Losartan is prescribed for managing hypertension (high blood pressure) and safeguarding the kidneys against diabetes-related damage. Additionally, it aids in reducing the likelihood of strokes in individuals with high blood pressure and an enlarged heart. By reducing high blood pressure, it plays a role in preventing strokes, heart attacks, and kidney complications. Losartan falls under the category of medications known as angiotensin receptor blockers (ARBs), operating by relaxing blood vessels to facilitate smoother blood flow.

Lisinopril

Lisinopril is prescribed for hypertension, aiming to reduce the risk of strokes, heart attacks, and kidney complications. Additionally, it is utilized for heart failure management and enhancing survival post-heart attack. Belonging to the ACE inhibitor class, Lisinopril operates by dilating blood vessels, facilitating smoother blood flow.

How to use lisinopril

Take this medicine orally, with or without food, as instructed by your physician, typically once daily.

If you’re using the liquid form of this medication, shake the bottle thoroughly before each dose. Measure the dose accurately using a specialized measuring device/spoon; avoid using a regular household spoon to ensure precise dosing.

The prescribed dosage depends on your medical condition and response to the treatment, with pediatric doses also factoring in the child’s weight.

To minimize potential side effects, your doctor might advise starting with a low dose and gradually increasing it. Adhere strictly to your doctor’s guidance.

Consistently use this medication to maximize its benefits, taking it at the same time daily to aid in remembering. Continue taking it even if you feel well, as high blood pressure often presents no noticeable symptoms.

For high blood pressure management, it may take 2 to 4 weeks to observe the full effects of this medication, while for heart failure treatment, it might take weeks to months. Inform your doctor if there’s no improvement or if your condition worsens, such as persistent or rising blood pressure readings.

Read Also: PINAVERIUM – ORAL Side Effects, Medical Uses, and Drug

Pros and Cons of losartan and lisinopril

Losartan:

Pros:

  • Effective
  • Well-Tolerated
  • Kidney Protection
  • Once-Daily Dosage

Cons:

  • Potassium Levels
  • Dizziness and Fatigue
  • Pregnancy Risk

Lisinopril:

Pros:

  • Effective
  • Kidney Protection
  • Once-Daily Dosage
  • Heart Protection

Cons:

  • Cough
  • Angioedema
  • Pregnancy Risk

Differences Between losartan and lisinopril

Losartan:

Used to treat hypertension (high blood pressure), reduce the risk of stroke in patients with hypertension and left ventricular hypertrophy, and manage certain types of heart failure.

Lisinopril:

Also used to treat hypertension, heart failure, and to improve survival after a heart attack.

Alternative to losartan and lisinopril

Alternative to losartan

Valsartan:

Valsartan is another type of angiotensin II receptor blocker (ARB) similar to losartan. It works by relaxing blood vessels, which helps lower blood pressure.

Alternative to lisinopril

Amlodipine:

Amlodipine belongs to a class of medications called calcium channel blockers. It works by relaxing blood vessels, making it easier for the heart to pump blood and lowering blood pressure.

Interactions between your drugs

lisinopril losartan

AVOID IN GENERAL: Combining an ACE inhibitor with an angiotensin II receptor antagonist can heighten the risk of hyperkalemia, low blood pressure, fainting, and kidney problems due to their combined impact on the renin-angiotensin system.

MANAGEMENT: It’s not recommended to simultaneously use an ACE inhibitor and an angiotensin II receptor antagonist, especially in patients with diabetic kidney disease. Most patients don’t see added benefits from this combination compared to using either drug alone. However, if the combination is necessary, closely monitor serum electrolytes, blood pressure, and kidney function. Regular checks of electrolytes and kidney function may be needed, especially in older patients or those with worsening heart failure or dehydration risks. Supplementing potassium should be done cautiously or avoided altogether unless closely supervised. Patients should be informed to seek medical help if they notice signs like weakness, confusion, tingling, or irregular heartbeat, which could indicate hyperkalemia.

Drug and food interactions

lisinopril food

AVOID IN GENERAL: Consuming moderate to high amounts of potassium in the diet can lead to hyperkalemia in certain individuals using ACE inhibitors. Some cases involved patients using potassium-rich salt substitutes. ACE inhibitors can contribute to hyperkalemia by inhibiting the renin-aldosterone-angiotensin (RAA) system.

MANAGEMENT: Patients taking ACE inhibitors should be counseled to steer clear of diets high in potassium. Special attention should be given to the potassium levels in salt substitutes.

losartan food

AVOID IN GENERAL: Consuming moderate to high amounts of potassium, particularly through salt substitutes, can increase the risk of hyperkalemia in patients taking angiotensin II receptor blockers (ARBs). ARBs can induce hyperkalemia by inhibiting angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency are at higher risk of developing hyperkalemia.

MANAGEMENT: Patients should receive dietary guidance and be advised against using potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their doctor. If salt substitutes are used, regular monitoring of serum potassium levels is recommended. Patients should also be instructed to seek medical help if they experience symptoms of hyperkalemia like weakness, irregular heartbeat, confusion, tingling in extremities, or heaviness in legs.

MONITOR: Grapefruit juice might modestly reduce and delay the conversion of losartan to its active metabolite, E3174. This is likely due to certain compounds in grapefruits inhibiting CYP450 3A4-mediated first-pass metabolism in the gut wall. The clinical significance of this interaction is uncertain, and changes in drug levels due to grapefruit juice can vary widely between patients.

MANAGEMENT: Patients who regularly consume grapefruits or grapefruit juice should be monitored for altered losartan efficacy. Avoiding grapefruits and grapefruit juice is advisable if an interaction is suspected. Orange juice is not expected to cause interactions.

lisinopril food

MONITOR: Various psychotherapeutic and central nervous system (CNS)-active medications (such as anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, and muscle relaxants) can cause low blood pressure, especially when starting treatment or increasing the dosage. Combining these drugs with antihypertensives and other medications that lower blood pressure, especially vasodilators and alpha-blockers, can lead to additional blood pressure reduction and orthostatic hypotension.

MANAGEMENT: It is important to exercise caution and closely monitor for the development of low blood pressure when using these medications together. Some experts recommend avoiding alcohol consumption in patients taking vasodilating antihypertensive drugs. Patients should be instructed to avoid sudden changes in posture from sitting or lying down and to inform their doctor if they experience dizziness, light-headedness, fainting, orthostatic hypotension, or rapid heart rate.

Conclusion

The interaction between losartan and lisinopril primarily revolves around their shared mechanism of action as angiotensin-converting enzyme (ACE) inhibitors. While both medications effectively lower blood pressure by targeting the renin-angiotensin-aldosterone system, combining them can increase the risk of hyperkalemia and other adverse effects such as low blood pressure and kidney dysfunction. Therefore, caution is advised when considering coadministration, and patients should be closely monitored for any signs of complications. It’s crucial for healthcare providers to assess the potential benefits versus risks before initiating dual therapy with losartan and lisinopril.

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The information presented on this website is not intended as specific medical advice and is not a substitute for professional treatment or diagnosis. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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