7 Alternatives to Losartan: A Practical Guide for Blood Pressure Control

When your doctor prescribes Losartan for blood pressure or kidney protection, it’s usually for good reason. But what happens if you need something different—maybe you get side effects, it’s out of stock, or you just want another option that fits your life better? There’s good news: Losartan isn't the only show in town. Plenty of alternatives work in similar ways and might have pros that fit you better.

Not all blood pressure meds work the same for everyone. Your genes, lifestyle, and other conditions can change what’s best for you. Some alternatives last longer in your system. Others might be gentler on your wallet, or maybe they work better with diabetes. You might even find a better fit if you’re juggling a bunch of different meds.

This guide gives you the lowdown on seven alternatives to Losartan, why doctors use them, and what you can actually expect from each. That way, you’ll have a clearer idea of what makes each one different—and why it might (or might not) be worth a try.

• Candesartan
• Valsartan
• Irbesartan
• Olmesartan
• Telmisartan
• Eprosartan
• Azilsartan
• Summary Table and Practical Comparison

Candesartan

If you’ve been using Losartan but need to try something else, candesartan is usually one of the first options your doctor might consider. This medication is in the same ARB (angiotensin II receptor blocker) family as Losartan, so it works by relaxing your blood vessels and helping your kidneys, but it brings a few unique perks to the table.

Candesartan is actually known for its better bioavailability. Basically, what you swallow is more likely to make it into your bloodstream and start working, compared to Losartan. Because of this (and its longer half-life), a lot of people only need to take it once a day and still get steady, all-day blood pressure control. This is a huge win if you hate juggling pills or tend to forget a midday dose.

Docs often use candesartan for people dealing with hypertension or diabetic kidney problems. It can be a solid choice if you need smoother, more reliable blood pressure control throughout the day—especially overnight, when blood pressure can sneak up.

Pros

• Longer half-life than Losartan (steady coverage, fewer peaks and valleys)
• Can be more effective for 24-hour blood pressure control
• Very similar effectiveness for both hypertension and diabetic nephropathy

Cons

• Similar risks as Losartan—mainly, if you have kidney issues or high potassium, you’ve still got to be careful
• Hyperkalemia (high potassium) can happen, especially if you’re on potassium-raising meds
• Tends to be pricier, especially if you’re paying out of pocket or your insurance doesn’t cover it well

If you’re switching from Losartan alternatives, your healthcare provider will probably start you at a low dose and check your blood pressure and labs after a couple weeks. Like any ARB, side effects are usually mild—think dizziness or a mild cough, but most folks don’t notice much difference after the first week. As always, don’t make any medication changes without chatting with your doctor first.

Valsartan

Valsartan is another solid option if you’re looking for an alternative to Losartan. Doctors reach for this one a lot because it tackles high blood pressure (hypertension) and can even help with heart failure or after a heart attack. Valsartan is in the same family of meds—angiotensin receptor blockers (ARBs)—so it blocks the same pathway and delivers similar results, but with its own twist.

This drug usually starts working within two hours and keeps your blood pressure lower for around 24 hours—so you usually just take it once a day. It’s got some similarities to Losartan but tends to be a bit stronger, and a lot of pharmacies stock generic versions. That helps with cost, which matters for a lot of people. Valsartan doesn’t just lower blood pressure; it also lowers your risk of hospital visits if you’ve had heart failure.

Fun fact: Valsartan made headlines in 2018 when some batches were recalled for contamination issues, but safety standards are much tighter now. Pharmacies today are careful about where they get their stock.

Pros

• Works similar to Losartan but can be more potent for some people
• Generic versions are usually affordable at most pharmacies
• Once-daily dosing keeps things simple
• Can help protect the kidneys, especially in people with diabetes
• Often used for heart failure or after a heart attack

Cons

• Can cause dizziness, especially when starting
• Not a good match for people with certain kidney issues
• Less effective in some Black patients when used alone
• Possible side effects include high potassium and rare allergic reactions
• Interactions with some other blood pressure or heart meds

Talking to your doctor about switching to Valsartan can pay off if cost or convenience is a big deal for you. Make sure you get your kidney function and potassium checked regularly, just to be safe.

Irbesartan

If you’ve heard of Losartan alternatives, there’s a good chance Irbesartan pops up. It’s another member of the ARB family (angiotensin II receptor blockers), used to chill out high blood pressure and slow down kidney trouble, especially for folks with type 2 diabetes.

One thing that makes Irbesartan stand out is it sticks around in your system a bit longer than Losartan, so you often only need to take it once a day. Plus, it’s well-studied for diabetic kidney disease—that’s actually one of its main claims to fame. A large clinical trial (the IDNT study) showed Irbesartan slowed kidney damage better than a common blood pressure med called amlodipine, particularly in people who spill protein into their urine. That’s a pretty big deal if you have diabetes and the doctor’s trying to juggle both your blood pressure and kidney health.

Another plus? Irbesartan usually plays nice with other meds. It doesn’t mess around with potassium as much as some older blood pressure pills. Still, you’ve got to watch your kidney numbers and potassium levels, so blood tests are a must—especially if you take other ARBs, ACE inhibitors, or even water pills like spironolactone.

Pros

• Once-daily dosing for most people—easy to stick with long-term
• Proven to protect kidneys in people with type 2 diabetes
• Less likely to cause a dry cough compared to ACE inhibitors
• Can be combined with other blood pressure meds for extra control

Cons

• Still can raise potassium—blood levels should be checked regularly
• Not ideal if you’re pregnant or planning to be
• Possible side effects like dizziness, especially right after starting
• Cost might be higher without insurance (though generics help)

Here’s a quick comparison of how Irbesartan stacks up next to Losartan and Valsartan for two big conditions:

So, if you’re looking for a Losartan alternative and especially if kidney health is on your mind, Irbesartan might be worth asking your doc about.

Olmesartan

Olmesartan is another solid alternative when it comes to keeping your blood pressure under control. Just like Losartan, it's part of the ARB family, which means it blocks certain hormones that tighten your blood vessels. When those vessels relax, your blood flows more easily, and your numbers come down.

Here's an interesting detail: Olmesartan is well-known for its steady performance. It keeps your blood pressure in check for a full 24 hours with just one dose a day. That makes it a favorite for people who want to keep their routine simple and not think about meds twice a day.

Pros

• Once-daily dosing so you’re not constantly watching the clock.
• Consistent 24-hour blood pressure lowering, which helps reduce blood pressure swings.
• May work a bit better for some people at lowering blood pressure compared with Losartan.
• Good for protecting kidney function in people with diabetes.
• Some studies show it’s less likely to cause cough than ACE inhibitors, so that’s a plus if you got that side effect before.

Cons

• Like other ARBs, you have to watch for high potassium levels—especially if you have kidney trouble.
• It is usually more expensive than generic Losartan.
• Rare, but can cause a GI side effect called "sprue-like enteropathy," which can lead to chronic diarrhea and weight loss. (Unlikely, but something to keep in mind and mention if you get stomach troubles.)
• Shouldn’t be used during pregnancy.

Here's a quick stat to put things in perspective: In direct comparisons between Olmesartan and Losartan, about 35% more people saw their blood pressure reach goal levels when using Olmesartan at standard doses. Keep in mind everyone’s different, so that may or may not hold true for you, but it gives a good sense of why some doctors prefer it if Losartan isn’t doing the trick.

Telmisartan

Telmisartan is one of those blood pressure meds in the ARB group that stands out for a couple of unique reasons. It controls blood pressure like Losartan, but it comes with a few extra perks—especially for folks with added risk of heart problems or diabetes. Sometimes doctors call it a "two-in-one" medicine because it can also help protect your kidneys and might even help manage sugar and fat levels in your blood.

One thing people like about Telmisartan: you usually only have to take it once a day because it sticks around in your system longer than Losartan. If you don’t love the hassle of popping pills more than once, this is a big plus. There’s also evidence that Telmisartan works especially well at keeping blood pressure steady over 24 hours, not just in the morning or evening.

Pros

• Long half-life means solid blood pressure control all day with one dose.
• Extra heart and kidney protection—studies show it helps lower risk of heart attacks and slows kidney damage.
• Can improve insulin sensitivity, so it’s a solid option if you’ve got type 2 diabetes.
• Some research suggests it beats Losartan when it comes to lowering "bad" cholesterol and boosting "good" cholesterol.

Cons

• A bit pricier than Losartan, especially without insurance.
• Like other ARBs, may cause a rise in potassium levels—dangerous if you already have kidney issues.
• Dry mouth and slight dizziness can pop up, especially when you first start taking it.
• Shouldn’t be used if you’re pregnant, or planning pregnancy.

If you want to see how Telmisartan compares head-to-head, here’s a quick data snapshot from a 2021 multi-country study on ARBs:

If day-long control and extra protection for your heart and kidneys are top priorities, Telmisartan could be worth talking to your doctor about. Just make sure you’re keeping an eye on blood tests, especially your potassium and kidney numbers.

Eprosartan

Eprosartan is another solid option if you’re looking at Losartan alternatives for managing high blood pressure. Like Losartan, it’s an angiotensin II receptor blocker (ARB), which means it helps keep blood vessels relaxed so your blood pressure stays in check. But there are a few things that make Eprosartan stand out from the crowd.

One thing people like: Eprosartan doesn’t hang around as long as some other ARBs, which can be useful if you’re sensitive to meds building up over time. It’s usually given once or twice a day, and because it clears your system a bit quicker, it’s sometimes chosen for folks with certain kidney or liver conditions. It’s also a decent choice if you’re on a bunch of other meds, since there aren’t many reported drug interactions—handy if you’ve got a complicated medicine cabinet.

Pros

• Good track record for lowering blood pressure (on par with Losartan)
• Usually well-tolerated with minimal side effects for most people
• Less likely to cause major drug interactions
• A bit shorter-acting, so potentially easier to manage if you get side effects

Cons

• Needs to be taken more often (sometimes twice a day)
• Can still cause potassium to go up, just like Losartan
• Not always covered by every insurance—can be pricier or harder to find
• Not as well-studied for some conditions, like heart failure, compared to other ARBs

Doctors sometimes recommend Eprosartan if you didn’t do well on Losartan or Valsartan or want an option that’s less likely to clash with your other medications. But just like with every blood pressure medication, it pays to keep an eye on potassium and kidney function with routine blood work. The bottom line? Eprosartan works as a reliable backup, especially if you and your doctor need a little more flexibility in your treatment plan.

Azilsartan

If you’re hunting for a newer blood pressure med because Losartan didn’t quite work or you want something with some extra punch, Azilsartan is worth looking at. It’s part of the ARB (angiotensin receptor blocker) family, just like Losartan, but it stands out because doctors have noticed it can lower blood pressure a bit more than some of its cousins. For folks with stubborn hypertension, that’s good to know.

Here’s the thing: a 2011 study compared Azilsartan to both Losartan and Olmesartan. The results showed that Azilsartan lowered systolic blood pressure 3–5 points more on average than Losartan over several weeks. Doesn’t sound huge, but if your numbers are tough to control, every notch counts.

Azilsartan is also designed to work once a day and has a long half-life, so it keeps working between doses. Most people take it in the morning, and it doesn’t tend to affect your schedule or sleep.

Pros

• May lower blood pressure a little more than Losartan or some other ARBs
• Long-acting—just one pill each day
• Similar side effect profile as Losartan, so you won’t usually get new surprises
• Good for people who need more aggressive hypertension control

Cons

• Tends to be pricier since it’s newer, especially without insurance
• Not as widely stocked as Losartan in small pharmacies
• Shares possible side effects: dizziness, high potassium, and shouldn’t be used in pregnancy
• Less experience with long-term use since it hasn’t been around as long as Losartan

If you need numbers, here’s how Azilsartan stacked up against Losartan in that 2011 head-to-head study:

So if you’re talking to your doctor about switching meds, Azilsartan is a solid option, especially if you or your doc feel like your BP needs tighter control. Just remember, it’s not always the cheapest or most available—but it packs a punch.

Summary Table and Practical Comparison

When you’re choosing between Losartan alternatives, it’s smart to see all the key differences in one place. Each ARB (angiotensin receptor blocker) does pretty much the same job—lowering blood pressure and protecting your kidneys—yet some stand out for how long they work, how they're processed, or how well they fit with certain conditions like diabetes or heart failure. Also, it’s no secret that prices can drive your decision. Here’s a simple table to help you compare.

So what does all this mean if you’re actually making a choice? If you hate taking pills twice a day and want to set-and-forget it, Telmisartan and Olmesartan can last a full 24 hours. If your insurance only covers generics, Valsartan could be the easiest on your wallet. For folks managing blood sugar, Irbesartan has a good track record with diabetics.

Don't ignore the cons. Some options like Olmesartan rarely cause a specific gut issue called sprue-like enteropathy. Others, like Candesartan, offer all-day coverage but can run steeper in price. Ask your doctor to match up your other meds and health needs before picking one.

Here’s a quick tip: when switching between ARBs, your new dose won’t always match Losartan mg-for-mg. Let your doctor or pharmacist handle the math, since starting too strong or too weak isn’t worth the risk.

At the end of the day, all these blood pressure medications are solid choices, but the best pick depends on your lifestyle, medical history, and coverage. Having the right info makes you a better partner with your doc in choosing what works for you.