it leaves the body unchanged in urine. Their formulas are C23H32N2O5 at 416.5 and C21H31N3O5 at 405.5. Both are prescription medicines, sold as Tritace and Altace, and as Zestril and Prinivil.

Side by side

Structural similarity 0.40 of 1, computed as a Morgan fingerprint Tanimoto coefficient. It measures shape, not effect.

Common questions

What is the difference between Ramipril and Lisinopril?

Ramipril and lisinopril are ACE inhibitors, two of the most widely prescribed blood pressure medicines, and both descend from a peptide found in the venom of a Brazilian pit viper. The main chemical difference is that ramipril is a prodrug: it is an ethyl ester that the liver must cut to make ramiprilat, the active form, while lisinopril is active as swallowed. Lisinopril is also unusual in its class for not being processed by the liver at all, and it leaves the body unchanged in urine.

Is Ramipril bigger than Lisinopril?

Ramipril is the heavier molecule, 416.5 g/mol against 405.5 g/mol for Lisinopril. Ramipril is C23H32N2O5 and Lisinopril is C21H31N3O5.