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Atacand vs Diovan
Introduction
For patients with hypertension or heart failure, certain drugs that modulate the activity of specific hormones in the body can help manage blood pressure and reduce strain on the heart. Atacand (candesartan) and Diovan (valsartan) are two such drugs often prescribed for these conditions. Both belong to a class of medications called angiotensin II receptor blockers (ARBs), which function by blocking the action of a hormone in the body that causes blood vessels to constrict. This has an effect of relaxing and widening blood vessels, thus lowering blood pressure. While both have similar effects on managing high blood pressure and heart failure symptoms, they differ slightly in their chemical structure and dosage requirements, which may affect how each individual patient responds to them.
Atacand vs Diovan Side By Side
| Attribute | Atacand | Diovan |
|---|---|---|
| Brand Name | Atacand | Diovan |
| Contraindications | Should not be taken with aliskiren, especially in patients with diabetes or kidney disease. Not to be used during pregnancy. | Should not be taken with aliskiren in patients with diabetes or kidney disease. Not to be used during pregnancy. |
| Cost | For the brand name, around $220 for 30 tablets (16 mg). For the generic version, prices range from $20-$40 for a month's supply. | For the brand name, about $260 for 30 tablets (80 mg). For the generic version, prices range from $15 to over $100 based on potency and quantity. |
| Generic Name | Candesartan | Valsartan |
| Most Serious Side Effect | Signs of allergic reaction, changes in kidney function, low blood pressure, elevated potassium levels, liver function abnormalities. | Symptoms of an allergic reaction, high potassium levels, kidney problems, liver problems, rapid weight gain with shortness of breath. |
| Severe Drug Interactions | Aliskiren, especially if you have diabetes or kidney disease. | Aliskiren, especially in patients with diabetes or kidney disease. |
| Typical Dose | 8–32 mg/day for adults. For children over 50 kg or adolescents, starting dose can be 4 mg/day. | 80-160 mg/day initially, may be increased up to 320 mg/day based on patient response. |
What is Atacand?
Candesartan (the generic name for Atacand) and Valsartan (the generic name for Diovan) are both part of the class of drugs known as angiotensin II receptor blockers (ARBs), which represent a significant advancement from the earlier classes of blood pressure medications. Both Candesartan and Valsartan were approved by the FDA in the late 1990s, with Candesartan getting its approval in 1998 and Valsartan a year earlier in 1997. These drugs work by blocking the action of angiotensin II, a chemical that can cause blood vessels to narrow. By doing so, they help to lower blood pressure and reduce strain on your heart. While both these medications have similar therapeutic effects, there may be differences in side effect profiles or how often they need to be taken each day due to their different pharmacokinetic properties.
What conditions is Atacand approved to treat?
Atacand is approved for the treatment of various cardiovascular conditions:
- Hypertension, also known as high blood pressure
- Heart failure in patients with impaired left ventricular systolic function (reduced ejection fraction) to reduce cardiovascular death and heart failure hospitalization. It can be used with other heart medications.
- Postmyocardial infarction: Atacand can be used in stable patients with left ventricular failure or left ventricular dysfunction following myocardial infarction.
How does Atacand help with these illnesses?
Atacand, also known as Candesartan, aids in managing high blood pressure by blocking the action of a hormone called angiotensin II. This hormone causes constriction or narrowing of blood vessels and release of another hormone (aldosterone) that increases sodium and water retention in kidneys. These actions lead to an increase in blood volume and pressure. Atacand binds to the receptors for angiotensin II, thus preventing its vasoconstrictive effect and aldosterone release which ultimately leads to dilation of blood vessels and reduces fluid volume hence decreasing blood pressure. Angiotensin II is part of a complex system that helps our bodies regulate blood pressure, electrolyte balance, systemic vascular resistance among other things. Therefore, inhibiting this hormone's action can help manage hypertension effectively aiding patients in achieving better cardiovascular health.
What is Diovan?
Diovan, the brand name for valsartan, is an angiotensin II receptor antagonist that works by preventing the action of a hormone called angiotensin II which narrows blood vessels. This allows blood to flow more smoothly and the heart to pump more efficiently. Diovan was first approved by the FDA in 1996 primarily for treating high blood pressure and heart failure.
As valsartan is not a beta-blocker or calcium channel blocker, it does not decrease heart rate or contractility. Its lack of action on these aspects means its side-effect profile differs from other types of hypertension drugs like atenolol or nifedipine. Specifically, it does not cause fatigue, depression (common with beta-blockers), nor constipation and edema (common side effects with calcium channel blockers). The inhibitory effect on angiotensin can be beneficial in managing high blood pressure especially in patients who do not respond well to "typical" hypertensive medications such as Atacand.
What conditions is Diovan approved to treat?
Diovan (Valsartan) has been approved by the FDA for the treatment of conditions such as:
- High blood pressure (hypertension)
- Heart failure
- Post-myocardial infarction, to improve survival in patients who have had a heart attack.
How does Diovan help with these illnesses?
Angiotensin II is a peptide hormone that plays a crucial role in regulating blood pressure and fluid balance. It works by inducing vasoconstriction and promoting the release of the hormone aldosterone, which encourages water reabsorption in the kidneys to increase blood volume. Diovan (Valsartan) functions as an angiotensin receptor blocker (ARB), preventing angiotensin II from binding to its receptors on blood vessels, thereby reducing vasoconstriction and lowering overall blood pressure. Its effects on renal sodium retention may also contribute to its antihypertensive properties. While Atacand (Candesartan) operates through a similar mechanism, Diovan is sometimes preferred due to its more favorable side effect profile or better tolerance among certain patients who do not respond well to other ARBs or ACE inhibitors.
How effective are both Atacand and Diovan?
Both candesartan (Atacand) and valsartan (Diovan) have been proven effective in treating hypertension, and were approved by the FDA within a few years of each other. Since they both act on the renin-angiotensin system, they are often prescribed under similar circumstances.
In a 2004 double-blind clinical trial comparing candesartan to valsartan, both drugs demonstrated similar efficacy in managing symptoms of hypertension as well as comparable safety profiles. The study found no significant difference between patients receiving Atacand or Diovan regarding blood pressure reduction.
A subsequent review of meta-analysis reports on candesartan affirmed its effectiveness from the first week of treatment onward. Its side effect profile was shown to be generally favorable compared to many other antihypertensive medications, with good tolerability even in elderly populations. Candesartan also displayed beneficial effects beyond lowering blood pressure such as reducing hospitalization for heart failure.
However, a 2016 review and meta-analysis suggested that while valsartan is more effective than placebo at reducing high blood pressure, it doesn't significantly outperform other common antihypertensives like ACE inhibitors or calcium channel blockers. Valsartan is typically considered after these first-line treatments if needed due to intolerable side effects or insufficient response. Nonetheless, due to their unique pharmacology acting directly on angiotensin II receptors without affecting bradykinin metabolism which has been associated with coughing - a common side effect seen among ACE inhibitors - both Atacand and Diovan may be optimal choices for patients who did not respond well or could not tolerate first line agents such as beta-blockers or calcium channel blockers.
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At what dose is Atacand typically prescribed?
Oral dosages for Atacand typically start from 8–32 mg/day, which is often sufficient to manage hypertension in most adults. For children with a weight over 50 kg or adolescents, the starting dose can be 4 mg/day. In either population, dosage can be increased after a few weeks if there is no significant response. The maximum daily dosage that should not be exceeded under any circumstance is 32 mg/day. Similarly, Diovan dosages range from 80-320mg per day for adults and are adjusted based on weight for pediatric patients (1.3-2.7mg/kg). Increasing the dose may happen if blood pressure isn't well controlled after several weeks of treatment but should always follow medical advice.
At what dose is Diovan typically prescribed?
Diovan (Valsartan) therapy is typically initiated at a dose of 80-160 mg/day, taken once daily. Depending on the patient's response to treatment, this dosage may be increased up to a maximum of 320 mg/day. The therapeutic effects of Diovan are usually noticeable within 2 weeks after initiation of treatment but in some cases, it may take up to 4 weeks for optimal effect. It's important for patients not to exceed the prescribed dosage and maintain regular follow-ups with their healthcare provider to monitor progress and adjust dosages if necessary.
What are the most common side effects for Atacand?
Common side effects of Atacand (candesartan) are generally milder and may include:
- Dizziness or lightheadedness due to a drop in blood pressure
- Respiratory tract infections, such as the common cold
- Back pain
- Sinusitis (inflammation of the sinus cavities in the head)
- Upper respiratory infection
On the other hand, Diovan (valsartan) also has its own set of potential side effects which can include:
- Headaches and dizziness
- Viral infections
- Fatigue and asthenia (general weakness)
- Abdominal pain, nausea, diarrhea -Coughing -Joint & back pain
Remember that these medications may affect individuals differently and it's essential to consult your healthcare provider for any concerns.
Are there any potential serious side effects for Atacand?
In very rare cases, Atacand may cause serious side effects such as:
- Signs of allergic reaction like rashes or hives, difficulty breathing, swelling in your face or throat
- Changes in kidney function: reduced urine output, swelling in the legs and ankles
- Low blood pressure: dizziness or lightheadedness especially upon standing up
- Elevated potassium levels which may manifest as muscle weakness, irregular heartbeat
- Liver function abnormalities that might result in jaundice (yellowing of skin/eyes), dark urine, severe nausea/vomiting
On the other hand, Diovan's adverse reactions include:
- Angioedema: Swelling of the face/lips/tongue/throat which can cause difficulty swallowing/breathing. Immediate medical help is needed if these symptoms occur.
- Kidney problems: Changes in urination frequency and amount; weight gain from fluid retention
- Hyperkalemia (high potassium): Nausea , slow/irregular pulse rate
If you experience any of these side effects while taking either medication stop taking it immediately and seek emergency medical attention.
What are the most common side effects for Diovan?
When comparing Atacand to Diovan, it's important to consider the potential side effects of Diovan. These may include:
- Dizziness or lightheadedness due to a drop in blood pressure
- Headaches
- Viral infections such as colds or flu
- Fatigue and exhaustion
- Abdominal pain and diarrhea
- Back pain, muscle cramps, or joint ache
- Dry mouth and dehydration symptoms Although these side effects are generally mild, it is crucial to consult with your healthcare provider if they persist or worsen over time.
Are there any potential serious side effects for Diovan?
While Diovan is generally well-tolerated, it can occasionally cause serious side effects. If you experience any of the following symptoms while taking Diovan, seek immediate medical attention:
- Symptoms of an allergic reaction such as hives; difficulty breathing; swelling in your face or throat
- Signs indicative of high potassium levels like slow heart rate, weak pulse, muscle weakness or limp feeling
- Kidney problems - little or no urination; painful or difficult urination; swelling in your feet or ankles; feeling tired
- Liver problems - nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools and jaundice (yellowing of the skin or eyes)
- Rapid weight gain with shortness of breath
- A light-headed sensation as if you might pass out.
Remember that this list isn't exhaustive and other side effects may occur. Always consult a healthcare provider for medical advice about side effects.
Contraindications for Atacand and Diovan?
Both Atacand and Diovan, like most other medications for high blood pressure, may cause some side effects. If you notice an increase in your symptoms or experience severe reactions such as feeling faint or dizzy, chest pain, rapid heartbeat, swelling of the face/lips/tongue/throat (indicative of an allergic reaction), please seek immediate medical attention.
Neither Atacand nor Diovan should be taken if you are using any medication containing aliskiren (particularly if you have diabetes or kidney disease). Always inform your physician about all the medications that you're currently taking; certain drugs require a specific time period to clear from your system to prevent harmful interactions with Atacand and Diovan.
It's also important to note that both these medicines should not be used during pregnancy due to potential harm they could cause to the unborn baby. If you become pregnant while taking these medications, stop using them immediately and contact your healthcare provider without delay.
How much do Atacand and Diovan cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Atacand (16 mg) averages around $220, which works out to approximately $7.50/day.
- The price for 30 tablets of Diovan (80 mg) is about $260, working out to roughly $8.60/day.
Thus, if you are taking a standard dosage for each medication, brand-name Diovan tends to be slightly more expensive on a per-day treatment basis than Atacand. Please note that cost should not be your primary consideration in determining which drug is right for you; efficacy and tolerance are also important factors.
For the generic versions :
- Candesartan (the generic version of Atacand) costs are significantly lower with prices ranging from as low as $20-$40 for a month's supply depending on your dose, translating into approximately $0.70–$1.30 per day.
- Valsartan (generic version of Diovan), is available at an average price range between $15 and up to over $100 based on potency and quantity needed - offering potential savings especially at quantities above 30 pills or doses under 160mg daily - bringing down the daily cost potentially below that found with Candesartan depending upon exact circumstances such as insurance coverage and local pharmacy pricing differences.
Popularity of Atacand and Diovan
Candesartan, available in generic form and under brand names like Atacand, was prescribed to over 3 million people in the USA in 2020. Candesartan accounts for roughly 10% of angiotensin receptor blocker (ARB) prescriptions in the US. It's a widely used antihypertensive medication that has been steadily increasing in prevalence since its approval by the FDA.
Valsartan, including brand versions such as Diovan, was prescribed to approximately 7 million people in the USA during 2020. In the US market of ARBs, valsartan represents around 30%. Valsartan is primarily used for treating high blood pressure and heart failure but also found usage post-heart attack. The prescription rate of valsartan saw a slight dip after recalls related to impurity concerns but remains one of the most frequently utilized medications within this drug class.
Conclusion
Both Atacand (candesartan) and Diovan (valsartan) have long-standing records of usage in patients with high blood pressure, heart failure, and kidney disease caused by diabetes. They are backed by numerous clinical studies indicating that they effectively reduce blood pressure and improve cardiac outcomes better than placebo treatments. Both drugs belong to the class of angiotensin receptor blockers (ARBs), acting primarily on renin-angiotensin system in the body which plays a significant role in controlling blood pressure.
Atacand is often used as a first-line treatment option for hypertension, whereas Diovan is frequently prescribed to patients who did not respond well to other first-line antihypertensive medications or require additional control of their blood pressure levels.
Both drugs are available in generic form, providing substantial cost savings especially for patients paying out-of-pocket. Both Atacand and Diovan may require an adjustment period meaning that effects may not be noticeable right away.
The side effect profile is similar between these two ARBs; both being generally well-tolerated but can cause dizziness due to reduction in blood pressure. For both drugs, patients must closely monitor their symptoms when starting therapy and seek medical help immediately if they notice any severe reactions like swelling face or difficulty breathing which could indicate rare allergic reaction.
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Refrences
- Croom, K. F., & Keating, G. M. (2004). Valsartan. American Journal of Cardiovascular Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00129784-200404060-00008
- Siragy, H. (1999, November). Angiotensin II receptor blockers: review of the binding characteristics. The American Journal of Cardiology. Elsevier BV.http://doi.org/10.1016/s0002-9149(99)00727-4
- de Leeuw, P. W. (1999, July). How do angiotensin II receptor antagonists affect blood pressure?. The American Journal of Cardiology. Elsevier BV.http://doi.org/10.1016/s0002-9149(99)00399-9