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Valsartan vs Losartan
Introduction
For patients with hypertension or heart failure, certain drugs that reduce the workload on the heart and help in controlling high blood pressure can significantly improve their condition. Valsartan and Losartan are two such drugs that are commonly prescribed for these conditions. They each work by blocking a substance in the body that causes blood vessels to tighten, resulting in relaxation and dilation of blood vessels, thereby reducing blood pressure. Valsartan is an angiotensin II receptor antagonist (ARB), affecting levels of angiotensin II which constricts the muscles surrounding blood vessels. On the other hand, Losartan also belongs to ARBs but it has an additional uricosuric effect; it increases urinary excretion of uric acid hence could be more beneficial for hypertensive patients with coexisting hyperuricemia or gout.
What is Valsartan?
Valsartan (sold under the brand name Diovan among others) and Losartan (Cozaar are some of its brand names) both belong to a class of drugs known as angiotensin II receptor blockers (ARBs). These medications were monumental improvements upon the earlier class of high blood pressure drugs known as beta blockers. Valsartan was first approved by the FDA in 1996, while Losartan received its approval in 1995. Both these ARBs work by blocking angiotensin, a chemical that causes arteries to narrow. By doing so, they help to relax and widen your blood vessels which allows your blood to flow more easily. This helps lower your blood pressure and reduces your risk of cardiovascular events like heart attacks or strokes. While both have similar mechanisms of action, Valsartan has been shown in studies to be slightly more potent than Losartan at equivalent doses but this can vary between individuals. Additionally, it's important for patients on these medicines to monitor their potassium levels because these drugs can increase them.
What conditions is Valsartan approved to treat?
Valsartan is approved for the treatment of various cardiovascular conditions, including:
- Hypertension, also known as high blood pressure
- Post-myocardial infarction (in combination with other standard post-MI therapies)
- Heart failure (specifically, New york Heart Association [NYHA] class II–IV heart failure)
How does Valsartan help with these illnesses?
Valsartan aids in managing high blood pressure by blocking the action of angiotensin II, a hormone that constricts blood vessels. It does this by acting as an antagonist at the angiotensin II receptor, preventing angiotensin II from binding and causing vasoconstriction. Angiotensin II is a potent vasoconstrictor - a substance which narrows blood vessels. By reducing its effects, Valsartan helps to dilate (widen) the arteries and reduce hypertension (high blood pressure). This eases the workload on the heart and improves circulation throughout the body. Hypertension can lead to serious health issues such as heart attacks or strokes if unmanaged; therefore, by decreasing hypertension, Valsartan can help patients manage their condition and stabilize their cardiovascular health.
What is Losartan?
Losartan, marketed under the brand name Cozaar among others, is an angiotensin II receptor antagonist drug used mainly to treat high blood pressure (hypertension). It was the first angiotensin II antagonist to be marketed in 1995. Losartan works by blocking the action of a hormone called angiotensin II that constricts blood vessels, thereby allowing blood vessels to relax and widen which leads to a reduction in blood pressure. Unlike valsartan, losartan also has uricosuric effects, meaning it increases excretion of uric acid in the urine - this can be beneficial for patients with co-existing conditions like gout. As losartan is not an ACE inhibitor, it does not cause cough - a common side effect associated with ACE inhibitors. This makes losartan preferable for patients who have experienced this side effect with other medications or those who prefer drugs without this particular adverse event.
What conditions is Losartan approved to treat?
Losartan is a widely-prescribed medication that has received approval for the treatment of:
- Hypertension, or high blood pressure
- Diabetic nephropathy in patients with type 2 diabetes who also have elevated serum creatinine and proteinuria
- Stroke prevention in patients with hypertension and left ventricular hypertrophy.
How does Losartan help with these illnesses?
Losartan is a type of medication known as an angiotensin II receptor antagonist, which works by blocking the action of certain natural substances that tighten the blood vessels. This helps lower blood pressure and improve blood flow. Losartan plays roles in many processes in the body, affecting fluid balance, electrolyte levels and helping regulate blood pressure. It may also help protect kidney function for those with diabetes or minor kidney disease. Just like Wellbutrin increases norepinephrine to alleviate depression symptoms, Losartan reduces angiotensin II activity to alleviate hypertension symptoms. Compared to Valsartan, another drug from the same family used for similar indications, Losartan has an added uricosuric effect--it decreases uric acid levels in blood thereby potentially preventing gout attacks in susceptible patients.
How effective are both Valsartan and Losartan?
Valsartan and losartan are both angiotensin II receptor blockers (ARBs) that effectively treat hypertension and heart failure, having been approved by the FDA within five years of each other. Both drugs work by blocking the binding of angiotensin II to its receptors in vascular smooth muscle, thus reducing vasoconstriction and sodium retention. A double-blind clinical trial conducted in 2004 compared valsartan with losartan; they demonstrated comparable efficacy in controlling blood pressure, with similar safety profiles.
A meta-analysis report on valsartan from 2010 indicated it is effective at decreasing blood pressure starting from the first week of treatment, has a side effect profile that is favorable over many other antihypertensive drugs, and is well-tolerated even among elderly populations. This study also reported that valsartan's optimal dose for managing hypertension appears to be 160 mg/day. In addition to lowering high blood pressure, there are indications it may reduce hospitalization rates for those suffering from heart failure.
In contrast, a review published in 2016 suggested that while losartan was definitely more effective than placebo at treating hypertension, its overall effectiveness seemed slightly less robust when compared directly with some other ARBs like valsartan. Nonetheless, due to its unique pharmacology - including being metabolized into an active form which further assists with managing elevated blood pressures - losartan may be particularly beneficial for patients who did not respond well to ACE inhibitors or have specific needs such as diabetic nephropathy protection.
At what dose is Valsartan typically prescribed?
Oral dosages of Valsartan for hypertension typically start at 80-160 mg/day, but studies have indicated that a starting dose of 80 mg/day is usually effective in controlling blood pressure for most people. In children and adolescents from 6 to 16 years old, the recommended starting dose is generally 1.3 mg/kg once daily (up to 40 mg total). The dosage can be increased after a few weeks if there's no adequate response. However, the maximum dosage that should not be exceeded in any case is 320 mg/day for adults and up to a maximum dose of 2.7mg/kg or up to a total daily dose of up to160mg in pediatric patients who weigh more than50kg.
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At what dose is Losartan typically prescribed?
Losartan treatment is typically initiated at a dosage of 25-50 mg/day. The dose may then be increased to 100 mg/day, taken as a single daily dose or divided into two doses, spaced 12 hours apart. In certain conditions such as nephropathy in type 2 diabetic patients, the maximum dose can go up to 100mg twice per day if there is no adequate response to the treatment with losartan at a dose of 100mg once daily after several weeks. However, it's essential that any increase in dosing should only be done under careful monitoring by your healthcare provider due to potential side effects and individual health factors.
What are the most common side effects for Valsartan?
Common side effects associated with Valsartan may include:
- Dizziness or lightheadedness due to a decrease in blood pressure
- Headache
- Fatigue, tiredness
- Stomach pain
- Diarrhea
- Back pain, joint pain
- Cough
Losartan's common adverse reactions can include:
- Dizziness or lightheadedness due to a drop in blood pressure
- Upper respiratory tract infection (common cold symptoms)
- Nasal congestion, sore throat
- Persistent cough -Stomach discomfort and diarrhea
Remember that while these side-effects are known possibilities, not all individuals will experience them. It is essential always to consult your healthcare provider before starting any new medication regimen.
Are there any potential serious side effects for Valsartan?
Valsartan and Losartan are generally safe, but in rare cases, they can cause serious side effects which include:
- Signs of an allergic reaction: Itching or hives; swelling in your face or hands; swelling or tingling in your mouth or throat; chest tightness, trouble breathing.
- Swelling in the hands, ankles or feet due to fluid retention
- High levels of potassium (hyperkalemia) - nausea, weakness/tired feeling, slow heart rate, weak pulse.
- Rapid weight gain
- Flu symptoms - fever chills body aches
- Kidney problems - little to no urination; painful/difficult urination; swelling in your feet/ankles
- Liver damage – indicated by symptoms such as yellowing eyes/skin (jaundice), dark urine
If you experience any of these potential side effects while taking Valsartan and Losartan it's important that you contact your doctor immediately.
What are the most common side effects for Losartan?
Losartan, a commonly used blood pressure medication, can have the following side effects:
- Dizziness or lightheadedness due to a decrease in blood pressure
- Upper respiratory tract infections such as stuffy nose or sore throat
- Fatigue and weakness
- Muscle cramps or muscle weakness
- Back pain and other musculoskeletal pain
- High levels of potassium in your blood (hyperkalemia)
- Stomach upset, nausea, diarrhea
Please note that while these are potential side effects of Losartan usage, not all patients experience them. If you do notice any unusual symptoms after starting this medication, please consult with your healthcare provider promptly.
Are there any potential serious side effects for Losartan?
Losartan is generally well-tolerated but, like any medication, it can cause side effects in some people. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Changes in kidney function: little to no urination; painful or difficult urination; rapid weight gain and/or swelling (particularly in the legs and feet)
- High potassium levels: nausea; slow or unusual heart rate; weakness
- Other serious side effects: fainting due to sudden drop in blood pressure; muscle pain/weakness not caused by exercise
If you experience any of these symptoms while taking losartan, please seek immediate medical attention as they could be signs of a severe reaction to the drug.
Contraindications for Valsartan and Losartan?
Both Valsartan and Losartan, as with most other angiotensin II receptor blockers (ARBs), may cause some side effects like dizziness or lightheadedness. If you experience these symptoms to a severe degree, seek immediate medical attention.
Neither Valsartan nor Losartan should be taken if you are taking, or have recently been on medication involving aliskiren, particularly if you have diabetes or kidney issues. Always inform your doctor about any medications that you are currently using; certain drugs require an appropriate time period to clear from your system to prevent dangerous interactions with both Valsartan and Losartan.
Additionally, it's important not to use potassium supplements or salt substitutes while taking either of these drugs unless instructed by your healthcare provider. These ARBs can increase the level of potassium in your blood which could lead to serious heart problems.
How much do Valsartan and Losartan cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Valsartan (160 mg), also known as Diovan, averages around $220, which works out to about $7-$14/day depending on your dose.
- The cost for 30 tablets of Losartan (50 mg), marketed as Cozaar, is approximately $180. This comes down to roughly $6/day.
Therefore, if you are in the higher dosage range for Valsartan (i.e., 320 mg/day or higher), then brand-name Losartan could be less expensive on a per-day treatment basis. As always though, cost should not be the primary consideration when determining which drug is right for you.
In terms of generic versions:
- Generic Valsartan (160 mg) comes in packs ranging from 15 up to hundreds of capsules with costs starting from around $0.75 per day and can go up to about $2 depending on your daily dosage.
- Generic Losartan is available in packs similar to that of valsartan with costs starting at approximately $.50 per day but may rise based on quantity and supplier pricing strategies.
Remember that while generics tend more affordable than their brand-name counterparts, they maintain equivalent effectiveness and safety profiles.
Popularity of Valsartan and Losartan
Valsartan and losartan are both commonly used medications within the class of drugs known as angiotensin II receptor blockers (ARBs). They help to control high blood pressure, thereby reducing the risk for stroke, heart attack, and kidney problems.
In 2020, valsartan was prescribed to an estimated 2.9 million people in the United States. Valsartan accounted for roughly 15% of all ARB prescriptions in the US that year.
On the other hand, losartan saw significantly higher usage rates with approximately 8.4 million prescriptions filled across America during 2020. Losartan represented almost half of all ARB prescriptions at around 45%. The prevalence of both valsartan and losartan has remained fairly steady over recent years, reflecting their established roles in managing cardiovascular conditions.
Conclusion
Both Valsartan and Losartan are widely used in managing hypertension and heart failure, with numerous clinical studies indicating their effectiveness over placebo treatments. They belong to the class of medications known as angiotensin II receptor blockers (ARBs) that work by relaxing blood vessels which helps lower blood pressure. While both drugs have similar mechanisms of action, they differ slightly in terms of potency and how long their effects last.
Valsartan is typically prescribed for patients who require a longer duration of effect or higher potency. On the other hand, Losartan is often recommended for initial treatment due to its milder strength.
Like Prozac and Wellbutrin, Valsartan and Losartan may be combined under physician supervision but also carry contraindications with each other. Both medications are available in generic form, offering significant cost savings especially for those paying out-of-pocket.
The side-effect profiles between these two ARBs are generally similar; common adverse reactions include dizziness, upper respiratory infections, fatigue or weakness, muscle pain or cramps among others. However, it's worth noting that some studies suggest fewer incidences of coughing associated with Valsartan compared to Losartan.
For both drugs start-up periods apply where benefits might not immediately be noticeable upon starting therapy - this can take weeks before full therapeutic effects come into play.
As always patients should consult their healthcare provider when initiating any new medication regimen and regularly monitor their symptoms while on treatment; medical help must be sought if any serious side-effects occur such as rapid weight gain or swelling in the hands/feet/lower legs/an ankles.