Losartan vs Atenolol

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For patients dealing with hypertension or other cardiovascular conditions, certain drugs that modulate the function of heart and blood vessels can help in managing blood pressure levels and reducing the risk of heart diseases. Losartan and Atenolol are two such medications often prescribed for these health conditions. They each have a different mode of action but both effectively control high blood pressure to prevent strokes, heart attacks, or kidney problems. Losartan is an angiotensin II receptor antagonist which works by blocking a substance in the body that causes the blood vessels to tighten. This ultimately relaxes and dilates (widens) the blood vessels allowing free flow of blood thereby lowering high pressure. On contrary, Atenolol belongs to a class called beta-blockers affecting directly on heart's functionality; it inhibits adrenaline effect on your heart causing it to beat more slowly and with less force which reduces its workload as well as lowers overall pressure within your circulatory system.

What is Losartan?

Losartan (the generic name for Cozaar) was one of the first drugs in the class known as angiotensin II receptor blockers (ARBs), which marked a significant advancement from the previous class of hypertension medications called beta-blockers, such as Atenolol. Losartan was first approved by the FDA in 1995. It works by blocking a substance in the body that causes blood vessels to tighten, thus relaxing and dilating them. This mechanism aids in lowering blood pressure and improving overall cardiovascular health. Unlike Atenolol, Losartan has no effect on heart rate because it does not target beta-adrenergic receptors located within cardiac tissues. Therefore, it often results in fewer side effects like bradycardia or fatigue that are commonly associated with beta-blockers like Atenolol.

What conditions is Losartan approved to treat?

Losartan is approved for the treatment of several cardiovascular conditions:

  • Hypertension, otherwise known as high blood pressure
  • Diabetic nephropathy in patients with type 2 diabetes mellitus and a history of hypertension
  • Stroke prevention in patients with hypertension and left ventricular hypertrophy, but there is evidence that this benefit does not apply to African American population.

How does Losartan help with these illnesses?

Losartan is designed to manage hypertension by blocking the action of angiotensin II, a chemical in your body that causes muscle tissue around blood vessels to contract. This contraction results in narrower blood vessels and higher blood pressure. Losartan works by preventing this contraction, allowing the blood vessels to widen which reduces blood pressure. Angiotensin II is a hormone that plays an important role in regulating kidney function, fluid balance, and vasoconstriction - all pivotal processes for maintaining proper heart health. It's known that individuals with hypertensive conditions have relatively higher levels of angiotensin II or are more sensitive to its effects. Therefore, by blocking angiotensin II actions, Losartan can limit the negative impact of hypertension and assist patients in controlling their condition and stabilizing their cardiovascular health.

What is Atenolol?

Atenolol, often sold under the brand name Tenormin, is a beta blocker that primarily affects the heart and circulation (blood flow through arteries and veins). It functions by reducing the workload on the heart and helps it to beat more regularly. This prevents chest pain, decreases blood pressure, reduces cardiovascular complications, and can even prevent migraines. Atenolol was first approved by the FDA in 1981. Unlike Losartan which is an angiotensin II receptor antagonist used mainly to treat high blood pressure (hypertension) and diabetic kidney disease, Atenolol does not focus on blocking substances in the body that cause blood vessels to tighten. The primary function of Atenolol means its side-effect profile is also different from those of drugs like Losartan; for instance it may cause dizziness or tiredness but is less likely to lead to coughing – a common side effect of medications such as Losartan. The effects of Atenolab can be beneficial for patients who need help with cardiovascular-related issues without experiencing too many disruptive side-effects.

What conditions is Atenolol approved to treat?

Atenolol is a widely approved medication for:

  • Hypertension, or high blood pressure
  • Angina pectoris, which is chest pain typically caused by heart disease
  • It can also be used as part of the treatment plan following an acute myocardial infarction, commonly referred to as a heart attack.

How does Atenolol help with these illnesses?

Atenolol is a beta-blocker, which works by blocking the effects of adrenaline (a hormone also known as epinephrine) on the heart. This slows down the heartbeat and reduces its force, helping to decrease blood pressure and prevent angina attacks. It's often used for patients with high blood pressure or heart conditions like angina or after a heart attack. Unlike losartan, which is an angiotensin receptor blocker that prevents blood vessels from narrowing to lower blood pressure and enhance kidney function, atenolol has no significant effect on these aspects but focuses more on controlling heart rate and force. Atenolol can sometimes be prescribed when a patient does not respond well to other types of hypertension drugs such as angiotensin receptor blockers like losartan or may be combined with them for compounded benefits.

How effective are both Losartan and Atenolol?

Both losartan and atenolol have established histories of success in treating patients with hypertension, and they were initially approved by the FDA within a decade of each other. Since they act on different parts of the blood pressure regulation system, they may be prescribed under different circumstances. The effectiveness of losartan and atenolol in managing hypertension was directly studied in several clinical trials; both drugs exhibited similar efficacy in reducing blood pressure as well as similar safety profiles.

A 2004 meta-analysis report on losartan demonstrated that it is effective in lowering blood pressure starting from the first week of treatment, that its side effect profile is favorable over many other antihypertensives, especially regarding cough production which can often occur with ACE inhibitors. Losartan has become one of the most widely prescribed angiotensin receptor blockers (ARBs) around the world due to its effectiveness and tolerability.

On the other hand, a 2016 review indicated that atenolol seems to be more effective than placebo in treating high blood pressure and preventing cardiac events such as heart attacks or strokes. While once considered a first-line treatment option for hypertension, guidelines have shifted toward recommending other classes like ARBs or ACE inhibitors before beta-blockers like atenolol for primary prevention. Nonetheless, significant research shows that when co-prescribed alongside another antihypertensive class drug like an ARB or diuretic, it significantly improves cardiovascular outcomes compared to monotherapy with either agent alone.

abstract image of a researcher studying a bottle of drug.

At what dose is Losartan typically prescribed?

Oral dosages of Losartan typically start from 25–50 mg/day, but research has suggested that 50 mg/day is generally sufficient for managing high blood pressure in most adults. For patients with possible depletion of intravascular volume (e.g., patients treated with diuretics), consider using a lower starting dose such as 25mg once daily. Children and adolescents who are over six years old may be started on a low dosage, typically around 0.7 mg/kg up to 50 mg once daily. Dosage can be adjusted every three weeks if there seems to be no adequate response, however the maximum dosage that should not exceed under any circumstance is usually set at 100 mg/day.

At what dose is Atenolol typically prescribed?

Atenolol therapy is typically initiated at a dosage of 50 mg/day. If the desired response is not achieved, the dosage can be increased to 100 mg/day in one or two divided doses as needed for optimal blood pressure control. The maximum dose should not exceed 200 mg per day, and it is usually given in one or two doses that are spaced evenly throughout the day. It may take up to a few weeks to see full effects on blood pressure, so don't get discouraged if you don't notice immediate improvements - consistency with taking Atenolol as prescribed by your healthcare provider is key.

What are the most common side effects for Losartan?

Common side effects of Losartan can include:

  • Dizziness or lightheadedness due to a drop in blood pressure
  • Stomach pain
  • Fatigue (general weakness and fatigue)
  • Diarrhea
  • Persistent cough
  • High potassium levels, which may cause muscle weakness, slow heart rate and weak pulse
  • Reduced renal function

On the other hand, common side effects for Atenolol are as follows:

  • Cold hands and feet due to reduced circulation
  • Tiredness or depression -Slow heartbeat
    -Nausea or diarrhea -Breathing difficulties such as shortness of breath.

Always inform your healthcare provider if you experience any adverse reactions while on medication.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Losartan?

While both Losartan and Atenolol are used to treat high blood pressure, they can cause different side effects. For example:

  • Some people have reported an increased feeling of depression or anxiety when taking either drug
  • Allergic reactions may occur with either medication, though less commonly. Symptoms include hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
  • Vision changes such as blurred vision could be a serious side effect of these medications.
  • Both drugs can also potentially cause rapid or pounding heartbeats, chest discomfort or pain (angina), shortness of breath and sudden dizziness.
  • Electrolyte imbalances including low sodium levels in the body might arise - symptoms include headache, confusion, slurred speech, severe weakness and loss of coordination.
  • Severe nervous system reaction is rare but possible - this includes muscle rigidity/stiffness/twitching/ tremors coupled with confusion and fast heartbeat. If you experience any unusual symptoms while taking Losartan or Atenolol such as persistent nausea/vomiting/diarrhea/severe dizziness/fainting/unexplained weight gain/swelling hands ankles feet/lightheadedness upon standing up/too slow/fast/irregular heartbeat it's crucial that you seek immediate medical attention.

What are the most common side effects for Atenolol?

Atenolol, as with other beta-blockers, carries potential side effects including:

  • Fatigue or lethargy, which could interfere with your daily activities.
  • Cold hands and feet due to reduced circulation.
  • Sleep disturbances such as nightmares and insomnia.
  • Slow heartbeat (bradycardia).
  • Nausea, stomach pain or upset stomach.
  • Constipation or diarrhea
  • Shortness of breath especially in those who have pre-existing asthma conditions.
  • Mild dizziness or light-headedness upon standing up too quickly from a sitting position. Remember that while these symptoms can occur, they do not happen in everyone taking Atenolol. It's essential to discuss any concerns about a medication's possible side effects with your healthcare provider before starting treatment.

Are there any potential serious side effects for Atenolol?

While Atenolol is generally well-tolerated, it's important to be aware of potential side effects. These may include:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
  • Slow or uneven heartbeats
  • Lightheadedness and fainting spells
  • Swelling in the hands, ankles or feet (indicative of fluid retention)
  • Shortness of breath even with mild exertion
  • Nausea, stomach pain along with dark urine and clay-colored stools (suggestive of liver problems)
  • Unusual changes in mood or behavior like feeling short tempered

If you experience any one from the above list while taking Atenolol, seek medical attention immediately. It's crucial not to ignore these symptoms as they could indicate a serious problem.

Contraindications for Losartan and Atenolol?

Losartan and atenolol, like other hypertension medications, may have some side effects. If you notice any significant changes in your health after starting these medications such as a slow heart rate, low blood pressure or kidney problems, please seek immediate medical attention.

Neither losartan nor atenolol should be taken if you are taking or have been taking certain types of medications for diabetes (like aliskiren) without consulting with your physician first. Always inform your doctor about the medications you are currently using; this is crucial to avoid potentially harmful drug interactions with losartan and atenolol.

Patients who suffer from specific conditions like asthma, bronchitis, emphysema, severe liver disease or certain types of heart rhythm disorders should not take atenolol. Similarly, people suffering from kidney diseases shouldn't use Losartan before seeking advice from their healthcare provider.

How much do Losartan and Atenolol cost?

For the brand name versions of these drugs:

  • The price of 30 tablets of Losartan (50 mg) averages around $160, which works out to about $5.33/day.
  • The price for 30 tablets of Atenolol (50 mg) is approximately $140, working out to roughly $4.67/day.

This indicates that if you are on a typical dosage for either drug, Losartan is slightly more expensive per day than Atenolol. Remember though that cost should not be your primary consideration when deciding between these medications; instead focus on efficacy and side effects.

As for the generic versions:

  • Generic Losartan costs can range from about $0.14 to over a dollar per tablet depending on where you purchase them and whether or not they're covered by insurance.
  • Generic Atenolol prices also vary widely but tend to hover in the range of about $0.20 –$1 per pill.

In both cases, purchasing larger quantities often results in lower costs per unit, so check with your healthcare provider and pharmacist regarding what might be most advantageous in your situation.

Popularity of Losartan and Atenolol

Losartan, available in generic form and under brand names such as Cozaar, is a widely-prescribed antihypertensive medication. In 2020, it was estimated that about 38 million people in the US were prescribed losartan, accounting for approximately 14% of all prescriptions for hypertension medications. Losartan belongs to the class of drugs known as angiotensin receptor blockers (ARBs) and has been generally increasing in prevalence since its approval by FDA in 1995.

Atenolol, including brand versions such as Tenormin, was prescribed to roughly 19 million people in the USA during the same year. Atenolol accounts for around 7% of beta-blocker prescriptions within the country and just over 3% of overall antihypertensive prescriptions. The use of atenolol has been gradually decreasing over recent years due its associated risk factors when compared with other beta-blockers or ARBs like losartan.


Both Losartan and Atenolol have been used extensively in the management of hypertension, with numerous clinical studies supporting their efficacy. The two drugs may be combined in some cases, but this should only be done under a physician's guidance as they can interact with each other. They work differently; losartan is an angiotensin II receptor blocker (ARB) that relaxes blood vessels by blocking the effects of a hormone called angiotensin II, while atenolol is a beta-blocker that slows your heart rate and decreases its workload.

Losartan is often considered first-line treatment for hypertension particularly in patients who also have type 2 diabetes or kidney disease from diabetes. Atenolol on the other hand is now less commonly prescribed as first-line therapy due to concerns about its inferior cardiovascular outcomes compared to other antihypertensive classes but it may still be useful especially for those with concurrent conditions like angina or certain arrhythmias.

Both medications are available in generic form which brings cost savings, especially beneficial for patients paying out-of-pocket. Some people might need time to adjust when starting these medications because full effects may not be immediately noticeable.

The side effect profiles between Losartan and Atenolol differ somewhat due to their distinct mechanisms of action although both are generally well-tolerated. Common side effects include dizziness and fatigue but atenolol being a beta-blocker could also potentially cause sexual dysfunction unlike ARBs like losartan. It's important that individuals taking either medication monitor their blood pressure regularly and consult healthcare professionals if they experience any adverse reactions or worsening symptoms.