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Lisinopril vs Diovan
Introduction
For patients with hypertension or heart failure, certain drugs that adjust the levels of compounds in the body associated with regulating blood pressure can assist in managing symptoms and avoiding complications. Lisinopril and Diovan are two such drugs often prescribed for these conditions. They each have different mechanisms of action but both are effective at reducing high blood pressure and relieving strain on the heart.
Lisinopril is classified as an angiotensin-converting enzyme (ACE) inhibitor, which works by blocking a substance in your body that causes blood vessels to tighten. As a result, it relaxes the vessels, making it easier for your heart to pump blood through them.
Diovan, on the other hand, belongs to a group of medicines known as angiotensin II receptor antagonists. It works by inhibiting a hormone called angiotensin II from binding to receptors on blood vessels which prevents constriction of these vessels hence lowering overall systemic vascular resistance leading to lower arterial pressure.
What is Lisinopril?
Lisinopril (the generic name for Prinivil and Zestril) belongs to the class of drugs known as angiotensin-converting enzyme inhibitors (ACE inhibitors), a significant advancement over older classes of blood pressure medication. Lisinopril was first approved by the FDA in 1987. It works by blocking an enzyme in your body that narrows blood vessels and releases hormones that can raise your blood pressure, resulting in relaxation and dilation of the blood vessels. This makes it easier for your heart to pump blood around your body, reducing high blood pressure levels. Although Lisinopril mainly targets this particular mechanism, its effects are not limited to it; it also slightly reduces heart rate which contributes to its antihypertensive effect.
On the other hand, Diovan (also known as valsartan) is part of another class called angiotensin II receptor blockers (ARBs). Instead of inhibiting production like Lisinopril does, Diovan blocks receptors where angiotensin causes constriction or narrowing of blood vessels. Both medications have similar side effect profiles but ARBs like Diovan tend to be better tolerated with fewer cough related side-effects compared with ACE inhibitors like Lisinopril.
What conditions is Lisinopril approved to treat?
Lisinopril is approved for the treatment of several cardiovascular conditions, including:
- Hypertension, also known as high blood pressure
- Congestive heart failure, often in combination with other medications
- Improving survival following a myocardial infarction (heart attack)
How does Lisinopril help with these illnesses?
Lisinopril helps manage high blood pressure and heart conditions by reducing the amount of angiotensin II, a hormone that causes constriction of blood vessels and release of another hormone called aldosterone from the adrenal gland. It does this by inhibiting an enzyme known as angiotensin-converting enzyme (ACE), which is involved in producing angiotensin II. Angiotensin II not only narrows blood vessels but also stimulates the release of aldosterone which can cause fluid retention, thereby increasing blood pressure. By inhibiting ACE, Lisinopril effectively lowers levels of angiotensin II leading to dilation of blood vessels and reduction in fluid volume, thus helping to lower blood pressure and reduce strain on the heart.
What is Diovan?
Diovan, also known by its generic name valsartan, is an angiotensin II receptor antagonist. Its primary function is to inhibit the action of angiotensin II, a hormone that causes blood vessels to constrict and promotes the release of another hormone called aldosterone. The effect of Diovan is thus vasodilation (widening of blood vessels) and reduced fluid volume — leading to lower blood pressure. This drug was first approved by the FDA in 1996.
As valsartan does not inhibit ACE (angiotensin converting enzyme), it doesn't have some side effects common with ACE inhibitors like Lisinopril such as persistent dry cough or angioedema. It's predominantly used for treating high blood pressure, heart failure, and for preventing kidney damage due to diabetes. The unique mechanism through which Diovan operates can be particularly beneficial for patients who do not respond well or have adverse reactions to other antihypertensive drugs like Lisinopril.
What conditions is Diovan approved to treat?
Diovan, a medication in the family of angiotensin II receptor blockers (ARBs), is FDA approved for managing several conditions including:
- High blood pressure (hypertension)
- Heart failure
- Kidney disease in patients with type 2 diabetes
How does Diovan help with these illnesses?
Diovan is an angiotensin II receptor antagonist and plays a significant role in many processes within the body, particularly those involving blood pressure regulation and fluid balance. It directly inhibits the action of angiotensin II, a hormone that constricts blood vessels, thereby causing relaxation and dilation of blood vessels which leads to reduced blood pressure. Diovan's unique ability to selectively block the receptors of angiotensin II may also have beneficial effects on kidney function and cardiac health. Unlike Lisinopril, an ACE inhibitor which prevents the production of Angiotensin II but can sometimes cause persistent dry cough as a side effect, Diovan works further down the biochemical pathway and does not significantly affect bradykinins levels thus making it more suitable for patients who do not respond well or are intolerant to ACE inhibitors such as Lisinopril.
How effective are both Lisinopril and Diovan?
Both lisinopril and valsartan (Diovan) have robust histories of success in managing high blood pressure, with initial FDA approvals occurring within a decade of each other. Since they target different aspects of the renin-angiotensin-aldosterone system, they may be prescribed under varying circumstances. The effectiveness of lisinopril and valsartan was directly studied in multiple double-blind clinical trials; both drugs demonstrated similar efficacy in reducing hypertension as well as promising safety profiles.
A 2000 review on lisinopril showcased its effectiveness from the first week of treatment, favorable side effect profile compared to many other antihypertensive medications, and good tolerability even among elderly populations. This study also reported that lisinopril has become one of the most widely-prescribed ACE inhibitors worldwide. As it is part of the first class (ACE inhibitors) developed specifically for hypertension management, there is substantial research into its effectiveness for this condition.
On the other hand, a 2012 meta-analysis indicated that valsartan seems to be more effective than placebo at managing hypertension and found it comparable in efficacy to other popular antihypertensives like beta-blockers or calcium channel blockers. Nonetheless, some guidelines consider ARBs such as valsartan secondary options after ACE inhibitors or diuretics due to their later development timeline. However, because it does not cause dry cough - a common side effect associated with ACE inhibitors -, Valsartan can be an optimal choice for patients who do not tolerate well or are allergic to ACE inhibitors.
At what dose is Lisinopril typically prescribed?
Oral dosages of Lisinopril range from 10-40 mg/day for treating hypertension, with studies indicating that a starting dose of 10 mg/day is sufficient for most individuals. For heart failure, the initial dosage may be as low as 5 mg/day. Children and adolescents' dosage must be determined by a healthcare provider. In any population, if there is no response after several weeks, the dosage can be increased gradually under medical supervision. The maximum daily dosage should not exceed 80 mg/day in any case.
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At what dose is Diovan typically prescribed?
Diovan therapy typically begins with a dosage of 80–160 mg/day. The dose can then be increased to 320 mg/day, taken in one single dose. Patients who tolerate this well might experience a further increase to the maximum recommended daily dose of 320 mg, depending on their response and tolerance. If there is no observable reduction in blood pressure after several weeks of treatment at this level, additional therapies may need to be considered.
What are the most common side effects for Lisinopril?
Common side effects of Lisinopril can include:
- Dizziness or light-headedness particularly after the first dose and when the dose is increased
- Dry cough
- Fatigue, sleepiness/drowsiness
- Headache
- Nausea, vomiting, diarrhea
- Chest pain or discomfort
- Rash
The potential side effects for Diovan are:
- Dizziness, vertigo (spinning sensation)
- Low blood pressure (hypotension)
- Diarrhea
- Joint pain
-Rash or itching skin
-Tiredness/fatigue
Remember that not everyone will experience these side effects and if any do occur they may be only temporary. If you're concerned about any symptoms you experience while taking either medication speak with your healthcare provider.
Are there any potential serious side effects for Lisinopril?
While both Lisinopril and Diovan are effective in managing high blood pressure, they do carry potential side effects. Here are some of the rare but serious ones you should note:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Severe skin reactions: fever, sore throat, burning eyes, skin pain or a red or purple skin rash that spreads and causes blistering and peeling
- Kidney problems: little or no urination; painful or difficult urination; swelling in your feet or ankles; feeling tired
- High potassium levels: nausea ; weakness ; tingly feeling; chest pain , irregular heartbeats
- Symptoms related to changes in blood count like persistent sore throat , severe stomach / abdominal pain , yellowing eyes/skin
- Symptoms of liver issues such as dark urine and jaundice (yellowing of the skin/eyes)
With either medication if you experience any of these symptoms it's important to seek immediate medical attention.
What are the most common side effects for Diovan?
When comparing Lisinopril to Diovan, it's important to note that Diovan can have the following side effects:
- Headache and dizziness
- Stomach pain, diarrhea or constipation
- Tiredness and weakness
- Back pain and joint pain
- Dry cough or sore throat
- Skin rash
- Nausea, loss of appetite or increased urination.
Diovan may also cause sleep problems (insomnia), a fast heartbeat, blurred vision, confusion or agitation in some people. It is crucial to monitor these symptoms closely if you are taking this medication for conditions such as high blood pressure. Always consult with your healthcare provider about any concerns you might have regarding potential side effects.
Are there any potential serious side effects for Diovan?
While Diovan is generally well-tolerated, it's important to be aware of potential side effects that may indicate a serious reaction. These include:
- Signs of an allergic reaction, such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- A light-headed feeling like you might pass out
- Shortness of breath (even with mild exertion), swelling in your hands or feet
- Rapid weight gain indicating possible kidney issues
- Symptoms related to high potassium which include nausea, weakness/tiredness, tingling/numbness and irregular heartbeat.
If any of these symptoms are experienced while taking Diovan, medical attention should be sought immediately. Do not ignore these signs as they can potentially lead to more severe health complications if untreated.
Contraindications for Lisinopril and Diovan?
Lisinopril and Diovan, like many other blood pressure medications, may cause a few common side effects such as dizziness or lightheadedness. If you notice your symptoms worsening, including an increase in fainting spells or irregular heartbeats, please seek immediate medical attention.
Neither Lisinopril nor Diovan should be taken if you are currently taking aliskiren (Tekturna), especially for those with diabetes or kidney disease. Always inform your physician about any medication you are taking; Aliskiren will require a period of about 2 weeks to clear from the system before starting Lisinopril or Diovan to prevent dangerous interactions.
Moreover, both these drugs shouldn't be used during pregnancy due to their severe potential harm to the fetus. It is crucial that women who plan on becoming pregnant discontinue use of Lisinopril and Diovan as soon as possible and consult with their doctor about safer alternative treatments.
How much do Lisinopril and Diovan cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Diovan (80 mg) averages around $140, which works out to approximately $4.67/day.
- The price for 30 tablets of Lisinopril (20 mg) is about $120, working out to roughly $4/day.
Thus if your dosage for Diovan is on the higher end (i.e., 160 mg/day or more), then brand-name Lisinopril could be less expensive on a per-day treatment basis. However, remember that cost shouldn't be your main deciding factor in choosing between these two medications.
As far as generic versions go:
- Valsartan (generic Diovan) costs range from around $0.50 to $2 per day depending on dose and where you purchase it.
- For Lisinopril, you can expect costs starting from as low as about $0.10 per day up to about $0.40 per day.
This makes both generic valsartan and lisinopril significantly cheaper than their branded counterparts while offering similar effectiveness in treating hypertension.
Popularity of Lisinopril and Diovan
Lisinopril, available in generic form as well as under the brand name Zestril, was estimated to have been prescribed to over 87.4 million people in the US in 2020. Lisinopril accounted for just about 25% of ACE inhibitor prescriptions in the US and is ranked first among ACE inhibitors. It has maintained a steady prevalence since it came into use.
Valsartan, also known by its brand name Diovan, was prescribed to approximately 13.7 million people in the USA within that same year. In terms of ARB (Angiotensin II receptor blocker) prescriptions, valsartan accounts for nearly 20%. The overall prevalence of valsartan has varied over time due to recalls related to impurities but remains a popular choice for hypertension management.
Conclusion
Both Lisinopril and Diovan (valsartan) are frequently prescribed medications that have been established as effective treatments for hypertension (high blood pressure). Numerous clinical studies back their efficacy over placebo treatments. They work in different ways, with Lisinopril being an ACE inhibitor that reduces the production of angiotensin II, a substance that can constrict blood vessels and release hormones causing fluid retention. On the other hand, Diovan is an ARB which blocks the action of angiotensin II directly.
Lisinopril is often chosen as a first-line treatment option for high blood pressure because it has additional benefits for diabetic patients and those with heart failure. Diovan might be considered as a replacement or addition to treatment if patients experience certain side effects from Lisinopril such as persistent coughing, or if they have conditions like heart failure where ARBs are shown to provide particular benefit.
Generic forms of both drugs are available offering significant cost savings especially for patients who must pay out-of-pocket. Both may require some adjustment period before their effects on lowering blood pressure become fully apparent.
The side effect profile between these two drugs varies with both being generally well-tolerated but having distinct potential adverse effects due to their different mechanisms – notably persistent dry cough more common in ACE inhibitors like Lisinopril, while dizziness is reported more frequently with ARBs like Diovan. Patients on either drug should monitor any symptoms closely when starting therapy and should seek medical help promptly if they notice serious problems such as facial swelling or difficulty breathing.