Does losartan cause a cough like lisinopril?
Lisinopril (an ACE inhibitor) commonly causes cough. The cough is linked to how ACE inhibitors increase levels of bradykinin, which can irritate the airways. [1][2]
Losartan is an angiotensin II receptor blocker (ARB). ARBs do not work the same way as ACE inhibitors and generally do not raise bradykinin, so they cause cough far less often than lisinopril. [1]
How do ACE inhibitors and ARBs differ in causing cough?
ACE inhibitors (like lisinopril) can lead to dry, persistent cough in some people. [1][2]
ARBs (like losartan) are typically used when someone needs a similar blood-pressure effect but has an ACE-inhibitor cough, because the cough rate is much lower. [1]
What should you do if you develop a cough on lisinopril?
If a person develops a persistent cough while taking lisinopril, clinicians often consider switching to an ARB such as losartan instead of stopping the blood-pressure treatment entirely. [1]
What if the cough happens while taking losartan?
Cough can still occur for many reasons unrelated to medication (for example, infections, smoking-related irritation, asthma, reflux, or other lung problems). If the cough is new or persistent, it should be discussed with a clinician to check whether it’s medication-related or from another cause. (Losartan itself is not known for causing cough at the rates seen with ACE inhibitors.) [1]
What’s the practical takeaway?
A cough is a known side effect of lisinopril, but losartan is much less likely to cause the same problem. [1][2]
Sources:
[1] https://www.nhs.uk/conditions/cough-caused-by-medicine/
[2] https://www.health.harvard.edu/newsletter_article/why-does-ace-inhibitor-cause-a-cough