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Losartan vs Diovan
Introduction
For patients with hypertension or heart disease, certain drugs that help relax blood vessels and lower blood pressure can be effective in managing symptoms. Losartan and Diovan (Valsartan) are two such medications often prescribed for these conditions. Both of them belong to a class of drugs known as angiotensin II receptor blockers (ARBs) which work by blocking the action of a natural substance called angiotensin II that tightens the body's blood vessels. Despite their similarities, they do have subtle differences. Losartan not only blocks the action of angiotensin II but also reduces its creation, whereas Valsartan solely blocks the binding site of this molecule on the muscles surrounding blood vessels - effectively reducing high blood pressure by allowing more relaxed and dilated arteries.
Losartan vs Diovan Side By Side
| Attribute | Cozaar | Diovan |
|---|---|---|
| Brand Name | Cozaar | Diovan |
| Contraindications | Should not be taken with renin inhibitors like aliskiren, especially in patients with diabetes or kidney disease. | Should not be taken with renin inhibitors like aliskiren, especially in patients with diabetes or kidney disease. |
| Cost | Generic version costs from just under a dollar up to about five dollars per month. | Generic version typically costs between $10 and $15 for a month’s supply. |
| Generic Name | Losartan | Valsartan |
| Most Serious Side Effect | Decreased kidney function, high potassium levels leading to heart rhythm problems. | Symptoms indicating kidney problems, signs of liver damage. |
| Severe Drug Interactions | Renin inhibitors (like aliskiren) when taken by patients with diabetes or kidney disease. | Renin inhibitors (like aliskiren) when taken by patients with diabetes or kidney disease. |
| Typical Dose | 25–100 mg/day, starting dose of 50 mg/day for adults. | 80-160 mg/day, can be increased to 320 mg/day. |
What is Losartan?
Losartan (the generic name for Cozaar) was one of the first drugs in the class of angiotensin II receptor blockers (ARBs), which represented a significant advancement over the initial class of high blood pressure medications known as beta-blockers. Losartan received FDA approval in 1995. It functions by blocking angiotensin, a hormone that constricts blood vessels, allowing these vessels to relax and expand thereby lowering blood pressure. It is prescribed primarily for treating hypertension and protecting kidneys from damage due to diabetes. Losartan has selectivity towards angiotensin with minimal influence on other hormones like aldosterone, resulting in it having fewer side effects than other high blood pressure medications that strongly affect these additional hormones.
Diovan (Valsartan) falls under the same ARB category and operates similarly to losartan but it's worth noting their differences: Diovan typically requires lower doses compared to losartan for equivalent therapeutic effect; also Diovan boasts slightly better tolerability when considering side-effect profiles.
What conditions is Losartan approved to treat?
Losartan is approved for the treatment of various conditions, including:
- Hypertension (high blood pressure)
- Diabetic nephropathy in patients with type 2 diabetes mellitus and a history of hypertension
- Stroke risk reduction in patients with hypertension and left ventricular hypertrophy. However, this drug should not be used as first-line therapy for this condition.
How does Losartan help with these illnesses?
Losartan works to control high blood pressure by blocking the action of angiotensin II, a chemical in your body that causes muscles surrounding your blood vessels to contract. This contraction results in narrower blood vessels and higher blood pressure. By inhibiting the effects of angiotensin II, Losartan allows the blood vessels to relax and expand, thereby reducing the pressure within them. Angiotensin II is also responsible for releasing another hormone that increases the amount of sodium and water in your body, which can contribute further to elevated blood pressure. Thus, using Losartan helps lower both these factors contributing to hypertension. Just like serotonin plays a crucial role in mood regulation as described above, angiotensin II plays an essential part in managing one's cardiovascular health.
What is Diovan?
Diovan, also known as Valsartan, is an angiotensin II receptor antagonist. This means it blocks the action of a natural chemical in your body that tightens blood vessels, thus allowing the blood to flow more smoothly and the heart to pump more efficiently. It was first approved by the FDA in 1996 for treating hypertension (high blood pressure) and heart failure.
Unlike Losartan, Diovan does not metabolize into an active form in the body; it's already active when ingested. In addition to its primary uses for managing hypertension and heart failure, Diovan is also prescribed post-heart attack because studies have shown that continued use can significantly decrease further cardiac events.
The side-effect profile of Diovan appears somewhat different from ACE inhibitors like Lisinopril since it does not cause a persistent cough - a common side effect associated with ACE inhibitors. However, similar to other medications used for high blood pressure control such as Losartan, it may cause dizziness or lightheadedness but less likely than some other groups of antihypertensive drugs.
What conditions is Diovan approved to treat?
Diovan is a medication that has gained approval from the FDA for the treatment of several significant health conditions, such as:
- High blood pressure (hypertension)
- Heart failure
- To improve survival after a heart attack
How does Diovan help with these illnesses?
Angiotensin II is a hormone that can tighten blood vessels, resulting in increased blood pressure. It also stimulates the release of another hormone that promotes sodium and water retention by the kidneys, further elevating blood pressure. Diovan (Valsartan) works by blocking the action of angiotensin II, leading to relaxation and dilation of blood vessels which lowers blood pressure. This makes it more effective at reducing cardiovascular mortality after a heart attack compared to Losartan. Diovan's activity on other hormones also plays a significant role in its effectiveness as an antihypertensive drug. Moreover, since it doesn't affect bradykinin levels significantly, patients usually experience fewer side effects like persistent dry cough which are commonly associated with ACE inhibitors.
How effective are both Losartan and Diovan?
Both Losartan and Diovan (Valsartan) are widely prescribed medications in the treatment of hypertension, and they were both approved by the FDA in the 1990s. Since they inhibit different components of renin-angiotensin system, they may be chosen under varying circumstances depending on a patient's specific condition or needs. The effectiveness of Losartan and Valsartan in reducing blood pressure was directly studied in a randomized controlled trial; both drugs displayed similar efficacy in managing hypertension as well as comparable safety profiles.
A review that covered various clinical trials on Losartan showed it to be effective in controlling high blood pressure from early stages of treatment with minimal side effects compared to other antihypertensive agents. It is also noted for its protective effect on kidney function, which makes it particularly useful for diabetic patients with renal complications. Furthermore, due to its unique mechanism of action targeting angiotensin II receptors specifically, it is often considered beneficial for those who have not responded favorably to ACE inhibitors.
On the other hand, an extensive meta-analysis conducted demonstrated that Valsartan appears equally effective as many other antihypertensive drugs but seems even slightly more tolerable regarding adverse effects like coughing common with ACE inhibitors use. However, Valsartan is typically considered after first-line treatments such as diuretics or beta blockers have been tried unless contraindicated or not tolerated by patients. While data supporting standalone use is solid enough, majority research involves valsartan being used alongside another class of antihypertensive agents so there might still be less robust proof than losartan when considering monotherapy usage.
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At what dose is Losartan typically prescribed?
Oral dosages of Losartan typically range from 25–100 mg/day, but studies have shown that a starting dose of 50 mg/day is adequate for treating hypertension in most adults. Children aged 6 and older may be started on a lower dose of 0.7 mg/kg up to 50 mg once daily. Both adult and pediatric doses can be adjusted upward after several weeks if blood pressure control is not achieved. However, the maximum dosage that should not exceed under any circumstance is generally set at 100mg/day for adults and the lesser amount between 1.4mg/kg or 100mg/day for children.
At what dose is Diovan typically prescribed?
Diovan treatment typically starts at a dosage of 80-160 mg/day. Depending on the patient's response, the dose can be increased to 320 mg/day, taken in one single dose. It should not be divided into multiple doses across the day. The maximum recommended daily dosage is 320 mg and may be considered if there is no adequate response to lower dosages after an appropriate period of time. Always follow your doctor's instructions when taking this medication for hypertension (high blood pressure), heart failure, or post-myocardial infarction (after a heart attack).
What are the most common side effects for Losartan?
Common side effects of Losartan can include:
- Dizziness or lightheadedness due to a drop in blood pressure
- Stuffy nose
- Back pain
- Fatigue, weakness and tiredness
- High potassium levels that can lead to heart rhythm problems (rare)
On the other hand, Diovan may cause similar but slightly different side effects:
- Headache
- Dizziness or light-headedness due to a decrease in blood pressure
- Viral infections
- Fatigue and lethargy
- Abdominal pain.
It's important to remember that everyone reacts differently to medications. If you experience any unusual symptoms or if these common side effects persist or worsen, seek medical attention immediately.
Are there any potential serious side effects for Losartan?
Losartan and Diovan are both used to treat high blood pressure, but they can have different side effects. Serious potential side effects of Losartan include:
- Signs of an allergic reaction: hives, difficulty breathing or swallowing, swelling in the face or throat
- Changes in vision: blurred or double vision, pain in your eyes
- Rapid heart rate, palpitations
- Shortness of breath and unexpected dizziness (which could lead to fainting)
- Decreased kidney function - noticeable through a reduced amount of urine being passed
- High potassium levels - symptoms may include muscle weakness or slow heartbeats.
On the other hand with Diovan you should watch out for:
- Allergic reactions including skin rash, itching or hives
- Swelling on your body such as mouth, lips tongue etc.
- Fast irregular heartbeat along with chest pain.
Remember that these lists do not cover all possible side effects. Always consult your doctor if you feel unwell after starting a new medication.
What are the most common side effects for Diovan?
Common side effects associated with Diovan include:
- Headache or dizziness
- Viral infection symptoms such as sore throat, stuffy nose
- Fatigue and lethargy
- Abdominal pain, nausea, constipation or diarrhea
- Muscle cramps and joint pain
- Rash or itching
- Insomnia and other sleep-related issues
- Increased heart rate (palpitations) -Dry mouth
These side effects are similar to those of Losartan; however, individuals may experience them differently. Always consult with your healthcare provider if you have any concerns about potential side effects.
Are there any potential serious side effects for Diovan?
While Diovan is generally well-tolerated, it's crucial to be aware of potential side effects that may necessitate medical attention. These can include:
- Signs of an allergic reaction such as hives, trouble breathing or swallowing, swelling in your face or throat.
- Symptoms indicating kidney problems like reduced urination frequency or amount; weight gain; fluid retention causing swelling in the legs, ankles or feet.
- Indications of liver damage including yellowing skin and eyes (jaundice), dark urine, severe nausea/vomiting.
- High potassium levels which may cause muscle weakness, slow heart rate.
It's important to note these are rare but serious side effects. If you experience any such symptoms while taking Diovan, immediately seek medical assistance.
Contraindications for Losartan and Diovan?
Both Losartan and Diovan, like most antihypertensive medications, may cause certain side effects such as lightheadedness or fainting. If you notice your symptoms worsening, or an increase in chest pain, changes in heartbeat or swelling of the hands/feet, please seek immediate medical attention.
Neither Losartan nor Diovan should be taken if you are taking renin inhibitors (like aliskiren). Always tell your physician which medications you are taking; renin inhibitors will require a period of about 48 hours to clear from the system to prevent dangerous interactions with Losartan and Diovan. It is also important for patients who have diabetes or kidney disease to avoid combining these drugs due to possible harmful effects on the kidneys.
How much do Losartan and Diovan cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Diovan (160 mg) averages around $220, which works out to approximately $7.33/day.
- The price for 30 tablets of Cozaar (Losartan 50mg), is about $180, working out to roughly $6/day.
Thus, if you are taking a higher dosage or multiple doses per day for either drug, their costs can add up quickly. However, it's important to note that cost should not be the primary consideration in determining which of these drugs is right for you.
Moving on to generic versions—these usually provide more affordable alternatives:
- Generic Diovan (valsartan) typically costs between $10 and $15 for a month’s supply—that's as low as around $0.33–$0.50 per day.
- Losartan also offers an inexpensive generic version with monthly costs ranging from just under a dollar up to about five dollars—so your daily cost could be less than mere pennies or up to about $.16 per day.
Remember that prices will vary depending on location and pharmacy pricing policies; check with your local pharmacies and consider online options too.
Popularity of Losartan and Diovan
Losartan, both in its generic form and under brand names like Cozaar, was estimated to have been prescribed to about 39 million people in the US in 2020. Losartan accounted for just over 16% of prescriptions for angiotensin II receptor blockers (ARBs) used commonly in the treatment of high blood pressure. The prevalence of losartan has been gradually increasing since its approval by FDA in 1995.
On the other hand, valsartan, including brand versions such as Diovan, was prescribed to approximately 14 million people in the USA during the same period. In terms of overall ARB prescriptions within the country, valsartan accounts for around 6%. Despite some fluctuations due to certain recalls related to impurity concerns, it remains a popular choice among healthcare professionals and patients alike.
Conclusion
Both Losartan and Diovan (valsartan) have been widely used in patients with hypertension, heart failure, or those who have recently had a heart attack. These medications are backed by numerous clinical studies and meta-analyses indicating that they effectively lower blood pressure more than placebo treatments. Both drugs belong to the class of angiotensin II receptor blockers (ARBs), which work by relaxing blood vessels for smoother blood flow. There is no direct contraindication between them; however, each should be prescribed considering the patient's overall health condition.
Losartan is often considered as a first-line treatment option due to its affordability since it is available in generic form. On the other hand, Diovan could typically be prescribed when patients did not respond well to Losartan or need better control over their high blood pressure.
In terms of safety profiles, both drugs share similar side effects such as dizziness, fatigue, and occasional coughing but these are generally well-tolerated by many patients. However, Diovan has slightly fewer reports of drug-induced cough compared to losartan.
As with any medication regimen aimed at managing chronic conditions like hypertension or heart disease risk factors - an adjustment period may be necessary meaning that effects might not be noticeable right away and regular monitoring of your blood pressure is advised.
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Refrences
- Hedner, T. (1999, April). A comparison of the angiotensin II antagonists valsartan and losartan in the treatment of essential hypertension. American Journal of Hypertension. Oxford University Press (OUP).http://doi.org/10.1016/s0895-7061(99)00082-5
- Moen, M. D., & Wagstaff, A. J. (2005). Losartan. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200565180-00012
- 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
- SHAHINFAR, S., CANO, F., SOFFER, B., AHMED, T., SANTORO, E., ZHANG, Z., … BLUMER, J. (2005, February). A double-blind, dose-response study of losartan in hypertensive children. American Journal of Hypertension. Oxford University Press (OUP).http://doi.org/10.1016/j.amjhyper.2004.09.009
- Goldberg, A. I., Dunlay, M. C., & Sweet, C. S. (1995, April). Safety and tolerability of losartan potassium, an angiotensin II receptor antagonist, compared with hydrochlorothiazide, atenolol, felodipne ER, and angiotensin-converting enzyme inhibitors for the treatment of systemic hypertension. The American Journal of Cardiology. Elsevier BV.http://doi.org/10.1016/s0002-9149(99)80413-5
- Fishman, T. J., Degu, T. A., Sun, L., & Salabei, J. K. (2019, December 13). Possible Association of Tremors and Dysarthria with Losartan Use: A Case Report. Cureus. Springer Science and Business Media LLC.http://doi.org/10.7759/cureus.6374