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Micardis vs Diovan
Introduction
For patients with hypertension or heart failure, certain medications that can alter the activity of specific enzymes in the body linked to blood pressure regulation and fluid balance are used for symptom management. Micardis and Diovan are two such drugs frequently prescribed for these conditions. Both belong to a class of medicines known as angiotensin II receptor blockers (ARBs), which work by blocking the effects of a hormone called angiotensin II that constricts the blood vessels. This blockage results in relaxation and widening of blood vessels, thus lowering blood pressure.
Micardis, also known scientifically as telmisartan, is often preferred when an additional protective effect on organs like kidneys is desired in diabetes patients. On other hand, Diovan (valsartan) has been widely studied for its beneficial impact on heart failure patients besides its role in managing high blood pressure.
What is Micardis?
Telmisartan (the generic name for Micardis) was a significant advancement in the class of drugs known as angiotensin II receptor antagonists, which are commonly used to treat high blood pressure. Telmisartan was first approved by the FDA in 1998. Micardis works by blocking substances that tighten the blood vessels, allowing blood to flow more smoothly and keeping blood pressure at an appropriate level. It is prescribed for both hypertension treatment and reduction of cardiovascular risk.
On the other hand, Valsartan (the generic name for Diovan), also an angiotensin II receptor antagonist, has a similar mechanism but with slightly different properties. While both medications effectively lower blood pressure, there could be variance in individual tolerance levels or side effects between these drugs.
Micardis has a selective influence on angiotensin II receptors with only minor influence on bradykinins, which results in it having fewer side effects than other antihypertensive drugs that have stronger effects on these peptides. This makes Micardis especially beneficial for patients who require long-term management of their high blood pressure.
What conditions is Micardis approved to treat?
Micardis is approved for the treatment of several health conditions, including:
- Hypertension, also known as high blood pressure
- Cardiovascular risk reduction in patients unable to take ACE inhibitors
- Post-myocardial infarction (heart attack), as it significantly reduces hospitalization due to heart failure.
How does Micardis help with these illnesses?
Micardis, also known as Telmisartan, works to manage high blood pressure by blocking the action of angiotensin II, a hormone that causes constriction or tightening of the blood vessels. This mechanism helps in relaxing and widening the blood vessels so that blood can flow more easily, thereby reducing the heart's workload. Angiotensin II is a potent vasoconstrictor - it constricts arteries and veins in your body - which subsequently increases blood pressure. It is believed that individuals with hypertension have an overactive renin-angiotensin system leading to excessive amounts of angiotensin II. Therefore, by inhibiting its effects, Micardis can help reduce high blood pressure and associated complications such as stroke and heart attack.
What is Diovan?
Diovan, a brand name for valsartan, is an angiotensin II receptor antagonist. This means it works by blocking the action of certain natural substances that tighten the blood vessels, allowing the blood to flow more smoothly and keeping your heart from working too hard. Diovan was first approved by the FDA in 1996 as a drug used primarily for treating high blood pressure and heart failure. Unlike Micardis (telmisartan), Diovan does not belong to the class of 'sartans' known as partial PPAR-gamma agonists, which means its effects are focused more directly on angiotensin receptors without influencing other pathways. This refined focus may result in fewer side effects compared to drugs like Micardis; common side effects such as dizziness or lightheadedness are typically less severe with Diovan use. The specific targeting of angiotensin receptors can be beneficial for managing hypertension or preserve kidney function in patients who have type 2 diabetes along with hypertension.
What conditions is Diovan approved to treat?
Diovan has been approved by the FDA for the management of several health conditions, including:
- Hypertension (high blood pressure)
- Heart failure
- Reducing cardiovascular mortality in patients with left ventricular dysfunction or heart failure post-myocardial infarction.
How does Diovan help with these illnesses?
Angiotensin II is a hormone that plays vital roles in various body functions, affecting blood pressure regulation, fluid balance, and electrolyte homeostasis. However, abnormally high levels of this hormone can lead to conditions such as hypertension and heart failure. Diovan works by blocking the action of angiotensin II on specific receptors (AT1) in the body, thereby reducing its harmful effects like vasoconstriction and release of aldosterone - both which contribute to increased blood pressure. This makes it an effective medication for lowering blood pressure or treating heart failure. Unlike Micardis which also belongs to the class of Angiotensin Receptor Blockers (ARBs), Diovan may be prescribed when a patient does not respond well to other ARBs or may be combined with other classes of antihypertensive drugs depending on individual clinical scenarios.
How effective are both Micardis and Diovan?
Telmisartan (Micardis) and Valsartan (Diovan) have both established histories of success in treating patients with hypertension, and they were initially approved by the FDA only 1 year apart. Since they act on different angiotensin receptors, they may be prescribed under different circumstances. The effectiveness of telmisartan and valsartan in reducing blood pressure was directly studied in a double-blind clinical trial; the two drugs exhibited similar efficacy in managing symptoms of hypertension as well as similar safety profiles.
A 2007 review comparing telmisartan to other angiotensin receptor blockers demonstrated that it is effective from the first dose onwards, that its side effect profile is favorable over many other antihypertensive drugs, and that it has good tolerability even for elderly populations. The same study reports telmisartan as a widely prescribed drug across the globe for controlling high blood pressure levels due to its long half-life allowing once-daily dosing regimen.
A comprehensive review conducted by Cochrane Hypertension Group indicated that valsartan seems to reduce systolic blood pressure significantly compared to placebo while also being comparable or sometimes better than other common antihypertensive agents. Nonetheless, choice between these medications might depend on individual patient characteristics such as renal function status or presence of heart failure where one might be preferred over another. Data confirms their efficacy as stand-alone treatments but combination therapy involving these agents alongside diuretics or calcium channel blockers are quite common.
At what dose is Micardis typically prescribed?
Oral dosages of Micardis typically range from 20–80 mg/day, but studies have shown that a starting dose of 40 mg/day is usually adequate for treating hypertension in most people. The dosage can be adjusted according to individual patient response. However, the maximum dosage should not exceed 80 mg/day under any circumstance. In comparison, Diovan's typical daily oral dosage ranges from 80-320 mg for adults and between 1.3-2.7mg/kg (up to 160mg) for children aged six years or older who weigh less than 35 kg. Dosage adjustments are also based on individual patient response with a maximum recommended dose of Diovan being up to 320 mg/day.
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At what dose is Diovan typically prescribed?
Diovan treatment usually commences with a dosage of 80–160 mg/day. The dose can then be elevated to 320 mg/day, divided into two doses, spaced 12 hours apart. Maximum dose is 640 mg/day split into two doses of 320 mg and spaced about an interval of 12 hours, which may be trialed if there's no response to the treatment at the lower dose after a few weeks. As always, it's crucial to follow your healthcare provider’s instructions when taking any medication including Diovan.
What are the most common side effects for Micardis?
The side effects of Micardis can include:
- Dizziness or lightheadedness due to a drop in blood pressure
- Upper respiratory tract infections such as sinusitis (inflammation of the sinuses) and pharyngitis (inflammation in the back of the throat)
- Back pain and muscle spasms
- Diarrhea, nausea, abdominal discomfort or dyspepsia (burning sensation, discomfort, or pain in the upper digestive tract)
- Unusual tiredness or weakness known as asthenia
- Skin rash
On the other hand, common side effects associated with Diovan are :
- Headache
- Dizziness
- Viral infection resulting symptoms like those experienced during flu syndrome such as fever and body ache.
- Fatigue and asthenia
-Diarrhea
-Nausea
-Joint Pain
-Stomach Pain
-Decreased kidney function
If you experience any severe reactions while using these medications, it is important to seek immediate medical attention.
Are there any potential serious side effects for Micardis?
While Micardis and Diovan are both used to treat high blood pressure, they can have differing side effects. In rare cases, serious side effects with Micardis may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Little or no urination
- A light-headed feeling like you might pass out
- High potassium levels - slow heart rate, weak pulse, muscle weakness or limp feeling
- Kidney problems - little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired
Diovan also has potential side effects that could be severe:
- Hyperkalemia (high potassium) - nausea, tingly feeling in extremities (hands/feet), slow heart rate
- Renal dysfunction - changes in amount/color of urine produced.
If any symptoms occur while using either medication it is important to seek medical help immediately.
What are the most common side effects for Diovan?
Diovan, also known as Valsartan, can lead to several side effects which include:
- Headache or dizziness
- Flu-like symptoms (such as a stuffy nose, sore throat)
- Viral infection
- Fatigue and lethargy
- Stomach discomfort or pain
- Diarrhea or constipation
- Back and joint pain However, it's important to remember that most people do not experience all of these side effects, and some may not experience any at all. As with any medication choice, the benefits should outweigh the risks.
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. These may include:
- Symptoms of an allergic reaction such as hives, difficulty breathing or swallowing, swelling of the face, lips, tongue or throat
- Rapid weight gain due to water retention and possible kidney problems
- A light-headed feeling like you might pass out (due to low blood pressure)
- High potassium levels which can cause leg cramps, dry mouth, increased thirst or urination; irregular heartbeats; feeling weak or tired
- Liver disease symptoms including nausea and vomiting that doesn't go away; loss of appetite; pain in your upper stomach area; dark urine or yellowing of your skin/eyes
- Severe ongoing diarrhea with considerable weight loss
Always consult a healthcare provider if you have any concerns about these potential side effects when using Diovan.
Contraindications for Micardis and Diovan?
Both Micardis and Diovan, like most other hypertension medications, may cause side effects in some people. If you notice your blood pressure increasing or symptoms of heart failure worsening, please seek immediate medical attention.
Micardis or Diovan should not be taken if you are taking, or have been taking aliskiren (Tekturna), especially if you have diabetes. Always tell your physician which medications you are using; aliskiren will need to clear from your system before starting treatment with either medication to prevent harmful interactions. Furthermore, both Micardis and Diovan should be avoided by pregnant women because they can cause injury or death to the developing fetus when used during the second and third trimesters. It's important to inform your doctor immediately if you're planning a pregnancy or become pregnant while on these drugs.
How much do Micardis and Diovan cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Micardis (40 mg) averages around $250, which works out to approximately $8.33/day.
- The price for 30 capsules of Diovan (160 mg) is about $230, working out to roughly $7.67/day.
Thus, if you are taking comparable doses, Diovan tends to be slightly less expensive on a per-day treatment basis than Micardis. However, it's important to note that cost should not be the primary factor in determining which medication is right for you.
In terms of generic alternatives:
- Telmisartan (the generic form of Micardis) comes in packs ranging from 15 up to 500 tablets with dosages varying between 20 and 80 mg. Costs can range from as low as $0.50/day up to about $2/day depending on dosage and pack size.
- Valsartan (the generic version of Diovan) also varies widely in cost based on pack size and dosage but generally falls within a similar price range as telmisartan - typically starting at around $0.60 per day and going up from there.
Again keep in mind that while generics tend to be significantly cheaper than their branded counterparts, individual prices can vary based on location, pharmacy pricing differences, insurance coverage etc., so these figures should only serve as rough estimates.
Popularity of Micardis and Diovan
Telmisartan, available under the brand name Micardis, and Valsartan, sold as Diovan, are both types of angiotensin II receptor blockers (ARBs) commonly used to treat high blood pressure.
In 2020, it was estimated that around 4 million people in the US were prescribed Telmisartan. Although this medication only accounts for about 7% of all ARB prescriptions in the US, its use has been generally increasing since its approval by FDA in 1998.
On the other hand, Valsartan recorded a significant number of prescriptions with approximately 6.5 million people being prescribed this drug in the USA during 2020 alone. This accounted for almost 13% of all ARB prescriptions within that year. Despite facing some stability issues due to recalls associated with impurities found in certain batches over recent years, Valsartan's prevalence has remained somewhat steady throughout these challenges.
Conclusion
Both Micardis (telmisartan) and Diovan (valsartan) are widely used in the management of hypertension, with a great deal of supportive evidence from clinical trials and meta-analyses indicating their effectiveness over placebo treatments. Occasionally, these drugs may be combined for therapeutic purposes but typically under close medical supervision as they can also potentially interact adversely. Due to their similar mechanisms of action as angiotensin receptor blockers (ARBs), working primarily by blocking the effects of angiotensin II which causes blood vessels to constrict, they tend to be prescribed interchangeably.
Micardis is sometimes preferred due to its longer duration of action compared to Diovan. On the other hand, Diovan might be chosen over Micardis in patients who have heart failure or recently had a heart attack.
Generic versions are available for both drugs which offer significant cost savings especially for patients not covered by insurance. Both Micardis and Diovan usually require some time before their full antihypertensive effect becomes apparent.
The side effect profile is generally comparable between these two medications: dizziness, lightheadedness, or increased potassium levels being common; however, few patients discontinue therapy due to adverse reactions. As with all medication regimes involving cardiovascular health maintenance or improvement, regular monitoring is advised while on either drug.