Based on NIH | Can Losartan cause joint pain, how common is this side effect, and what should I do if it occurs?

Losartan can cause joint pain in some people, although this appears to be an uncommon side effect. In official product information, “arthralgia” (joint pain) and “myalgia” (muscle pain) are listed among post‑marketing adverse reactions for losartan. ^{[1] [2]} In studies and consumer-facing labeling, musculoskeletal complaints such as back, leg, or knee pain are reported, but they were generally infrequent and often similar to placebo in clinical trials. ^{[3] [4]}

How common is joint pain with losartan?

• Clinical trials: Reports of musculoskeletal pain (e.g., back or leg pain) occurred at low rates; in one dataset, muscle cramps 1%, back pain 2%, and leg pain 1% were noted in treated participants, reflecting relatively uncommon events. ^[3] While these categories include more than just joint pain, they give a sense that musculoskeletal symptoms were not frequent in trials. ^[3]
• Post‑marketing experience: After approval, joint pain (arthralgia) and muscle pain have been reported, leading to inclusion in labeling, but exact percentages are not provided because spontaneous reports do not allow precise incidence estimation. ^{[1] [2]}
• Combination products: When losartan is combined with hydrochlorothiazide (HCTZ), musculoskeletal complaints including arthralgia, joint swelling, and generalized musculoskeletal pain are listed, again without precise frequency, suggesting they can occur but are not among the most common effects. ^{[5] [6]}
• Overall tolerability: Across large trials, losartan’s overall side‑effect rates were similar to placebo and dizziness was the most common drug‑related effect, implying that significant joint pain is not a frequent limiting issue for most users. ^[4]

Why might joint pain occur?

The exact mechanism is not well defined. Most reports come from real‑world use after approval rather than from consistent signals in controlled trials, which suggests joint pain may occur idiosyncratically in susceptible individuals. ^{[1] [2]} Other factors like underlying arthritis, gout, or interactions with other medicines can also contribute; notably, thiazide diuretics can raise uric acid and trigger gout, which can cause acute joint pain, so this is more relevant for losartan/HCTZ combinations than losartan alone. ^{[5] [6]}

What to do if you develop joint pain on losartan

• Assess severity and timing: If joint pain is mild and started soon after beginning losartan, it may improve as your body adjusts. Monitoring for a short period while keeping a log of timing, location, and severity can be reasonable if symptoms are tolerable. ^[4]
• Check other causes: Consider recent activity, new medications, dehydration, or a history of arthritis or gout, as these are common non‑drug causes of joint pain. If you take a losartan/HCTZ combination and the pain is in a single joint, sudden, red, or swollen, gout should be considered. ^{[5] [6]}
• When to contact your clinician:
  • Pain is moderate to severe, persistent, or worsening. ^{[1] [2]}
  • There is joint swelling, redness, warmth, fever, or inability to bear weight, which could suggest gout or another inflammatory process. ^{[5] [6]}
  • You have other new symptoms (e.g., rash, muscle weakness) that raise concern for broader side effects. ^[2]
• Medication adjustments: Do not stop losartan on your own. Your clinician may recommend ruling out other causes, trying supportive care (e.g., acetaminophen if appropriate), adjusting the dose, or switching to another blood pressure class if the pain appears drug‑related and does not resolve. ^[4]
• Emergency care: Seek urgent care if pain is severe with high fever, marked swelling, or if you suspect an acute gout attack or infection of the joint. ^{[5] [6]}

Practical tips for symptom relief

• Supportive measures: Rest the affected joint, ice or warm compresses as helpful, gentle stretching, and over‑the‑counter pain relievers like acetaminophen if safe for you (avoid NSAIDs without discussing with your clinician if you have kidney disease or are on certain blood pressure medicines). Hydration and avoiding high‑purine foods may help if gout is suspected, particularly with diuretic combinations. ^{[5] [6]}
• Track and share: Keep a simple diary (start date of pain, daily severity, joints involved, what helps or worsens). This information helps your clinician decide whether losartan is the likely cause and whether a change is needed. ^[4]

Bottom line

• Yes, losartan can be associated with joint pain, but it appears to be uncommon. ^{[1] [2]}
• Musculoskeletal symptoms were generally infrequent in trials, and overall tolerability was similar to placebo, indicating that significant joint pain is not typical for most users. ^{[3] [4]}
• If you experience joint pain, especially if it’s persistent, severe, or accompanied by swelling or redness, contact your clinician to evaluate causes and discuss options, which may include monitoring, symptomatic treatment, or switching therapies if needed. ^{[1] [2] [5] [6]}