Losartan vs. Olmesartan
See how Losartan and Olmesartan compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Losartan and olmesartan are both angiotensin II receptor blockers (ARBs) used to treat high blood pressure, and both are taken once daily by mouth.
Losartan carries extra FDA approvals for reducing stroke risk in people with left ventricular hypertrophy and for slowing kidney damage from type 2 diabetes, which olmesartan does not have.
Generic losartan typically costs far less per month than olmesartan, which can matter for people without strong insurance coverage.
Losartan vs. Olmesartan Drug Summary
Losartan
Losartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure in adults and children 6 and older. It is also FDA-approved to lower stroke risk in people with high blood pressure and left ventricular hypertrophy, and to slow kidney damage in type 2 diabetes with protein in the urine. It comes as a tablet taken once a day, usually starting at 50 mg.
Olmesartan
Olmesartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure in adults and children 6 and older, alone or with other blood pressure medicines. It comes as a tablet taken once a day, typically starting at 20 mg and adjusted after a few weeks. Unlike losartan, it does not carry FDA approval for reducing stroke risk or treating diabetic kidney disease.
Losartan vs. Olmesartan Side Effects
Losartan
Olmesartan
Losartan vs. Olmesartan Dosage
Losartan
Olmesartan
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 100 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 40 mg once daily | Week 3 onward |
| Dose changes | 2 increases | As tolerated |
Losartan
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 100 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Olmesartan
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 40 mg once daily | Week 3 onward |
| Dose changes | 2 increases | As tolerated |
Losartan vs. Olmesartan Indications
Losartan
Losartan is FDA-approved to treat high blood pressure in adults and children 6 and older. It also lowers the risk of stroke in people who have high blood pressure with left ventricular hypertrophy, though this benefit has not been shown in Black patients. It is approved to slow kidney damage in adults with type 2 diabetes, high blood pressure, and protein in the urine.
Treats high blood pressure in adults and children 6+
Reduces stroke risk with high blood pressure and LVH
Slows diabetic kidney disease with proteinuria
Can be combined with other blood pressure medicines
Olmesartan
Olmesartan is FDA-approved to treat high blood pressure in adults and children 6 and older, either alone or combined with other antihypertensive medicines. It is not approved as initial therapy for people 75 and older or for those with liver problems. It does not carry the added stroke-risk or kidney-protection approvals that losartan has.
Treats high blood pressure in adults and children 6+
Can be combined with other blood pressure medicines
Not approved as first therapy in people 75 or older
Not approved as first therapy with liver impairment
Losartan vs. Olmesartan Pros and Cons
Losartan
Losartan has decades of use, broad insurance coverage, and low-cost generics at nearly every pharmacy. It also carries added FDA approvals for stroke-risk reduction and diabetic kidney protection that not every ARB has. Its main tradeoff is a somewhat shorter duration of action than some newer ARBs.
Pros
FDA-approved for stroke-risk reduction with LVH
FDA-approved to slow diabetic kidney disease
Generic tablets often cost $10 to $90 a month without insurance, before savings programs
Cons
Shorter duration of action than some newer ARBs
May need a second daily dose for full 24-hour control in some people
Stroke-risk benefit not shown in Black patients
Olmesartan
Olmesartan lowers blood pressure with once-daily dosing and a long half-life that gives steady 24-hour control. It lacks the added stroke-risk and kidney-protection indications that losartan carries. Its generic list price also tends to run higher than losartan's before any discounts or coupons.
Pros
Long half-life gives steady 24-hour blood pressure control
Doses above 40 mg add no extra benefit, simplifying titration
Effective as monotherapy or combined with other medicines
Cons
No FDA approval for stroke-risk reduction
No FDA approval for diabetic kidney protection
Rare risk of severe chronic diarrhea with weight loss
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.