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Avapro vs Benicar
Introduction
For patients with hypertension or other types of high blood pressure conditions, certain drugs that control the constriction and dilation of blood vessels can help in stabilizing blood pressure levels and managing symptoms. Avapro (Irbesartan) and Benicar (Olmesartan) are two such drugs that are prescribed for these conditions. They each impact different aspects of the renin-angiotensin system, but both have effects in lowering high blood pressure. Avapro is classified as an angiotensin II receptor antagonist, which 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. On the other hand, Benicar also belongs to a class of drugs called angiotensin receptor blockers (ARBs). It relaxes blood vessels so that blood can flow more easily, thereby efficiently reducing high-blood-pressure-related risks.
Avapro vs Benicar Side By Side
Attribute | Avapro | Benicar |
---|---|---|
Brand Name | Avapro | Benicar |
Contraindications | Should not be taken with aliskiren especially in patients with diabetes or kidney disease. | Should not be taken with aliskiren particularly in patients with diabetes or kidney disease. |
Cost | Prices start from as low as $0.15/day for the generic version. Brand name averages around $180 for 30 tablets of 150 mg. | Generic costs start from as low as $1/day. Brand name averages about $220 for 30 tablets of 20 mg. |
Generic Name | Irbesartan | Olmesartan Medoxomil |
Most Serious Side Effect | Signs of high potassium levels: nausea; slow or unusual heart rate; weakness; feeling light-headed. Severe skin reaction and signs indicating kidney problems. | Symptoms indicative of high potassium levels such as muscle weakness and irregular heartbeat. Signs of an allergic reaction and difficulty urinating. |
Severe Drug Interactions | Aliskiren, especially in patients with diabetes or kidney disease. | Aliskiren, especially for those with diabetes or kidney issues. |
Typical Dose | 150 mg/day, up to a maximum of 300 mg/day. | 20 mg/day, up to a maximum of 40 mg/day. |
What is Avapro?
Irbesartan (the generic name for Avapro) was a significant advancement in the category of drugs known as angiotensin II receptor antagonists, which are primarily used to treat high blood pressure and kidney problems associated with diabetes. Irbesartan was first approved by the FDA in 1997. Avapro prevents the hormone angiotensin II from narrowing the blood vessels, thus helping to reduce blood pressure and improve blood flow. It is commonly prescribed for managing hypertension and protecting kidneys from damage due to diabetes.
On the other hand, Olmesartan (the generic name for Benicar) belongs to same class of drugs but has a slightly different mechanism of action compared to irbesartan; it blocks angiotensin II receptors more selectively, resulting in further dilation of blood vessels and reduction in fluid volume. This results in greater efficacy at lower doses than many other drugs within this classification.
While both medications exhibit similar side effects such as dizziness or lightheadedness due to lowered blood pressure, some patients might find one medication better tolerated over another based on individual health conditions and genetic factors.
What conditions is Avapro approved to treat?
Avapro is approved for the treatment of various high blood pressure conditions:
- Hypertension, also known as high blood pressure
- Diabetic nephropathy in patients with type 2 diabetes (a kidney disease that can develop in people with diabetes)
- Reduction in the rate of progression of nephropathy due to hypertension and diabetes
How does Avapro help with these illnesses?
Avapro helps to manage hypertension by blocking the action of angiotensin II, a hormone that can constrict blood vessels and increase blood pressure. It does this by inhibiting the enzyme known as angiotensin-converting enzyme (ACE), preventing it from converting angiotensin I into its active form, angiotensin II. Angiotensin II is a potent vasoconstrictor, meaning it causes blood vessels to narrow which can elevate blood pressure levels. By reducing levels of this hormone, Avapro allows for easier passage of blood through your arteries and veins which ultimately reduces overall pressure in the vascular system helping patients manage their hypertension more effectively.
What is Benicar?
Benicar, a brand name for olmesartan medoxomil, is an angiotensin II receptor antagonist (ARB). Its mechanism of action involves blocking the binding of angiotensin II to its receptors in many tissues such as vascular smooth muscle and the adrenal gland. This inhibits the effects of angiotensin II which include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation and renal reabsorption of sodium. Benicar was first approved by the FDA in 2002.
Unlike ACE inhibitors or beta-blockers like Avapro, it does not inhibit enzymes or block beta-adrenergic receptors. The lack of impact on these other systems means that its side effect profile is often different from drugs like Avapro; specifically, it has less potential to cause coughing and swelling (common side-effects with some blood pressure medications). The specific antagonism towards angiotensin II can be particularly beneficial for treating hypertension especially in patients who do not respond well to "typical" hypertensive drugs such as those containing irbesartan.
What conditions is Benicar approved to treat?
Benicar is a medication that has received approval for the management of:
- Essential hypertension, a term referring to high blood pressure with no identifiable cause
- Reduction of cardiovascular morbidity in patients with:
- Manifest atherosclerotic cardiovascular disease or
- Type 2 diabetes mellitus accompanied by documented target organ damage.
How does Benicar help with these illnesses?
Angiotensin II is a hormone that narrows blood vessels and releases another hormone that can increase the amount of sodium and water your body retains. This narrowing can cause high blood pressure and force your heart to work harder. Benicar, also known as Olmesartan, works by blocking the effects of this hormone hence relaxing and widening your blood vessels which helps lower blood pressure. It's part of a class of drugs called angiotensin receptor blockers (ARBs), similar to Avapro but it may be more effective in reducing blood pressure according to some studies. Its action on preventing the vasoconstrictive effects caused by Angiotensin II plays an integral role in its effectiveness against hypertension or high blood pressure. Since it does not significantly affect bradykinin levels, it is sometimes prescribed when a patient does not respond well to ACE inhibitors or may be combined with other classes of antihypertensive medication.
How effective are both Avapro and Benicar?
Both irbesartan (Avapro) and olmesartan (Benicar) are potent angiotensin II receptor blockers, used primarily to manage hypertension. They were approved by the FDA within a span of two years, with Avapro securing approval in 1997 and Benicar following in 2002. Given that they both act on the renin-angiotensin system, they can be prescribed interchangeably depending on individual patient needs and responses.
A direct comparison study carried out in 2011 revealed that both drugs exhibit similar efficacy in reducing blood pressure levels. However, it was noted that patients treated with olmesartan had slightly fewer incidences of side effects compared to those on irbesartan.
In terms of their pharmacokinetics properties, a review published in 2005 found that both medications demonstrated significant reductions in systolic blood pressure from the first week of treatment onwards. Irbesartan's optimal dose is generally considered to be around 150 mg/day for most patients though up-titration to 300 mg may yield additional benefits for some individuals.
As per a meta-analysis conducted in 2013, it was concluded that despite being more recent entrant into market than irbesartan, olmesartan has been proven to be just as effective as other antihypertensive agents including irbesartan. Although typically not chosen as first-line therapy due its higher cost compared to older antihypertensives like ACE inhibitors or thiazide diuretics; when these alternatives fail or aren't tolerated well by patients then either one could serve as an excellent second line option due their effectiveness & tolerability profile.
At what dose is Avapro typically prescribed?
Oral dosages of Avapro are typically started at 150 mg/day for adults with hypertension, but studies have indicated that doses can be increased to a maximum of 300 mg/day if necessary. Children and adolescents may be started on a lower dose, which is calculated based on their weight (typically around 0.7 mg/kg up to a maximum of 150 mg). In either population, the dosage can be adjusted after several weeks depending on blood pressure response. The maximum dosage that should not be exceeded in any case is 300 mg/day.
At what dose is Benicar typically prescribed?
Benicar treatment is typically initiated at a dosage of 20 mg/day. Depending on the patient's response, the dose can be increased to 40 mg/day taken once daily. Should there not be an adequate response to this regimen after two weeks, physicians may consider increasing the dose or adding additional medications to control elevated blood pressure levels. However, exceeding a daily dose of 40mg is generally not recommended due to limited experience with higher dosages and potential risk for side effects.
What are the most common side effects for Avapro?
Common side effects of Avapro can include:
- Diarrhea
- Heartburn, indigestion
- Dizziness or lightheadedness due to a drop in blood pressure
- Fatigue (general weakness and tiredness)
- Muscle or joint pain
- Mild skin rash
Meanwhile, Benicar's typical side effects can encompass:
- Dizziness, particularly upon standing up quickly
- Lightheadedness as a result of lowered blood pressure
- Stomach pain with nausea or vomiting
- Weakness combined with rapid heartbeat.
It is crucial to consult your healthcare provider if any symptoms persist.
Are there any potential serious side effects for Avapro?
When choosing between Avapro and Benicar, it's important to be aware of potential side effects. Rare but serious side effects can include:
- An allergic reaction that may cause hives, difficulty breathing, or swelling in your face or throat
- A severe skin reaction which includes a fever with a sore throat, burning eyes, pain in the skin area followed by a red or purple skin rash that spreads (especially in the face or upper body) causing blistering and peeling
- Blurred vision, loss of vision, eye pain or swelling
- Rapid heart rate/pulse rate increase
- Feeling faint due to sudden drop in blood pressure
- Signs of high potassium levels: nausea; slow or unusual heart rate; weakness; feeling light-headed
If you notice any changes such as muscle stiffness/weakness/spasms/twitches/seizures - these could indicate issues with nervous system.
Lastly if you observe signs like weight gain from fluid retention particularly around your ankles and shortness of breath – this could potentially point towards kidney problems.
In case you experience any such symptoms after starting medication with either Avapro or Benicar immediately seek medical help.
What are the most common side effects for Benicar?
Common side effects of Benicar may include:
- Nausea, stomach pain
- Diarrhea or constipation
- Headache, dizziness
- Skin rash
- Weakness or tired feeling
- Back pain, joint pain or stiffness
- Sinusitis symptoms such as stuffy nose, sore throat
- Increased urination. It's important to note that this is not a complete list and other side effects might occur. Always consult your healthcare provider for medical advice about potential side effects.
Are there any potential serious side effects for Benicar?
While Benicar is generally well-tolerated, it is important to remain vigilant for possible side effects that may require immediate medical attention. Some of these include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Change in the amount of urine produced or difficulty urinating
- Severe or persistent dizziness
- Unusual change in the amount of sweat (or lack thereof)
- Abnormally fast or slow heartbeats
- Blurry vision and/or sudden loss of vision
- Symptoms indicative of high potassium levels such as muscle weakness and irregular heartbeat
If you experience any such symptoms while taking Benicar, seek immediate medical help. Your healthcare provider can guide you on whether to continue medication usage or consider alternatives based on your symptoms severity and overall health condition.
Contraindications for Avapro and Benicar?
Both Avapro and Benicar, like most other medications for hypertension, may cause a drop in blood pressure that can lead to symptoms such as lightheadedness or fainting. If you notice any of these symptoms worsening or if you experience an increase in dizziness, weakness, fatigue or changes in the amount of urine produced, please seek immediate medical attention.
Neither Avapro nor Benicar should be taken if you are taking aliskiren especially if you have diabetes or kidney disease. Always tell your physician which medications you are taking; aliskiren will require a period of about 48 hours to clear from the system to prevent dangerous interactions with both Avapro and Benicar. Furthermore, inform your doctor about all other medicines you use including prescription drugs, nonprescription drugs and herbal products before starting treatment with either drug.
How much do Avapro and Benicar cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Avapro (150 mg) averages around $180, which works out to $6/day.
- The price of 30 tablets of Benicar (20 mg) averages about $220, working out to approximately $7.33/day.
Thus, if you are taking a standard dose for hypertension management, then brand-name Avapro is less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which medication is best suited for you.
In terms of generic versions:
- Irbesartan (the active ingredient in Avapro) costs are significantly lower with prices starting from as low as $0.15/day for dosages at 150mg and could go up to roughly $0.50/day depending on the dosage and where it's purchased.
- Olmesartan Medoxomil (the active ingredient in Benicar), costs start from as low as $1/day but can exceed up to about$5 /day depending on where it's bought and the dosage taken.
Remember that your healthcare provider will determine the most suitable medication based upon your medical condition and other factors such as side effects or drug interactions rather than just focusing primarily on cost.
Popularity of Avapro and Benicar
Irbesartan, available in generic form and under the brand name Avapro, was estimated to have been prescribed to about 4.2 million people in the US in 2020. Irbesartan accounted for just over 15% of angiotensin II receptor blocker (ARB) prescriptions in the US. Despite being relatively newer than some other ARBs, it has seen a steady increase in prevalence since its FDA approval.
Olmesartan medoxomil, including brand versions such as Benicar, was prescribed to about 2.8 million people in the USA during 2020. In terms of overall ARB prescriptions within the US, olmesartan accounts for around 10%. Over time however,the trend shows an approximately stable prescription rate for this medication over the past decade.
Conclusion
Both Avapro (irbesartan) and Benicar (olmesartan) have been widely used for the treatment of hypertension and are supported by numerous clinical studies demonstrating that they are more effective than placebo. In some instances, these medications may be used together, but this would need a physician's careful evaluation since they can also interact with each other. As angiotensin receptor blockers, their mechanisms of action involve inhibiting the effects of Angiotensin II – a hormone that causes constriction of blood vessels. However, there might be variations in prescribing one over the other due to patient-specific factors.
Avapro is commonly prescribed as an initial therapy for high blood pressure or kidney disease in people with diabetes, whereas Benicar is typically considered when patients fail to respond adequately to first-line antihypertensive drugs or those who require an additional agent to control their blood pressure levels.
Both medications have generic versions available which can lead to significant cost savings particularly for those paying out-of-pocket. The effectiveness of both Avapro and Benicar might not be immediately noticeable as it often takes several weeks for these drugs to reach maximal efficacy.
The side-effect profiles between Avapro and Benicar are similar; however, specific adverse effects like dizziness or lightheadedness upon standing up may occur less frequently with Avapro compared to Benicar. Patients should monitor their health closely during treatment initiation or dose adjustments and seek immediate medical attention if symptoms such as fainting spells or unusually fast heartbeat occur.
Refrences
- Swindle, J. P., Buzinec, P., Iorga, Ş. R., Ramaswamy, K., & Panjabi, S. (2011, July 18). Long-term clinical and economic outcomes associated with angiotensin II receptor blocker use in hypertensive patients. Current Medical Research and Opinion. Informa Healthcare.http://doi.org/10.1185/03007995.2011.589434
- Croom, K. F., Curran, M. P., Goa, K. L., & Perry, C. M. (2004). Irbesartan. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200464090-00011
- Nussberger, J., & Koike, H. (2004, January). Antagonizing the angiotensin II subtype I receptor: A focus on olmesartan medoxomil. Clinical Therapeutics. Elsevier BV.http://doi.org/10.1016/s0149-2918(04)90141-5
- AGATA, J., URA, N., YOSHIDA, H., SHINSHI, Y., SASAKI, H., HYAKKOKU, M., … SHIMAMOTO, K. (2006). Olmesartan Is an Angiotensin II Receptor Blocker with an Inhibitory Effect on Angiotensin-Converting Enzyme. Hypertension Research. Japanese Society of Hypertension.http://doi.org/10.1291/hypres.29.865
- Smith, D. H. G., Dubiel, R., & Jones, M. (2005). Use of 24-Hour Ambulatory Blood Pressure Monitoring to Assess Antihypertensive Efficacy. American Journal of Cardiovascular Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00129784-200505010-00006