Doctors often prescribe either lisinopril or losartan for hypertension as the first line of pharmaceutical treatment. This is particularly true for patients with heart issues. While they are two entirely different drugs, they both serve the same purpose: they lower your blood pressure. However, lisinopril works differently than losartan, so it can be helpful to understand how they differ.
Lisinopril and Losartan Work in Different Ways
To understand how lisinopril and losartan work differently, you first have to grasp what each drug is and how it achieves its goal of lowering your blood pressure.
Lisinopril is part of the class of drugs called ACE (angiotensin-converting enzyme) inhibitors. ACE inhibitors lower blood pressure by helping your arteries and veins relax. Angiotensin II, a peptide hormone that the body produces naturally, makes your blood vessels contract, which in turn makes your heart have to work harder, leading to high blood pressure. It also releases certain hormones that cause your blood pressure to increase directly. ACE inhibitors work by blocking angiotensin II production.
Losartan is in a separate drug category known as ARBs (angiotensin II receptor blockers). These drugs also reduce blood pressure by relaxing your arteries and veins. ARBs block the receptors angiotensin II acts on, thereby allowing your blood vessels to widen so that your heart can more easily pump blood.
Which Drug Is More Effective?
Your individual health circumstances will determine whether lisinopril or losartan is the better option. Both drugs have been approved by the FDA to treat hypertension, though their additional approved uses are slightly different.
Lisinopril (as brands Zestril and Prinivil) got approval in the 1980s to treat hypertension, heart failure, and post-heart-attack.
Losartan (as brand Cozaar) was approved in the 1990s for the treatment of hypertension and diabetes-related kidney damage, and to prevent stroke in patients with hypertension and left ventricular hypertrophy.
The American Diabetes Association states that either ACE inhibitors or ARBs can be used to treat hypertension if kidney damage issues are a concern without providing a preference for one or the other. While lisinopril has been around longer and therefore has more studied longer, in the end, it will be up to your doctor to decide depending on your unique bodily situation.
How to Take Lisinopril vs. Losartan
Lisinopril is a bit easier to take than losartan. Lisinopril should be taken once a day, with or without food. Your dosage will vary based on what exactly you are using it for. Prescriptions for lisinopril usually start between 2.5 and 5 mg daily, though dosages can go up to 40 mg.
Losartan is also taken once a day with or without food, but it should always be taken at the same time and under the same circumstances. For instance, if you decide to take losartan with food, always take it with food. Using losartan to treat hypertension, the dosage will typically start at 50 mg a day. Your doctor might increase your dose up to 100 mg daily, sometimes split into one 50 mg dose twice a day.
Patients over 65 years old or who have sensitivity to blood pressure reduction drugs will likely start with a lower daily dosage. Additionally, patients who are pregnant or trying to get pregnant should avoid both lisinopril and losartan.
Side Effects of Lisinopril and Losartan
The side effects of both lisinopril and losartan are similar, as they have similar functions on the body. Both can cause high potassium blood levels, which can lead to feeling weak, trouble breathing, and heart palpitations. Those who take an ACE inhibitor or ARB should avoid consuming a lot of potassium.
As with all ACE inhibitors and ARBs, lisinopril and losartan can cause dangerous levels of tongue, mouth, lips, and throat swelling that can prevent you from breathing. While this side effect is rare, a patient who noticing any swelling in these areas should contact their doctor immediately.
Lisinopril and losartan can help with kidney issues, though they can also worsen them. Doctors monitor the kidney function of all patients taking either of these medications as a result.
Lisinopril can also cause patients to develop a persistent cough. This is not a side effect of losartan, however. While the cough may be bothersome, it is harmless. About 10 percent of patients taking an ACE inhibitor may experience this side effect. If lisinopril causes you to cough, doctors may switch you over to losartan, if it is safe to do so.
This is not an exhaustive list of potential side effects from these medications, though they are the most common.
The Cost of Lisinopril and Losartan
The generic versions of lisinopril and losartan are much cheaper than the brand-name alternatives. The brand names can cost upwards of $150 a month, whereas the generics could be as high as $40 a month. Luckily, most insurance plans cover these drugs.
If you don’t have insurance, the cost of taking lisinopril and losartan can really add up. Also, sometimes coupons can bring the price of these drugs down lower than your copay, so it’s worth checking out prices beforehand.
A prescription savings card company like ScriptSave® WellRx can offer the lowest prices around, their coupons for medications sometimes saving you up to 80 percent. You can easily search lisinopril or losartan by zip code to check the coupons they offer at different pharmacies in your area and find the best price.
References:
https://www.wellrx.com/LISINOPRIL/drug-information/
https://www.wellrx.com/LOSARTAN%20POTASSIUM/drug-information/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108782/#:~:text
Jess Lakritz 