Does Cozaar Cause Dry Cough Like Lisinopril?
No, Cozaar (losartan), an angiotensin II receptor blocker (ARB), does not typically cause a dry cough. Lisinopril, an ACE inhibitor, commonly triggers this side effect in 5-20% of patients by increasing bradykinin levels, which irritate airways.[1][2] ARBs like losartan block angiotensin II receptors without raising bradykinin, so cough rates match placebo (around 3%).[3]
Why Do ACE Inhibitors Cause Cough but ARBs Don't?
ACE inhibitors like lisinopril degrade bradykinin less effectively, leading to its buildup and cough. Losartan avoids this pathway entirely, making it a frequent switch for patients intolerant to ACE inhibitors.[1][4]
How Common Is Cough with Cozaar?
Clinical trials report cough in 3.4% of losartan users versus 3.1% on placebo, far below lisinopril's 10-15% incidence. Persistent cough warrants checking for other causes like infections or GERD.[2][5]
When Do Doctors Switch from Lisinopril to Cozaar?
Physicians often prescribe ARBs like Cozaar for hypertensive patients with ACE inhibitor-induced cough. Studies show 70-90% of switchers resolve symptoms within weeks.[4][6]
Other Side Effects of Cozaar to Watch
Common ones include dizziness (4%), back pain (3%), and nasal congestion (2%). Rare risks: hyperkalemia, kidney issues in dehydrated patients, or angioedema (less than with ACE inhibitors).[5]
[1]: FDA Label: Cozaar (losartan)
[2]: FDA Label: Lisinopril
[3]: Lacourcière Y, et al. Hypertension 1994;24:355-73.
[4]: Burnier M. J Hypertens 2001;19 Suppl 1:S3-10.
[5]: Drugs.com: Cozaar Side Effects
[6]: Goldberg AI, et al. Am J Hypertens 1995;8:296-304.