LisinoprilvsLosartan
Different drug classes • Side-by-side comparison
Lisinopril vs Losartan: Overview
Lisinopril and losartan are both first-line antihypertensive (blood pressure-lowering) medications widely prescribed for hypertension, heart failure, and kidney disease protection in diabetics. Lisinopril is an ACE inhibitor that works by blocking the angiotensin-converting enzyme, preventing the production of angiotensin II. Losartan is an angiotensin receptor blocker (ARB) that works by directly blocking angiotensin II receptors. While their clinical outcomes for blood pressure reduction and cardiovascular protection are similar, their tolerability profiles differ: ACE inhibitors like lisinopril commonly cause a persistent dry cough in 10-15% of patients, while ARBs like losartan generally do not. Losartan is often prescribed as an alternative when patients cannot tolerate the cough from lisinopril. Both are available as very affordable generics.
Key Facts at a Glance
- ✓Lisinopril is an ACE inhibitor; losartan is an ARB — different mechanisms, similar outcomes
- ✓Lisinopril causes a persistent dry cough in 10-15% of patients; losartan does not
- ✓Both protect kidneys in diabetic patients — key reason for use in diabetes
- ✓Losartan additionally has evidence for reducing gout attacks (uricosuric effect)
- ✓Both are very affordable as generics — often under $10/month
- ✓Both are contraindicated in pregnancy (can cause fetal harm)
Lisinopril
Drug AUsed For
- ✓ High blood pressure
- ✓ Heart failure
Losartan
Drug BUsed For
- ✓ High blood pressure
- ✓ Diabetic nephropathy
Key Differences
Which Should You Choose?
Lisinopril is often tried first due to its long track record and extremely low cost. If you develop a persistent dry cough (a common side effect), your doctor will typically switch you to losartan or another ARB. For patients with gout alongside high blood pressure, losartan may be preferred as it also has uric acid-lowering properties. Both are excellent first-line options for hypertension, heart failure, and diabetic kidney protection. The decision often comes down to side effects rather than effectiveness.