Alternatives to Losartan If You Can't Fill Your Prescription

Losartan (Cozaar) is a first-line blood pressure medication for millions of Americans. But if your pharmacy is out of stock, a specific lot has been recalled, or your insurance has changed its formulary, you may need to know your options. The good news: several medications work in very similar ways and may be suitable alternatives — with your doctor's guidance.

Important: Never switch blood pressure medications on your own. The alternatives below require a prescription change, and appropriate dosing depends on your specific condition, kidney function, and other medications.

Other ARBs: The Closest Alternatives to Losartan

Losartan belongs to a class of medications called angiotensin II receptor blockers (ARBs). All ARBs work by blocking the same hormone — angiotensin II — from constricting your blood vessels. When one ARB is unavailable, another in the same class is often a reasonable substitution.

Valsartan (Diovan)

Valsartan is one of the most prescribed ARBs and is approved for hypertension, heart failure, and after a heart attack. Generic valsartan is widely available and is covered as a Tier 1 drug on most insurance plans. Approximate equivalent dose: Losartan 50 mg ≈ Valsartan 80 mg; Losartan 100 mg ≈ Valsartan 160 mg.

Note: Valsartan had its own major recall in 2018 due to nitrosamine contamination, but current generic supply has been tested and is considered safe.

Irbesartan (Avapro)

Irbesartan (brand name Avapro) is FDA-approved for hypertension and diabetic nephropathy — the same two main uses as losartan. It's taken once daily and generic irbesartan is widely available. Approximate equivalent dose: Losartan 50 mg ≈ Irbesartan 150 mg; Losartan 100 mg ≈ Irbesartan 300 mg.

Candesartan (Atacand)

Candesartan (brand name Atacand) is approved for hypertension and heart failure. It's generally taken once daily and is available in generic form. Candesartan may provide slightly longer blood pressure control than losartan due to its higher receptor binding affinity. Approximate equivalent dose: Losartan 50 mg ≈ Candesartan 8 mg; Losartan 100 mg ≈ Candesartan 16 mg.

Olmesartan (Benicar)

Olmesartan (brand name Benicar) is one of the more potent ARBs and is approved for hypertension. It's generally taken once daily, and generic olmesartan is available. Approximate equivalent dose: Losartan 50 mg ≈ Olmesartan 20 mg; Losartan 100 mg ≈ Olmesartan 40 mg.

Telmisartan (Micardis)

Telmisartan (brand name Micardis) is approved for hypertension and also for reducing cardiovascular risk in people who can't tolerate ACE inhibitors. It has the longest half-life of all ARBs (about 24 hours), providing consistent 24-hour blood pressure control. Generic telmisartan is available, though it tends to be slightly more expensive than some other generic ARBs.

ACE Inhibitors: A Different Class, Similar Effect

If no ARBs are available or appropriate, ACE inhibitors are another class that works upstream in the same renin-angiotensin-aldosterone system. They also lower blood pressure and protect the kidneys, and many patients switch between ARBs and ACE inhibitors without issues.

Lisinopril (Zestril, Prinivil) is one of the most common ACE inhibitors. It's extremely affordable as a generic (often less than $5/month). The key difference: ACE inhibitors can cause a dry, persistent cough in 5-20% of patients. ARBs like losartan were specifically developed to avoid this side effect. If you've had a cough on an ACE inhibitor in the past, stick with ARB alternatives.

What About the Losartan/HCTZ Combination?

If you take the combination pill (losartan/hydrochlorothiazide), one practical option when it's out of stock is to take the two components as separate tablets. Both generic losartan and generic hydrochlorothiazide are widely available and inexpensive. Taking them separately may actually be more flexible for dosing. Ask your doctor if this is appropriate for your situation.

How to Talk to Your Doctor About Switching

When calling your doctor's office about an alternative, be prepared with:

• Your current losartan dose and how long you've been taking it
• The reason for switching (shortage, cost, insurance change)
• Any history of cough with ACE inhibitors (rules out that class for you)
• Any recent kidney function labs or potassium levels (relevant for dose selection)
• Your insurance formulary tier list or the specific ARB your pharmacist has in stock

For more context on why losartan may be hard to find, see: Why Is Losartan Hard to Find? [2026]

Or read: How to Save Money on Losartan in 2026.