Losartan alternatives: what works when losartan isn’t right

Losartan is a common ARB used to lower blood pressure and protect the kidneys. But it won’t suit everyone — side effects, cost, pregnancy plans, or kidney concerns can make people look for other options. If you’re wondering what to try next, here’s a clear, practical guide to common alternatives and what they mean for you.

Drug alternatives — quick comparison

Not all blood pressure drugs act the same. Choosing an alternative depends on your other health issues, like diabetes, heart disease, or kidney problems. Here are the main classes and examples:

• Other ARBs — valsartan, irbesartan, candesartan. These work like losartan and often have similar side effects. Switching within the class is common if one ARB causes problems or is unavailable.
• ACE inhibitors — lisinopril, enalapril. Good for heart and kidney protection, but they can cause a dry cough or, rarely, angioedema. Not for pregnancy.
• Calcium channel blockers — amlodipine, diltiazem. Useful if you need strong blood pressure lowering and often help people who don’t tolerate ARBs or ACEs.
• Thiazide diuretics — hydrochlorothiazide, chlorthalidone. Cheap and effective for many people. Watch for low potassium or high blood sugar in susceptible patients.
• Beta-blockers — metoprolol, atenolol. Often used when there’s also heart disease or after a heart attack. Less preferred as sole therapy for older adults with simple hypertension.

Many people need two drugs from different classes for full control. Combination pills (for example an ARB + thiazide) can simplify dosing and cut cost.

Non-drug options and practical tips

Medication choice matters, but so do everyday habits. Small changes often lower blood pressure enough to reduce pill burden or let a lower dose do the job:

• Lose weight if you’re overweight — losing 5-10% of body weight can drop BP noticeably.
• Cut sodium: aim for under 2,000 mg daily if possible.
• Move more: 30 minutes of moderate activity most days helps.
• Limit alcohol and stop smoking — both raise blood pressure and add heart risk.

Safety notes: ARBs and ACE inhibitors must not be used in pregnancy. They can affect kidney function and raise potassium, so your doctor will check creatinine and electrolytes after a switch. Also tell your provider about NSAIDs, potassium supplements, or herbal products — these can interfere with many blood pressure drugs.

If cost is an issue, generics like losartan, lisinopril, amlodipine, and hydrochlorothiazide are widely available. Don’t stop or swap meds on your own: abrupt changes can cause rebound high blood pressure or other problems. Ask your healthcare provider for a plan tailored to your health, lifestyle, and budget.

Need a quick next step? Write down your current meds, side effects, and any pregnancy plans, then bring that list to your next appointment. A short conversation can find a safe, effective alternative that fits your life.