Losartan vs lisinopril: blood pressure medicines compared
Losartan and lisinopril are two of the most prescribed blood pressure medicines in the US. They act on the same hormone system in different ways, which is why the main practical difference is a dry cough that lisinopril causes in some people and losartan rarely does.
Updated October 4, 2026
At a glance
- How it works
- Losartan
- Blocks the receptor for angiotensin II
- Lisinopril
- Stops the body making angiotensin II
- Approved for
- Losartan
- High blood pressure; kidney disease in type 2 diabetes; lowering stroke risk in some people with high blood pressure
- Lisinopril
- High blood pressure; heart failure; improving survival after a heart attack
- How often
- Losartan
- Once or twice a day
- Lisinopril
- Once a day
- Dry cough
- Losartan
- Uncommon
- Lisinopril
- A common side effect, and a frequent reason to switch
- Generic
- Losartan
- Yes, inexpensive
- Lisinopril
- Yes, inexpensive
Losartan Cozaar, an angiotensin receptor blocker (ARB) | Lisinopril Prinivil, Zestril, an ACE inhibitor | |
|---|---|---|
| How it works | Blocks the receptor for angiotensin II | Stops the body making angiotensin II |
| Approved for | High blood pressure; kidney disease in type 2 diabetes; lowering stroke risk in some people with high blood pressure | High blood pressure; heart failure; improving survival after a heart attack |
| How often | Once or twice a day | Once a day |
| Dry cough | Uncommon | A common side effect, and a frequent reason to switch |
| Generic | Yes, inexpensive | Yes, inexpensive |
Why the cough matters
ACE inhibitors such as lisinopril also raise levels of bradykinin, a substance that can trigger a persistent dry, tickly cough. It is harmless but annoying, and it is one of the most common reasons people stop the medicine. Because losartan works further along the same pathway without affecting bradykinin, switching to it usually resolves the cough. Swelling of the face, lips or throat, called angioedema, is also more likely with ACE inhibitors, though rare with either, and needs urgent care.
What they share
Both lower blood pressure well, both protect the kidneys in people with diabetes and protein in the urine, and both need blood tests for potassium and kidney function after starting or changing the dose. Neither can be taken during pregnancy. Potassium supplements, salt substitutes that contain potassium and anti-inflammatories such as ibuprofen need care with both, and they are generally not taken together.
Cost
Both are long-established generics with low cash prices, though prices still vary between pharmacies. A 90-day supply usually costs less per day, which matters for a medicine taken every day for years.
Switching between them
If lisinopril causes a cough, prescribers commonly switch to losartan or another ARB, and the cough usually fades within weeks of stopping lisinopril, occasionally longer. Blood pressure, potassium and kidney function are rechecked after the switch, and the two medicines are not taken together.
Questions for your prescriber
- Is this cough likely to be from lisinopril, and would losartan avoid it?
- Which of these suits my kidney function and other conditions?
- How soon should my potassium and kidney blood tests be checked?
Already have a prescription?
Upload it and licensed pharmacies respond with their own cash price. You choose, and pay the pharmacy.
Read more
Sources
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.