Ramipril vs Losartan

Overview

What is each medicine used for?

Key differences between Ramipril and Losartan

• Mechanism: ramipril (ACE inhibitor) reduces formation of angiotensin II; losartan (ARB) blocks receptors that angiotensin II acts on. The overall effect on blood pressure can be similar, but side effects differ.
• Cough: an annoying dry cough affects a noticeable minority of people on ACE inhibitors and is a common reason to switch to an ARB under medical supervision.
• Angioedema (swelling under the skin, sometimes severe) can occur with ACE inhibitors; ARBs are used cautiously if there has been ACE inhibitor angioedema — this is a specialist prescribing area.
• Both raise potassium and affect kidney blood flow; NSAIDs can interfere with their protective effects and kidney function — your prescriber may advise limiting or avoiding NSAIDs.

Side effects: how do they compare?

• Ramipril: cough, dizziness on standing, tiredness, raised potassium, kidney function changes, rare angioedema.
• Losartan: dizziness, tiredness, similar electrolyte and kidney monitoring themes; cough is much less typical as an ARB effect.
• Both classes can cause low blood pressure if dehydrated or over-diuresed; reporting dizziness or fainting matters.
• Individual tolerance varies; one person may feel fine on ramipril while another needs losartan or a different class entirely.

Safety and who may need extra GP or pharmacist advice

• Do not take both an ACE inhibitor and an ARB together unless a specialist has a specific reason — routine combination is not standard in primary care.
• Avoid in pregnancy; contact your GP urgently if you become pregnant on either medicine.
• Tell your doctor if you take potassium supplements, potassium-sparing diuretics, or NSAIDs regularly.
• If you develop lip or tongue swelling, or difficulty breathing, seek emergency care.

How your prescriber may choose between them

• Guidelines often favour ACE inhibitors or ARBs for many people with high blood pressure, diabetes-related kidney disease, or heart failure — the exact drug depends on your history and blood tests.
• If an ACE inhibitor causes cough or is not tolerated, an ARB is a common alternative.
• Kidney artery narrowing, very low blood pressure, or past angioedema changes which option is safe.

When to speak to your GP or pharmacist

• If you faint, have persistent dizziness, or your home blood pressure readings are very low or very high.
• Before starting ibuprofen, naproxen, or new supplements, including potassium.
• If you develop a new cough on ramipril — do not stop suddenly without advice, but do arrange a review.
• If planning pregnancy or breastfeeding.

Read the full medicine guides

Each DrugABC medicine page covers uses, how to take it, interactions, pregnancy, and more — for reference alongside what your clinician tells you.

• RamiprilUses, side effects, dosage topics →
• LosartanUses, side effects, dosage topics →

Other comparisons

• Atorvastatin vs Simvastatin
• Omeprazole vs Lansoprazole
• Ibuprofen vs Paracetamol
• Sertraline vs Fluoxetine