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Key takeaways
Losartan, used for hypertension and other conditions, may not be suitable for everyone.
Alternatives to losartan include various classes of blood pressure medications, such as ACE inhibitors, calcium channel blockers, and diuretics.
Alternatives to Losartan include various classes of blood pressure medications like ACE inhibitors, calcium channel blockers, and diuretics, which may be more appropriate based on individual health profiles and side effect tolerance.
Consult a healthcare provider before switching from losartan to an alternative to ensure safety and effectiveness.
Losartan is a commonly prescribed blood pressure drug called an angiotensin II receptor blocker or ARB. It’s FDA-approved to treat high blood pressure (hypertension), kidney disease due to Type 2 diabetes (diabetic nephropathy), and to prevent stroke in people with an enlarged heart (left ventricular hypertrophy). Doctors may use it off-label to treat heart failure. Losartan may not be the best or safest option for all patients. For instance, losartan has a black box warning for fetal toxicity, so pregnant women should never take losartan. Healthcare professionals can use several alternative blood pressure drugs.
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What can I take instead of losartan?
If losartan is not effective or causes side effects, there are several alternative options available to treat high blood pressure. These include other types of angiotensin receptor blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), calcium channel blockers (CCBs), diuretics, beta blockers, central alpha agonists, and alpha blockers. These options may be more suitable for certain individuals due to their different uses, side effect profiles, drug interactions, or dosages.
| Compare Cozaar (losartan) alternatives | |||
|---|---|---|---|
| Drug name | Price without insurance | SingleCare price | Savings options |
| Cozaar (losartan) | $682 for 90, 100 mg tablets | $11 for 90, 100 mg tablets | See latest prices |
| Hyzaar (losartan and hydrochlorothiazide) | $193 per 30, 50-12.5 mg tablets | $4 per 30, 50-12.5 mg tablets | See latest prices |
| Diovan (valsartan) | $1,136 per 90, 160 mg tablets | $30 per 90, 160 mg tablets | See latest prices |
| Zestril (lisinopril) | $1,434 for 90, 10 mg tablets | $7 for 90, 10 mg tablets | See latest prices |
| Norvasc (amlodipine) | $419 for 30, 10 mg tablets | $4 for 30, 10 mg tablets | See latest prices |
| Chlorthalidone | $125 for a supply of 90, 25 mg tablets | $15 for a supply of 90, 25 mg tablets | See latest prices |
| Atacand (candesartan) | $315 per 30, 16 mg tablets | $27 per 30, 16 mg tablets | See latest prices |
| Benicar (olmesartan) | $396 for 30, 20 mg tablets | $9 for 30, 20 mg tablets | See latest prices |
| Avapro (irbesartan) | $315 for 30, 16 mg tablets | $27 for 30, 16 mg tablets | See latest prices |
| Micardis (telmisartan) | $224 for 30, 80 mg tablets | $17 for 30, 80 mg tablets | See latest prices |
| Exforge (valsartan and amlodipine) | $528 for 30, 10-320 mg tablets | $24 for 30, 10-320 mg tablets | See latest prices |
| Lotensin (benazepril) | $75 for 30, 10 mg tablets | $8 for 30, 10 mg tablets | See latest prices |
| Vasotec (enalapril) | $1,003 for 30, 20 mg tablets | $9 for 30, 20 mg tablets | See latest prices |
| Dilt-XR (diltiazem ER) | $58 for 90, 120 mg capsules | $24 for 90, 120 mg capsules | See latest prices |
| Propranolol | $42 for 60, 10 mg tablets | $8 for 60, 10 mg tablets | See latest prices |
| Toprol XL (metoprolol succinate ER) | $160 for 90, 25 mg tablets | $9 for 90, 25 mg tablets | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price, without insurance, refers to the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the “Savings options” link to see the latest drug prices.
Top 5 losartan alternatives
1. Hyzaar (losartan and hydrochlorothiazide)
Hyzaar (losartan-HCTZ) is a brand-name combination tablet that contains losartan and hydrochlorothiazide, a diuretic. Along with losartan, thiazide diuretics like hydrochlorothiazide are recommended as first-line medications for hypertension treatment, according to the American Heart Association (AHA) hypertension treatment guidelines. Since people managing hypertension will often need more than one medication, Hyzaar is a more convenient option as only one tablet is needed each day.
Hyzaar should not be used in pregnant women due to fetal toxicity risk. Side effects are similar to those of losartan but also include increased urination, headache, lightheadedness, and possible electrolyte imbalances. It’s important for those taking diuretics to have their fluid status and electrolytes checked regularly.
2. Diovan (valsartan)
Valsartan is an angiotensin II receptor blocker (ARB) that works like losartan. It, too, is a first-line treatment for high blood pressure and may be equally effective at lowering diastolic blood pressure, the pressure inside the arteries when the heart rests. Along with treating hypertension, valsartan is FDA-approved to treat heart failure and to reduce the risk of stroke after a heart attack. Common side effects include dizziness and low blood pressure (hypotension), while serious side effects are similar to those of losartan. Doses are taken once or twice daily.
RELATED: Valsartan side effects
3. Zestril (lisinopril)
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. Like losartan, lisinopril is recommended as a first-line medication for treating hypertension. Lisinopril is also FDA-approved to treat heart failure and acute myocardial infarction (heart attack). Like losartan, lisinopril, and other ACE inhibitors should not be used in pregnant women due to fetal toxicity risk. Common side effects include dizziness, low blood pressure, and a persistent cough. The cough can be bothersome enough to some people to require a change in medication. Tablets are taken once daily.
RELATED: Losartan vs. lisinopril
4. Norvasc (amlodipine)
Amlodipine is a calcium channel blocker (CCB) recommended as a first-line medication for treating hypertension. Aside from hypertension treatment, amlodipine is approved for use in coronary artery disease with chest pain (angina). Amlodipine may be considered as an alternative for people managing hypertension and heart disease. Common side effects include headache and edema. Amlodipine tablets are taken once daily.
RELATED: Amlodipine alternatives
5. Chlorthalidone
Chlorthalidone is a thiazide diuretic, or “water pill,” that increases the body’s elimination of fluids and electrolytes. Like losartan, chlorthalidone is recommended as a first-line medication for treating hypertension. Aside from hypertension treatment, chlorthalidone can be used to reduce fluid build-up and swelling. Chlorthalidone may be considered as an alternative for people managing hypertension or edema associated with congestive heart failure, kidney problems, and other medical conditions. Common side effects include increased urination, headache, lightheadedness, and possible electrolyte imbalances. It’s important for those taking diuretics to have their fluid status and electrolytes monitored regularly. Tablets are taken once daily.
Natural alternatives to losartan
Natural therapies for lowering blood pressure are recommended and often prescribed. However, natural treatments should not replace prescription blood pressure medications.
Lifestyle changes are a major part of hypertension treatment. Regular physical exercise and weight loss help lower blood pressure, sometimes significantly. Being overweight, especially weight in the belly, is linked to increased blood pressure. A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, is recommended for people with hypertension. The DASH diet emphasizes consuming fruits, vegetables, low-fat dairy products, whole grains, lean meats, poultry, legumes, and nuts. This diet also aims to decrease sodium, foods and beverages with added sugars, and red meat.
The AHA also recommends adults with elevated blood pressure limit alcohol intake to no more than two standard drinks for men and one standard drink for women per day.
The AHA guidelines also recommend increasing potassium intake, except for people with kidney problems or who are taking ACE inhibitors or ARBs. Potassium is found in a variety of foods, including raisins, apricots, potatoes, beans, spinach, broccoli, avocados, bananas, and oranges. Supplements are recommended if it’s too difficult to get sufficient potassium through foods alone.
RELATED: How to lower blood pressure quickly and naturally
Over-the-counter blood pressure medications
There are no effective over-the-counter medications for blood pressure. Supplements containing CoQ10, omega-3 fatty acids, or magnesium may have a minor effect on blood pressure, but should never substitute for prescription medications in the treatment of hypertension.
How to switch to a losartan alternative
1. Do not suddenly stop taking losartan without medical advice
Only stop taking losartan after consulting the prescribing healthcare provider. Stopping losartan suddenly may cause a sudden spike in blood pressure. The prescriber will create a therapy plan to stop losartan and possibly start a new antihypertensive drug. Before starting the new drug or drugs, review the medication guide or prescribing information.
2. Discuss all health conditions with a healthcare provider
Before switching from losartan to an alternative antihypertensive drug, it’s important that the prescriber is aware of all medical conditions. Some alternatives should be used with caution or avoided with certain medical conditions. For example, pregnant women or women planning on becoming pregnant cannot safely take medications that contain ACE inhibitors or ARBs. Beta blockers, such as atenolol and metoprolol succinate, must be avoided by people with certain heart conditions, such as bradycardia (slow heart rate).
3. Discuss all prescription and over-the-counter medications with a healthcare provider
Before switching from losartan to an alternative, the prescribing healthcare provider must review a patient’s medication list, including prescription and over-the-counter meds. Some other options have dangerous drug interactions that must be avoided.
4. Continue to monitor blood pressure readings
It’s important to check blood pressure with an at-home monitor for those managing hypertension. Keeping a blood pressure journal can help healthcare providers determine whether the medication plan works or needs adjustments.
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- Coenzyme Q10 in cardiovascular and metabolic diseases: current state of the problem, Current Cardiology Reviews (2018)
- Cozaar losartan potassium tablet prescribing information, DailyMed (NIH National Library of Medicine)
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- Effects of magnesium supplementation on blood pressure: a meta-analysis of randomized double-blind placebo-controlled trials, Hypertension (2016)
- Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials, American Journal of Hypertension (2014)
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