8 Losartan Alternatives: ACE Inhibitors, Calcium Channel Blockers, and More

If you or a loved one have high blood pressure, a heart condition, or kidney disease, you may have heard of losartan. Losartan (Cozaar) is a commonly used medication that’s best known as a blood pressure treatment. But it has other benefits, such as protecting against stroke and helping to prevent kidney problems. It belongs to the angiotensin II receptor blocker (ARB) medication class.

While losartan is effective for many people, there are many reasons why you may want or need an alternative. You’ll have several options to choose from in this case, but the best losartan alternative will depend on a few factors — such as what health condition(s) you have and why you’re switching from losartan.

Here, we’ll cover eight losartan alternatives you should know about.

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1. Other ARBs

Most ARBs treat high blood pressure. Some of them may also be used for other medical conditions, such as chronic kidney disease or heart failure. 

In addition to losartan, common ARBs include:

• Valsartan (Diovan)

• Olmesartan (Benicar)

• Telmisartan (Micardis)

• Irbesartan (Avapro)

• Candesartan (Atacand)

Choosing between ARBs isn’t always straightforward, since no single one is considered the best choice overall. Losartan is prescribed the most frequently, but they all work the same way, are effective at lowering blood pressure, and have similar side effects and interactions. And they’re all usually taken once a day, so their recommended dosages are similar. What’s more, most ARBs are available as generics, so they typically aren’t very expensive.

Choosing which ARB to take may ultimately depend on your prescriber’s preference or whether one is preferred by your insurance. It could also depend on your specific diagnosis.

Ultimately, you and your prescriber can decide which ARB is best for you. You should only take one ARB at a time, though. Taking more than one ARB can lead to added side effects.

EXPERT PICKS: WHAT TO READ NEXT

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• What are the different types of blood pressure medications? Read about both common and less common options for treating high blood pressure.

Arbli

Arbli is a newer losartan product. The FDA approved it in March 2025. The medication is approved for adults and children ages 6 years and older, and it’s available as an oral liquid. Arbli may be a good losartan alternative for you if you have difficulty swallowing pills.

2. ACE inhibitors

Angiotensin-converting enzyme (ACE) inhibitors are very similar to ARBs. They’re both common blood pressure medication classes. And they work similarly well, while having comparable effects on the body.

Common ACE inhibitors include:

• Lisinopril (Zestril)

• Benazepril (Lotensin)

• Enalapril (Vasotec)

• Ramipril (Altace)

• Quinapril (Accupril)

The main difference between ARBs and ACE inhibitors is that ACE inhibitors are more likely to cause side effects. And people are more likely to stop taking ACE inhibitors than ARBs. Specifically, ACE inhibitors are more likely to cause a dry cough and angioedema — a serious condition where the lips, tongue, and throat can swell and cause breathing problems.

In many cases, the choice between an ARB (such as losartan) and an ACE inhibitor isn’t clear. It may depend on your prescriber’s preference. You should avoid taking both an ARB and an ACE inhibitor, though, because there is a higher chance of side effects without much added benefit.

3. Aliskiren

Aliskiren (Tekturna) is a blood pressure medication that has similar effects to losartan (as well as other ARBs and ACE inhibitors). Some research suggests that aliskiren is as effective as ARBs at managing blood pressure, and it doesn’t have a notable difference in side effects. 

However, aliskiren is typically only prescribed in select situations. If you have heart-related risk factors or established cardiovascular disease, it may not help you live longer in a meaningful way. And while a generic version of aliskiren is available, it tends to be more expensive than losartan.

Good to know: Aliskiren has also been studied in combination with ARBs and ACE inhibitors. But the FDA has warned against these combinations due to increased risks for side effects — especially in people with Type 2 diabetes. 

4. Calcium channel blockers

Calcium channel blockers (CCBs) are another common type of blood pressure medication. They work differently than losartan and may be prescribed in combination with ARBs or ACE inhibitors. If you’re unable to take an ARB or ACE inhibitor for blood pressure, a CCB may be a good option.

Common CCBs include:

• Amlodipine (Norvasc, Katerzia)

• Felodipine extended-release

• Nifedipine (Procardia)

• Diltiazem (Cardizem)

• Verapamil

Two of these CCBs — diltiazem and verapamil — also lower heart rate. They aren’t used as often as other CCBs for treating high blood pressure because of this effect. But they’re often prescribed to treat certain heart conditions.

5. Beta blockers

Beta blockers are another possible losartan alternative. Beta blockers are sometimes used to treat high blood pressure, but they aren’t first-choice options. They’re best known for treating heart conditions such as heart failure and arrhythmias. And it’s not uncommon to take both a beta blocker and losartan because they work in different ways.

Common beta blockers include:

• Atenolol (Tenormin)

• Carvedilol (Coreg)

• Metoprolol (Toprol XL, Lopressor)

• Propranolol

Beta blockers also have different side effects than losartan, such as fatigue (from a lower heart rate), cold hands and feet, and sexual problems. And some of them can also cause or worsen breathing problems in people with respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD).

For these reasons and others, losartan is used more often than beta blockers to treat blood pressure. But for other heart conditions, beta blockers can be important treatments.

6. Diuretics

Diuretics, also known as “water pills,” can help relieve fluid buildup. This in turn helps manage blood pressure and fluid and salt levels in the body.

As a blood pressure treatment, diuretics may work as an alternative to losartan. However, in cases where the main purpose of treatment is to remove fluid from the body, diuretics are the clear choice.

Diuretics that are commonly used for blood pressure treatment are called thiazide diuretics. Examples include:

• Hydrochlorothiazide

• Chlorthalidone (Thalitone)

• Indapamide

• Metolazone

Other diuretics such as furosemide (Lasix) and torsemide (Soaanz) are known as loop diuretics. They aren’t often prescribed specifically for blood pressure, but they can certainly help. These diuretics tend to be better at removing fluid from the body.

Another set of diuretics, known as potassium-sparing diuretics, include spironolactone (Aldactone) and eplerenone (Inspra). Potassium-sparing diuretics are possible alternatives to losartan and are occasionally used in combination with it. However, losartan and these diuretics can both raise potassium. Potassium levels should be monitored closely if they’re used together.

7. Alpha blockers

Alpha blockers are another group of medications that lower blood pressure. But they aren’t prescribed very often. Alpha blockers are better known for treating a condition called benign prostatic hyperplasia (BPH), or an enlarged prostate. In this sense, they aren’t a common alternative to losartan, but they can still lower blood pressure.

Common alpha blockers include tamsulosin (Flomax), prazosin (Minipress), and doxazosin (Cardura).

8. Other options

There are other blood pressure medications not mentioned above that are possible losartan alternatives. These sometimes include alpha-2 receptor agonists like clonidine (Catapres-TTS) and vasodilators like hydra​​lazine.

While these other blood pressure medications aren’t first-choice options for treating high blood pressure due to side effects and dosage considerations, they’re still options in some cases. Your prescriber will recommend these on a case-by-case basis.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Ferras Bashqoy, PharmD, BCCCP, BCPPS

Ferras Bashqoy, PharmD, BCCCP, BCPPS, is a clinical pharmacotherapy specialist in the Neonatal Intensive Care Unit (NICU) at Hassenfeld Children’s Hospital in New York City. His favorite part of the job is working with preterm newborns because they are strong and mighty despite their size.

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