Losartan vs Alternatives: Which Blood Pressure Med Works Best for You?

When your doctor prescribes Losartan, a type of angiotensin II receptor blocker (ARB) used to lower blood pressure and protect kidneys in people with diabetes. Also known as Cozaar, it works by relaxing blood vessels so your heart doesn’t have to pump as hard. It’s one of the most common pills for high blood pressure—but it’s not the only one. Many people end up switching from Losartan to something else, either because of side effects, cost, or because it just didn’t do enough. So what are the real alternatives? And how do they stack up in practice?

There are several other ARBs, a class of blood pressure medications that block the action of angiotensin II, a hormone that narrows blood vessels. Also known as sartans, they include Valsartan, Irbesartan, and Olmesartan. These all work similarly to Losartan but differ in how long they last, how strong they are, and how they affect your body. For example, Valsartan might work faster but doesn’t last as long as Losartan in some people. Olmesartan can be more potent at lower doses, which helps if you’re sensitive to medication. Then there are ACE inhibitors, another major class of blood pressure drugs that stop the body from making angiotensin II instead of blocking it. Also known as pril drugs, like Lisinopril and Enalapril. These are often cheaper and just as effective, but they can cause a dry cough in up to 20% of users—which is why many switch to ARBs like Losartan in the first place. And if you’re looking beyond ARBs and ACE inhibitors, you’ve got calcium channel blockers, medications that relax the muscles in your blood vessel walls. Also known as dihydropyridines, like Amlodipine and Diltiazem. These are often paired with ARBs for better control, especially in older adults or people with certain heart conditions. Each of these has different side effects: ARBs are gentler on the kidneys, ACE inhibitors can cause coughing, and calcium blockers might make your ankles swell.

Cost matters too. Losartan is generic, so it’s usually cheap—but so are most of its top rivals. Valsartan and Irbesartan are also generic now, making price differences tiny. What really changes the game is how your body responds. Some people feel dizzy on Losartan but do fine on Olmesartan. Others find their blood pressure drops too low with one but stays steady with another. It’s not about which one is "best"—it’s about which one works for you. That’s why so many people end up trying a few before settling. Below, you’ll find detailed comparisons of Losartan with the most common alternatives, side by side. You’ll see real differences in how they work, what side effects to watch for, and which ones doctors actually recommend when the first choice doesn’t fit.