Table of ContentsView AllTable of ContentsUnderstanding HypertensionWhat Is Losartan?What Is Lisinopril?DosingEfficacyAlternative Treatment OptionsSafetyInteractionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Understanding Hypertension
What Is Losartan?
What Is Lisinopril?
Dosing
Efficacy
Alternative Treatment Options
Safety
Interactions
Frequently Asked Questions
Hypertension (high blood pressure, or HBP)is one of the primary catalysts behindstrokeandheart disease.
Losartan(brand name:Cozaar) andlisinopril(brand name:Zestril) are first-lineantihypertensive drugsthat control HBP. However, their class, dosage forms, dosing regimens, and uses differ.
Furthermore, they work in different ways. Losartan is anangiotensin receptor II receptor blocker (ARB)medication that works on specific receptors to provide a therapeutic effect.
Lisinopril is anangiotensin-converting enzyme inhibitor (ACE inhibitor)that inhibits enzyme conversion that raises blood pressure.
Lisinopril is available in tablet and liquid dosage forms, while losartan is available only in tablet form.
This article compares and contrasts losartan versus lisinopril.
Getty Images / Kinga Krzeminska
Understanding HBP
The risk of stroke increases with HBP (above 115/75 millimeters of mercury [mm Hg]).HBP is a significant risk factor for stroke, associated with 54% of stroke episodes worldwide.
Blood pressure is the force blood pushes against the wall of the arteries.
More specifically, HBP is when the force pushing the blood against the blood vessels' walls is consistently too high.
HBP increases the workload of the heart and blood vessels, which makes them weaker and work less efficiently. Weak blood vessels can burst or clog more easily.
Consequences
HBP can damage arteries. It can lead to other conditions, includingarrhythmia (irregular heartbeat),myocardial infarction (heart attack), and stroke.
Associated Risk Factors
Risk factors that can increase the risk of HBP include health conditions such as diabetes, lifestyle, and family history.
Significant factors that can be controlled to reduce the risk of high blood pressure are physical inactivity, reducing sodium, obesity, too much alcohol, tobacco use, and a balanced diet.
Various medical treatment options, such as diuretics, beta-blockers, ACE inhibitors, ARBs, and others, are available on prescription to manage HBP.
Along with these, non-medical options such as lifestyle changes are also effective ways to avoid disease progression.
In both generic and name-brand form, this product is available via prescription as an oral tablet once or twice a day as prescribed, with or without food.
Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular (CV) problems, including stroke and heart attack.
Losartan also reduces the risk of stroke in people with HBP andleft ventricular hypertrophy(enlargement of the walls of the left side of the heart).
However, evidence shows it is not beneficial to decrease the risk of stroke for African-Americans.
Losartan is also approved for the treatment of diabetic nephropathy (kidney disease in people who havetype 2 diabetes, which results in a lack of blood sugar control) and a history of HBP.
Losartan also reduces the rate of progression of diabetic nephropathy in these people.
Off-Label Uses
Losartan has been used off-label (a use for which the drug was not FDA-approved initially to be used) to treatheart failure(HF, a condition in which the heart cannot pump enough blood to the body).
In addition to Cozaar, other name-brand forms of losartan available include Hyzaar (containing a combination of two active ingredients,hydrochlorothiazideand losartan).
How It Works
Losartan blocks the action of certain natural substances on the receptors (angiotensin II receptors) that work to tighten the blood vessels.
The blockage of receptors reduces the action of these enzymes to improve the blood flow and helps the heart to pump blood more efficiently.
Losartan controls HBP but does not cure it.
Your blood pressure may start decreasing during the first week of the treatment. It may take three to six weeks to get the full benefit of losartan.
Lisinopril is an ACE inhibitor that is FDA-approved to treat HBP in adults and children 6 years and older.
Lisinopril is also used to reduce signs and symptoms ofsystolic heart failure(SHF, when the heart’s main chamber pumps blood ineffectively).
Moreover, this drug reduces mortality in people at risk for a heart attack.
Off-label uses for lisinopril includemigraine prevention. myocardial fibrosis (MF), andinfertilitytreatment.
Lisinopril is marketed under various brand names.
In addition to Zestril, there exists Qbrelis (lisinopril),and as a combination medicine, Zestoretic (lisinopril and hydrochlorothiazide).
The inhibition of these enzymes eases the blood flow and makes the heart pump blood more efficiently.
Dosing Guidelines
The following briefly overviews some standard dosing practices for losartan vs. lisinopril.
Note that neither drug is approved for use in children under 6 years old.
Losrtan
Losartan is available as 25, 50, and 100 milligrams (mg) film-coated tablets.
The dosing regimen for losartan is as follows:
HBP:
Hypertensive people with LVH:
Nephropathyin type 2 diabetic people:
Lisinopril
Lisinopril is available as 2.5, 5, 10, 20,30 and 40 mg tablets.It is also available in a 150-milliliter (mL) bottle as an oral solution.
The general dosing regimen for lisinopril is as follows:
HF:
Post-heart attack:
Safe Consumption Guidelines
Take losartan tablet orally once a day with or without food as prescribed. Start taking at a lower dose and gradually increase as required.
Conversely, take a lisinopril tablet or solution (liquid) orally once a day as prescribed. Start taking at a lower dose and gradually increase as required.
When taking liquid dosage form, only use the measuring device (cup or syringe) provided to measure the dose.
Take these medicines as prescribed, and do not increase or change the dose.
Don’t stop taking these drugs without asking your healthcare provider, even if your symptoms improve.
Talk to your healthcare provider before using salt substitutes containing potassium. Take a low-salt or low-sodium diet when taking these medicines.
Which Works Better?
Losartan and lisinopril have been deemed safe and effective options for treating various HBP-related conditions. Furthermore, both drugs have similar levels of efficacy.
To support this, one study compared the effectiveness and safety of lisinopril versus losartan for the treatment ofcardiomyopathy (heart disease that harms heart muscle).
The study found no therapeutic difference between lisinopril and losartan over a one-year duration of treatment.
Moreover, the study showed that each drug significantly improvedsystolic function(cardiac output, which is a product of stroke volume and heart rate) following one year of analysis.
HBP is the leading cause of many other vascular disorders.
Antihypertensive medications are an effective way to treat high blood pressure and other associated complications.
However, many non-medical remedies are also proven effective in controlling blood pressure.
The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure also recommends lifestyle changes for people with HBP.
It recommends reducing sodium intake, increasing exercise, moderating alcohol consumption, losing weight, and following a balanced diet.
Also, as a holistic approach to well-being includes dietary, exercise, and mental health-related pursuits, behavioral therapies such asmeditationordeep breathingcan also help treat HBP.
Finally, noninvasive procedures, such asacupuncture, have been documented as beneficial in lowering blood pressure to treat HBP and other vascular disorders.
Side Effects & Safety
Like all drugs, losartan and lisinopril carry the potential for side effects upon consumption.
However, these medications come with an FDA warning that neither drug should be used in pregnant people due to potential damage to a developing fetus.
Side effects associated with the use of losartan and lisinopril are listed below.
Common Side Effects
Some common side effects of losartan and lisinopril include:
Drug-Specific Side Effects
In the case of losartan, it may also causeheartburnand decreased sensitivity to touch.
Some other side effects of lisinopril include:
Call your healthcare provider if the symptoms do not go away.
Severe Side Effects
On rare occasions, losartan and lisinopril carry the potential for more severe side effects.
Call your healthcare provider if you have any of the following symptoms:
Warnings and Precautions
The use of losartan and lisinopril should be avoided in people with the following:
Use losartan and lisinopril with caution and monitor carefully for:
Potential for Interaction
Examples of drugs that may negatively interact with losartan or lisinopril include:
Losartan-Specific Interactions
Specific to losartan, the following drugs should not be taken while using losartan:
Lisinopril-Specific Interactions
Specific to lisinopril, the following drugs should not be taken while using lisinopril:
Furthermore, do not take lisinopril if you take other antihypertensive medications, such as Diovan (valsartan) or Entresto (sacubitril), or have stopped taking this type of medication within 36 hours.
Always tell your healthcare provider about all prescription, non-prescription, vitamins, and herbal drugs you take before starting the therapy with these drugs.
Summary
HBP increases the risk of heart disease and stroke.Tens of millions of adults in the United States have uncontrolled HBP, which is Americans' leading cause of death.
Regular exercise, a balanced diet, a low intake of alcohol and tobacco, and a healthy weight can reduce the tension and stress of vessels to lower blood pressure.
Losartan and lisinopril are first-line, effective therapies for controlling and managing HBP and associated conditions.
Losartan and lisinopril belong to different classes of drugs and are available in different dosage forms and strengths.
However, know that losartan and lisinopril come with an FDA warning regarding its use in pregnant people. Pregnant people must not use these drugs to avoid harm to the fetus.
Do not take these drugs more than prescribed. Continue taking even if you feel better, and don’t discontinue without asking your healthcare provider.
Frequently Asked QuestionsStore all forms of losartan and lisinopril in a dry, secure place (away from children and pets) and at room temperature (68-77 F).Furthermore, keep either product away from areas susceptible to high moisture levels or harsh lightning.Regardless of your feelings or current blood pressure levels, do not stop taking losartan or lisinopril without first asking your healthcare provider.
Store all forms of losartan and lisinopril in a dry, secure place (away from children and pets) and at room temperature (68-77 F).Furthermore, keep either product away from areas susceptible to high moisture levels or harsh lightning.
Store all forms of losartan and lisinopril in a dry, secure place (away from children and pets) and at room temperature (68-77 F).
Furthermore, keep either product away from areas susceptible to high moisture levels or harsh lightning.
Regardless of your feelings or current blood pressure levels, do not stop taking losartan or lisinopril without first asking your healthcare provider.
27 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Facts about hypertension.DailyMed.Label: Cozaar- losartan potassium tablet, film coated.DailyMed.Label: Zestril- lisinopril tablet.MedlinePlus.Losartan.MedlinePlus.Lisinopril.Gaciong Z, Siński M, Lewandowski J.Blood pressure control and primary prevention of stroke: summary of the recent clinical trial data and meta-analyses.Curr Hypertens Rep. 2013;15(6):559-574. doi:10.1007/s11906-013-0401-0MedlinePlus.High blood pressure.American Heart Association.What is high blood pressure?American Heart Association.Health threats from high blood pressure.National Institute of Neurological Disorders and Stroke.Stroke.Centers for Disease Control and Prevention.High blood pressure.MedlinePlus.Blood pressure medicines.Julius S, Alderman MH, Beevers G, et al.Cardiovascular risk reduction in hypertensive black patients with left ventricular hypertrophy: the LIFE study.J Am Coll Cardiol. 2004;43(6):1047-1055. doi:10.1016/j.jacc.2003.11.029Ferreira JP, Konstam M, Rossignol P, Kiernan MS, Zannad F.High- versus low-dose losartan and serum potassium: an analysis From HEAAL.J Card Fail. 2023;29(1):45-52. doi:10.1016/j.cardfail.2022.09.008DailyMed.Label: Hyzaar- losartan potassium and hydrochlorothiazide tablet, film coated.Sadat-Ebrahimi SR, Parnianfard N, Vahed N, et al.An evidence-based systematic review of the off-label uses of lisinopril.Br J Clin Pharmacol. 2018;84(11):2502-2521. doi:10.1111/bcp.13705DailyMed.Label: Qbrelis- lisinopril solution.DailyMed.Label: Zestoretic- lisinopril and hydrochlorothiazide tablet.British Heart Foundation.ACE inhibitors - drug cabinet -HeartMattersmagazine - BHF.DailyMed.Label: losartan potassium 25 mg- losartan potassium tablet, film coated losartan potassium 50 mg- losartan potassium tablet, film coated losartan potassium 100 mg- losartan potassium tablet, film coated.DailyMed.Label: lisinopril tablet.National Institutes of Health. Office of Dietary Supplements.Potassium.Allen HD, Flanigan KM, Thrush PT, et al.A randomized, double-blind trial of lisinopril and losartan for the treatment of cardiomyopathy in duchenne muscular dystrophy [published correction appears inPLoSCurr]. 2015;7. doi:10.1371/currents.md.2cc69a1dae4be7dfe2bcb420024ea865National Institutes of Health National Heart, Lung, and Blood Institute.The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.Schaare HL, Blöchl M, Kumral D, et al.Associations between mental health, blood pressure and the development of hypertension.Nat Commun. 2023;14(1):1953. doi:10.1038/s41467-023-37579-6Sudhakaran P.Acupuncture for hypertension using traditional Chinese medicine concepts.MedAcupunct. 2021;33(1):15-21. doi:10.1089/acu.2020.1422Centers for Disease Control and Prevention.Prevent high blood pressure.
27 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Facts about hypertension.DailyMed.Label: Cozaar- losartan potassium tablet, film coated.DailyMed.Label: Zestril- lisinopril tablet.MedlinePlus.Losartan.MedlinePlus.Lisinopril.Gaciong Z, Siński M, Lewandowski J.Blood pressure control and primary prevention of stroke: summary of the recent clinical trial data and meta-analyses.Curr Hypertens Rep. 2013;15(6):559-574. doi:10.1007/s11906-013-0401-0MedlinePlus.High blood pressure.American Heart Association.What is high blood pressure?American Heart Association.Health threats from high blood pressure.National Institute of Neurological Disorders and Stroke.Stroke.Centers for Disease Control and Prevention.High blood pressure.MedlinePlus.Blood pressure medicines.Julius S, Alderman MH, Beevers G, et al.Cardiovascular risk reduction in hypertensive black patients with left ventricular hypertrophy: the LIFE study.J Am Coll Cardiol. 2004;43(6):1047-1055. doi:10.1016/j.jacc.2003.11.029Ferreira JP, Konstam M, Rossignol P, Kiernan MS, Zannad F.High- versus low-dose losartan and serum potassium: an analysis From HEAAL.J Card Fail. 2023;29(1):45-52. doi:10.1016/j.cardfail.2022.09.008DailyMed.Label: Hyzaar- losartan potassium and hydrochlorothiazide tablet, film coated.Sadat-Ebrahimi SR, Parnianfard N, Vahed N, et al.An evidence-based systematic review of the off-label uses of lisinopril.Br J Clin Pharmacol. 2018;84(11):2502-2521. doi:10.1111/bcp.13705DailyMed.Label: Qbrelis- lisinopril solution.DailyMed.Label: Zestoretic- lisinopril and hydrochlorothiazide tablet.British Heart Foundation.ACE inhibitors - drug cabinet -HeartMattersmagazine - BHF.DailyMed.Label: losartan potassium 25 mg- losartan potassium tablet, film coated losartan potassium 50 mg- losartan potassium tablet, film coated losartan potassium 100 mg- losartan potassium tablet, film coated.DailyMed.Label: lisinopril tablet.National Institutes of Health. Office of Dietary Supplements.Potassium.Allen HD, Flanigan KM, Thrush PT, et al.A randomized, double-blind trial of lisinopril and losartan for the treatment of cardiomyopathy in duchenne muscular dystrophy [published correction appears inPLoSCurr]. 2015;7. doi:10.1371/currents.md.2cc69a1dae4be7dfe2bcb420024ea865National Institutes of Health National Heart, Lung, and Blood Institute.The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.Schaare HL, Blöchl M, Kumral D, et al.Associations between mental health, blood pressure and the development of hypertension.Nat Commun. 2023;14(1):1953. doi:10.1038/s41467-023-37579-6Sudhakaran P.Acupuncture for hypertension using traditional Chinese medicine concepts.MedAcupunct. 2021;33(1):15-21. doi:10.1089/acu.2020.1422Centers for Disease Control and Prevention.Prevent high blood pressure.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Facts about hypertension.DailyMed.Label: Cozaar- losartan potassium tablet, film coated.DailyMed.Label: Zestril- lisinopril tablet.MedlinePlus.Losartan.MedlinePlus.Lisinopril.Gaciong Z, Siński M, Lewandowski J.Blood pressure control and primary prevention of stroke: summary of the recent clinical trial data and meta-analyses.Curr Hypertens Rep. 2013;15(6):559-574. doi:10.1007/s11906-013-0401-0MedlinePlus.High blood pressure.American Heart Association.What is high blood pressure?American Heart Association.Health threats from high blood pressure.National Institute of Neurological Disorders and Stroke.Stroke.Centers for Disease Control and Prevention.High blood pressure.MedlinePlus.Blood pressure medicines.Julius S, Alderman MH, Beevers G, et al.Cardiovascular risk reduction in hypertensive black patients with left ventricular hypertrophy: the LIFE study.J Am Coll Cardiol. 2004;43(6):1047-1055. doi:10.1016/j.jacc.2003.11.029Ferreira JP, Konstam M, Rossignol P, Kiernan MS, Zannad F.High- versus low-dose losartan and serum potassium: an analysis From HEAAL.J Card Fail. 2023;29(1):45-52. doi:10.1016/j.cardfail.2022.09.008DailyMed.Label: Hyzaar- losartan potassium and hydrochlorothiazide tablet, film coated.Sadat-Ebrahimi SR, Parnianfard N, Vahed N, et al.An evidence-based systematic review of the off-label uses of lisinopril.Br J Clin Pharmacol. 2018;84(11):2502-2521. doi:10.1111/bcp.13705DailyMed.Label: Qbrelis- lisinopril solution.DailyMed.Label: Zestoretic- lisinopril and hydrochlorothiazide tablet.British Heart Foundation.ACE inhibitors - drug cabinet -HeartMattersmagazine - BHF.DailyMed.Label: losartan potassium 25 mg- losartan potassium tablet, film coated losartan potassium 50 mg- losartan potassium tablet, film coated losartan potassium 100 mg- losartan potassium tablet, film coated.DailyMed.Label: lisinopril tablet.National Institutes of Health. Office of Dietary Supplements.Potassium.Allen HD, Flanigan KM, Thrush PT, et al.A randomized, double-blind trial of lisinopril and losartan for the treatment of cardiomyopathy in duchenne muscular dystrophy [published correction appears inPLoSCurr]. 2015;7. doi:10.1371/currents.md.2cc69a1dae4be7dfe2bcb420024ea865National Institutes of Health National Heart, Lung, and Blood Institute.The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.Schaare HL, Blöchl M, Kumral D, et al.Associations between mental health, blood pressure and the development of hypertension.Nat Commun. 2023;14(1):1953. doi:10.1038/s41467-023-37579-6Sudhakaran P.Acupuncture for hypertension using traditional Chinese medicine concepts.MedAcupunct. 2021;33(1):15-21. doi:10.1089/acu.2020.1422Centers for Disease Control and Prevention.Prevent high blood pressure.
Centers for Disease Control and Prevention.Facts about hypertension.
DailyMed.Label: Cozaar- losartan potassium tablet, film coated.
DailyMed.Label: Zestril- lisinopril tablet.
MedlinePlus.Losartan.
MedlinePlus.Lisinopril.
Gaciong Z, Siński M, Lewandowski J.Blood pressure control and primary prevention of stroke: summary of the recent clinical trial data and meta-analyses.Curr Hypertens Rep. 2013;15(6):559-574. doi:10.1007/s11906-013-0401-0
MedlinePlus.High blood pressure.
American Heart Association.What is high blood pressure?
American Heart Association.Health threats from high blood pressure.
National Institute of Neurological Disorders and Stroke.Stroke.
Centers for Disease Control and Prevention.High blood pressure.
MedlinePlus.Blood pressure medicines.
Julius S, Alderman MH, Beevers G, et al.Cardiovascular risk reduction in hypertensive black patients with left ventricular hypertrophy: the LIFE study.J Am Coll Cardiol. 2004;43(6):1047-1055. doi:10.1016/j.jacc.2003.11.029
Ferreira JP, Konstam M, Rossignol P, Kiernan MS, Zannad F.High- versus low-dose losartan and serum potassium: an analysis From HEAAL.J Card Fail. 2023;29(1):45-52. doi:10.1016/j.cardfail.2022.09.008
DailyMed.Label: Hyzaar- losartan potassium and hydrochlorothiazide tablet, film coated.
Sadat-Ebrahimi SR, Parnianfard N, Vahed N, et al.An evidence-based systematic review of the off-label uses of lisinopril.Br J Clin Pharmacol. 2018;84(11):2502-2521. doi:10.1111/bcp.13705
DailyMed.Label: Qbrelis- lisinopril solution.
DailyMed.Label: Zestoretic- lisinopril and hydrochlorothiazide tablet.
British Heart Foundation.ACE inhibitors - drug cabinet -HeartMattersmagazine - BHF.
DailyMed.Label: losartan potassium 25 mg- losartan potassium tablet, film coated losartan potassium 50 mg- losartan potassium tablet, film coated losartan potassium 100 mg- losartan potassium tablet, film coated.
DailyMed.Label: lisinopril tablet.
National Institutes of Health. Office of Dietary Supplements.Potassium.
Allen HD, Flanigan KM, Thrush PT, et al.A randomized, double-blind trial of lisinopril and losartan for the treatment of cardiomyopathy in duchenne muscular dystrophy [published correction appears inPLoSCurr]. 2015;7. doi:10.1371/currents.md.2cc69a1dae4be7dfe2bcb420024ea865
National Institutes of Health National Heart, Lung, and Blood Institute.The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.
Schaare HL, Blöchl M, Kumral D, et al.Associations between mental health, blood pressure and the development of hypertension.Nat Commun. 2023;14(1):1953. doi:10.1038/s41467-023-37579-6
Sudhakaran P.Acupuncture for hypertension using traditional Chinese medicine concepts.MedAcupunct. 2021;33(1):15-21. doi:10.1089/acu.2020.1422
Centers for Disease Control and Prevention.Prevent high blood pressure.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
