Open Community Question @DriftlessAngler_WI • 45-59M • Lisinopril 20mg to Losartan • Week 8

▲ 47 Helpful • 2 Peer Replies

Lisinopril gave me a dry tickle cough after 8 weeks: is switching to losartan safe, and how fast does the cough go away?

Public question: "I take lisinopril 20 mg for hypertension and have had a dry, tickling cough for about 2 months. Is it the drug, and can I just switch to losartan?" Evidence Desk answer: ACE inhibitor cough is a class effect caused by bradykinin buildup. It is reported in roughly 5-20% of users, can start weeks to months after the first dose, and is not dose-dependent. ARBs such as losartan do not block bradykinin breakdown, and their cough rates are close to placebo. Typical swap: stop lisinopril and start losartan 50 mg once daily the next day, with no washout needed. Never take an ACE inhibitor and an ARB together. Cough usually fades within 1-4 weeks after stopping, but can take up to 3 months. Ask for a BMP (potassium, creatinine) 1-2 weeks after the switch. New lip or tongue swelling needs emergency care.

⚕ Pinned FDA / NIH / PubMed Clinical Context • Priya Nair — Literature & Label Auditor

The FDA DailyMed lisinopril label lists cough as a common adverse reaction (about 3-4% in trials, higher in post-marketing use) and warns against dual RAAS blockade. The ONTARGET trial (NEJM 2008) showed that combining an ACE inhibitor with an ARB raised hyperkalemia and renal dysfunction without added benefit.

Connected Clinical Guides: Condition: Hypertension Condition: Heart Failure Rx: Lisinopril Rx: Losartan Supplement: Magnesium Glycinate Supplement: Potassium Citrate

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Verified Peer Replies (2)

@DesertRunner_AZ • Verified Cohort Member • Week 17

One label point: if you have ever had ACE inhibitor angioedema, ARBs are used with caution, because cross-reactivity is uncommon but reported. Tell your prescriber about any past swelling. Also confirm that no old lisinopril/HCTZ combination tablets remain in your cabinet, so you don't double up with the new losartan.

@SteadyGlucose52 • Age 45-59 • Week 6

My cough took about 3 weeks to fade after I stopped lisinopril. I started losartan 50 mg the next morning, and my pharmacist advised against finishing the lisinopril supply. My labs at week 2 showed normal potassium and creatinine.