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Losartan vs Atacand
Introduction
For patients with hypertension or other heart-related conditions, certain drugs can assist in managing blood pressure levels and potentially reducing the risks of fatal conditions such as stroke and heart attack. Losartan and Atacand are two such medications that are often prescribed for these purposes. They both fall into a category known as angiotensin II receptor blockers (ARBs), which function by blocking the action of a natural substance called angiotensin II that can tighten blood vessels. Losartan is frequently used not only to treat high blood pressure but also to protect kidneys from damage due to diabetes. On the other hand, Atacand, while it also treats high blood pressure effectively, is additionally used by some patients to manage certain types of heart failure.
Losartan vs Atacand Side By Side
| Attribute | Cozaar | Atacand |
|---|---|---|
| Brand Name | Cozaar | Atacand |
| Contraindications | Should not be taken with aliskiren in diabetic patients, and should be avoided during pregnancy. | Should not be taken with aliskiren in diabetic patients, and should be avoided during pregnancy. |
| Cost | About $100 for 30 tablets of 50 mg, or roughly $3.33/day. Generic versions can range from just over $0.10 up to about $1 per day. | About $200 for 30 tablets of 16 mg, which works out to approximately $6.67/day. Generic versions range between $0.60 and $2/day depending on dosage. |
| Generic Name | Losartan | Candesartan |
| Most Serious Side Effect | Allergic reactions, kidney problems, elevated levels of potassium, liver problems, a drop in blood pressure causing dizziness upon standing, and rarely serotonin syndrome. | Signs of an allergic reaction, high potassium levels, kidney problems, liver problems, low white blood cell counts. |
| Severe Drug Interactions | Taking with aliskiren in diabetic patients. | Taking with aliskiren in diabetic patients. |
| Typical Dose | Starts at 50 mg/day for adults, up to 100 mg/day. For children aged 6-16 years, starts at 0.7 mg/kg up to 50 mg once daily. | Starts at 8–16 mg/day for hypertension, up to 32 mg/day. For heart failure, starts at 4mg once daily, up to 32 mg per day. |
What is Losartan?
Losartan, also known under the brand name Cozaar, is a first-generation angiotensin II receptor antagonist (ARB) medication. Losartan was approved by the FDA in 1995 and has since been utilized for managing hypertension and protecting kidneys from damage due to diabetes. It works by blocking the action of certain natural substances that tighten blood vessels, thus allowing smoother blood flow and causing your heart to pump more efficiently.
In comparison, Candesartan (the generic name for Atacand), another ARB drug approved later by the FDA in 1998, provides similar therapeutic effects but tends to be slightly more potent than Losartan at equivalent doses. Both these medications have selective influences on angiotensin receptors with minimal impact on other bodily systems which results in them having fewer side effects compared to older antihypertensive drugs like beta blockers or diuretics.
What conditions is Losartan approved to treat?
Losartan is approved for the treatment of multiple health conditions:
- Hypertension, often referred to as high blood pressure
- Stroke prevention in patients with hypertension and left ventricular hypertrophy (enlarged heart muscle)
- Kidney disease in patients with type 2 diabetes mellitus and a history of hypertension.
How does Losartan help with these illnesses?
Losartan works to manage high blood pressure by blocking the action of a hormone known as angiotensin II. This hormone typically binds to receptors in the body, causing them to constrict and thereby increasing blood pressure. Losartan acts as an antagonist at these receptors, preventing angiotensin II from binding and thus allowing for vasodilation, or widening of the blood vessels. The resulting effect is a reduction in blood pressure.
Angiotensin II also stimulates the release of another hormone called aldosterone which causes salt and water retention in the body that can further increase blood pressure. By blocking angiotensin II's effects with losartan, we can limit this process too.
Just like serotonin plays a critical role in mood regulation as described above, angiotensin II has significant physiological roles including regulating overall cardiovascular function and maintaining fluid balance among other things. Consequently, by inhibiting its activity using drugs like losartan or Atacand (another similar medication), we are able to actively manage conditions such as hypertension effectively.
What is Atacand?
Atacand is a brand name for candesartan, an angiotensin receptor blocker (ARB), meaning it works by blocking the action of a substance in the body that causes blood vessels to tighten. As a result, Atacand relaxes and widens your blood vessels. It was first approved by the FDA in 1998 and is specifically used to treat high blood pressure and heart failure.
Unlike losartan, which also belongs to the ARB class of drugs but has been associated with some risk of cancer, research indicates no such association with Atacand. Its side-effect profile differentiates from other ARBs like Losartan as well; while all ARBs can potentially cause symptoms like dizziness or upper respiratory infections, certain side effects like back pain are more commonly seen with Losartan than Atacand. The relaxing effect on blood vessels makes it particularly beneficial for patients who require long-term management of hypertension or heart conditions.
What conditions is Atacand approved to treat?
Atacand is a medication that has gained approval from health authorities for the treatment of:
- High blood pressure, also known as hypertension
- Heart failure in patients who cannot tolerate ACE inhibitors
- Kidney disease in patients with type 2 diabetes mellitus and hypertension
How does Atacand help with these illnesses?
Atacand, also known as candesartan, is an angiotensin II receptor antagonist that works by blocking the binding of angiotensin II to its receptors. Angiotensin II is a hormone that narrows blood vessels and releases another hormone which increases the amount of sodium and water in your body. Much like Losartan, Atacand plays a significant role in managing high blood pressure; however, it's often prescribed when patients do not respond well to other typical antihypertensive medications such as Losartan or may be combined with them for better control over hypertension. Its action on inhibiting vasoconstriction (narrowing of blood vessels) and retention of sodium and water can significantly help reduce the workload on the heart, thereby helping manage conditions like heart failure or kidney disease associated with diabetes.
How effective are both Losartan and Atacand?
Both losartan and candesartan (Atacand) are widely prescribed medications for the management of hypertension, and they were approved by the FDA within a few years of each other. They belong to a class of drugs known as angiotensin II receptor blockers (ARBs), which work by blocking the action of a hormone that causes blood vessels to constrict.
Several clinical trials have directly compared these two agents in terms of their antihypertensive efficacy and safety profiles. In general, both drugs have been found to be similarly effective at reducing blood pressure levels, with comparable tolerability.[1] However, some studies suggest that candesartan may produce slightly greater reductions in systolic blood pressure than losartan.[2]
In terms of side effects, both drugs are generally well-tolerated and share similar side effect profiles including dizziness, headache, upper respiratory tract infections. But like all medications they can cause more serious adverse effects such as kidney problems or elevated potassium levels.
Moreover, one advantage that losartan has over many other ARBs is its uricosuric effect - it reduces serum uric acid levels which could be beneficial for patients with gout or at high risk for developing this condition [3].
Candesartan on the other hand is often preferred in heart failure treatment due to evidence suggesting superior mortality benefit over Losartans [4].
However individual patient's response may vary significantly depending on genetic factors among others so provider discretion based on individual patient characteristics remains crucial when selecting between these two options.
[1] https://pubmed.ncbi.nlm.nih.gov/10439901/ [2] http://www.bloodpressureuk.org/microsites/u40/Home/treatment/Medication/Categoriestable/Angiotensinllreceptorantagonists [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868029/ [4] https://pubmed.ncbi.nlm.nih.gov/12094192/
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At what dose is Losartan typically prescribed?
Oral dosages of Losartan typically start at 50 mg/day for adults with high blood pressure, but studies have indicated that an increase to 100 mg/day may provide a further decrease in blood pressure. Children aged 6-16 years may be started on 0.7 mg/kg up to 50 mg once daily. In either population, dosage can be adjusted based on blood pressure response after three weeks of therapy. The maximum dosage that should not be exceeded is 100 mg daily for adults and 50mg daily for children.
At what dose is Atacand typically prescribed?
Atacand treatment typically begins with a dosage of 8–16 mg/day for the management of hypertension. The dose can then be increased to a maximum of 32 mg/day, depending on blood pressure response. For patients with heart failure, Atacand is usually started at a lower dosage of 4mg once daily and then adjusted as needed up to 32 mg per day based on patient tolerance and response. This medication should be taken at the same time each day, preferably in the morning to maintain consistent blood levels throughout the day. If after several weeks there is no significant improvement or control over blood pressure or symptoms related to heart failure, your doctor may reconsider your treatment plan.
What are the most common side effects for Losartan?
Common side effects of Losartan include:
- Dizziness, lightheadedness due to a drop in blood pressure
- Stomach upset or pain
- Diarrhea
- Cough
- Fatigue and weakness (asthenia)
- Decreased hemoglobin (a substance in the blood that carries oxygen to cells throughout the body)
On the other hand, Atacand may cause:
- Headache
- Dizziness or lightheadedness
- Respiratory tract infections
- Back pain and muscle cramps -Diarrhea or constipation -Nausea
Please note: This is not an exhaustive list. If you experience any unusual symptoms while on these medications, it's essential to bring them up with your healthcare provider immediately.
Are there any potential serious side effects for Losartan?
While Losartan is generally tolerated well by patients, there are certain rare but serious side effects to watch out for:
- Allergic reactions: Symptoms can include swelling of the face, lips, tongue or throat; hives; and difficulty breathing. Seek emergency medical help if you experience these symptoms.
- Kidney problems: Indicated by a change in the amount of urine passed, blood in the urine or sudden weight gain due to fluid retention.
- Elevated levels of potassium: This may cause muscle weakness, slow heart rate and a "fluttering" sensation in your chest.
- Liver problems: These may be indicated by nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin or dark urine.
- A drop in blood pressure causing dizziness upon standing
- Rarely this medication might increase serotonin level leading to serotonin syndrome with symptoms like agitation, hallucinations fever etc.
If you observe any of these symptoms while taking Losartan it's recommended to seek immediate medical attention.
What are the most common side effects for Atacand?
Atacand, a popular medication used to treat high blood pressure, can have several side effects such as:
- Headache or dizziness
- Upper respiratory tract infections leading to stuffy nose and sore throat
- Back pain or muscle cramps
- Nausea and upset stomach
- Fatigue or lethargy
- Increased heart rate, sometimes causing palpitations
- Minor rash occurrence in some cases
Please remember that while these are potential side effects of Atacand, not all patients will experience them. Always consult with your healthcare professional for advice tailored specifically to you.
Are there any potential serious side effects for Atacand?
Atacand, like any other medication, can have its own set of side effects. Though most people tolerate it well, some serious symptoms that require immediate medical attention include:
- Signs of an allergic reaction such as hives; difficulty breathing or swallowing; swelling of the face, lips, tongue or throat
- High potassium levels which may cause weakness on one side of your body, slow heart rate, weak pulse or feeling lightheaded
- Kidney problems like little to no urination at all or painful and difficult urination
- Liver problems including nausea and upper stomach pain with loss of appetite leading to jaundice (yellowing of the skin and eyes)
- Low white blood cell counts causing sudden weakness and illness with fever, chills and sore throat If you experience any unusual changes in behavior such as confusion or mood swings while taking Atacand be sure to consult your physician immediately.
Contraindications for Losartan and Atacand?
Both Losartan and Atacand, along with most other antihypertensive medications, may sometimes cause a decrease in blood pressure that is too rapid or severe. If you notice symptoms such as dizziness, fainting, or feeling lightheaded, especially when getting up from lying down or sitting position, please seek immediate medical attention.
Neither Losartan nor Atacand should be taken if you are taking certain other medicines like aliskiren (a renin inhibitor), used to reduce high blood pressure particularly in diabetic patients. Always inform your doctor about all the medications you're currently on; it's essential to manage drug interactions effectively for optimal treatment outcomes.
Moreover, both drugs should be avoided during pregnancy due to their potential risk of causing harm to the unborn baby. Always discuss these considerations thoroughly with your healthcare provider before starting any new medication regimen.
How much do Losartan and Atacand cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Atacand (16 mg) averages around $200, which works out to approximately $6.67/day.
- The price for 30 tablets of Losartan (50 mg) is about $100, working out to roughly $3.33/day.
Therefore, if you're prescribed a typical dose of either drug then Losartan tends to be less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which one is right for you - effectiveness and side-effects are more important factors.
In terms of generic versions, costs are significantly lower:
- Generic Atacand (candesartan cilexetil) ranges between $0.60 and $2/day depending on dosage.
- Generic losartan can range from as little as just over $0.10 up to about $1 per day depending on dosage and pharmacy pricing policies.
Remember always consult with your healthcare provider before making any decisions about medication changes or additions based upon expense alone; each patient's needs may vary greatly due to individual health conditions and tolerances towards certain medications.
Popularity of Losartan and Atacand
Losartan, also known under the brand name Cozaar, is a widely prescribed medication for high blood pressure and kidney problems in patients with diabetes. In 2020, it was estimated that about 45 million prescriptions were made out to patients in the US. Losartan makes up roughly 15% of all angiotensin receptor blocker (ARB) prescriptions in the United States. Since its introduction into the market in 1995, losartan usage has been increasing steadily.
On the other hand, Candesartan or Atacand had approximately 2 million people receiving prescriptions for it within the USA during 2020. This medication accounts for just over 3% of ARB prescriptions overall. Despite being less prevalent than losartan due to its higher cost and later entry onto pharmaceutical markets (introduced around early-2000s), Atacand's use has remained steady over time because some medical professionals prefer it due to perceived better tolerance by certain patients.
Conclusion
Both Losartan and Atacand (candesartan) have been extensively used for managing hypertension, heart failure, and kidney disease in diabetic patients. They are both angiotensin II receptor blockers (ARBs), which means they work by blocking the action of a natural substance that narrows blood vessels. While they may be combined under certain circumstances, this should only be done under careful medical supervision as it can lead to potential adverse effects such as hyperkalemia or renal dysfunction.
Their different pharmacokinetic properties often influence prescribing choices; Losartan has a shorter half-life requiring twice daily dosing whereas Atacand is typically administered once daily due to its longer half-life. Both medications are available in generic forms offering notable savings for patients who pay out-of-pocket.
There may be an adjustment period when starting these medications where full blood pressure lowering effects might not be immediately evident. The side effect profiles between these two ARBs are similar, with dizziness being quite common but generally well-tolerated. However, if any severe reactions like rapid weight gain or difficulty breathing occur while using either medication, immediate medical attention is crucial. For all patients on antihypertensive therapy including those taking losartan or candesartan it's important to monitor their blood pressure regularly especially during initiation of treatment or dose adjustments.
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Refrences
- Moen, M. D., & Wagstaff, A. J. (2005). Losartan. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200565180-00012
- Webb, N. J. A., Wells, T. G., Shahinfar, S., Massaad, R., Dankner, W. M., Lam, C., … Blaustein, R. O. (2014, August). A Randomized, Open-Label, Dose-Response Study of Losartan in Hypertensive Children. Clinical Journal of the American Society of Nephrology. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.2215/cjn.11111113
- Parvanova, A., Chiurchiu, C., Ruggenenti, P., & Remuzzi, G. (2005, September). Inhibition of the renin-angiotensin system and cardio-renal protection: focus on losartan and angiotensin receptor blockade. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.6.11.1931
- RAYNER, B., TRINDER, Y., BAINES, D., ISAACS, S., & OPIE, L. (2006, February). Effect of Losartan Versus Candesartan on Uric Acid, Renal Function, and Fibrinogen in Patients With Hypertension and Hyperuricemia Associated With Diuretics. American Journal of Hypertension. Oxford University Press (OUP).http://doi.org/10.1016/j.amjhyper.2005.08.005