Comparing Cozaar (Losartan) To Benicar (Olmesartan)

In our latest question and answer, the pharmacist compares two blood pressure medications in the same class, Cozaar (losartan) and Benicar (olmesartan).

Question

I’m stuck in Mexico because of US flight cancellations. I take Benicar 40mg and HCTZ 12.5 mg every day for hypertension. They carry HCTZ here, but not Benicar. They do have Losartan however. Can I safely substitute 40mg of that for the next 5 days until I get home?

Asked by Joe On Jan 07, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jan 09, 2018

The substitution of losartan (generic for Cozaar) for Benicar (olmesartan) is most likely okay, but it would be prudent to discuss this with your doctor to appropriate work out the correct dosing of losartan.


Benicar (olmesartan) is known as an ARB (Angiotensin Receptor Blocker), and is in the same class of medication as Cozaar (losartan). Most studies and experts agree that there generally is not a significant difference in efficacy between drugs in this class. Having said that, certain studies have shown potential differences that should be considered... although they need to be studied further.


Differences Between Cozaar (Losartan) And Benicar (Olmesartan)

One large meta-analysis showed that Benicar is slightly more effective in lowering overall blood pressure numbers when compared to Cozaar.


Blood Pressure Lowering Comparison

Drug 

Dose (mg)Systolic BPDiastolic BP



Benicar 

5

10

20

40


11-13

10-17

11-21

5-22

8-12

13-18

4-17

5-17


Cozaar

25

50

100

8-12

8-19

9-12

7-10

5-15

9-10

Most studies show no differences in safety profiles between drugs in the ARB class.


While Benicar (olmesartan) and Cozaar (losartan) are similar, they do have different FDA approved indications.


Cozaar Indications

  • Hypertension
  • Diabetic Nephropathy
  • Proteinuria
  • Stroke Prophylaxis


Benicar Indications

  • Hypertension


While Benicar (olmesartan) only has the one FDA approved indication, it doesn't necessarily mean it's not effective for the indications that Cozaar (losartan) has.


As Cozaar (losartan) and Benicar (olmesartan) are so similar and Benicar is currently unavailable to you, your doctor may agree temporarily switching to Cozaar is a good idea. The main consideration will be the dose.


When switching blood pressure drugs, it is often recommended to try and find a dose that is comparable in terms of average reduction of blood pressure and stay on the conservative side to avoid potential side effects such as dizziness and hypotension (low blood pressure). Be sure to discuss the situation with your doctor.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor Of Pharmacy degree in 2010. He has been featured in several publications including the Huffington Post as well as a variety of health and pharmacy related blogs. Please feel free to reach out to him directly if you have any questions or want to connect! [email protected]; Office: 716-389-3076

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