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Micardis vs Benicar
Introduction
For patients with high blood pressure or heart conditions, certain drugs that can help manage these conditions by relaxing blood vessels, reducing fluid build-up and decreasing the workload on the heart are crucial. Micardis and Benicar are two such drugs that are often prescribed for hypertension. They both belong to a class of medications called angiotensin II receptor blockers (ARBs) which prevent certain chemicals in your body from constricting the blood vessels and making your kidneys retain salt and water. Micardis, known generically as telmisartan, inhibits these actions at their source while Benicar, also known as olmesartan medoxomil acts similarly but may have slightly different side effects or interactions with other medications. Both play an important role in maintaining cardiovascular health, especially in patients diagnosed with hypertension.
Micardis vs Benicar Side By Side
| Attribute | Micardis | Benicar |
|---|---|---|
| Brand Name | Micardis | Benicar |
| Contraindications | Cannot be taken with aliskiren in patients with diabetes or kidney disease. Not recommended for patients with liver disease, congestive heart failure, dehydration, or electrolyte imbalances. Pregnancy should be avoided. | Cannot be taken with aliskiren in patients with diabetes or kidney disease. Not recommended for patients with liver disease, congestive heart failure, dehydration, or electrolyte imbalances. Pregnancy should be avoided. |
| Cost | For brand name: around $90 for 30 tablets of 40 mg. For generic (telmisartan): ranges from $0.50 to $1 per day. | For brand name: about $130 for 30 tablets of 40 mg. For generic (olmesartan): estimated cost between $0.75 and $2 per day. |
| Generic Name | Telmisartan | Olmesartan |
| Most Serious Side Effect | Severe complications such as allergic reactions, changes in vision, rapid heart rate, shortness of breath, symptoms related to low sodium levels, severe muscle pain, and potential kidney failure. | Severe skin reactions, kidney problems, liver issues, high potassium levels. |
| Severe Drug Interactions | Aliskiren (if patient has diabetes or kidney disease) | Aliskiren (if patient has diabetes or kidney disease) |
| Typical Dose | 20-80 mg/day, with a starting dose often being 40mg/day. | Starts at 20 mg/day, can be increased to 40 mg/day if necessary. |
What is Micardis?
Telmisartan (the generic name for Micardis) and Olmesartan (Benicar) are both angiotensin II receptor antagonists, which represent a significant advancement in the category of antihypertensive drugs previously dominated by ACE inhibitors. Telmisartan was first approved by the FDA in 1998. It functions by blocking the action of certain natural substances that tighten blood vessels, effectively allowing the blood to flow more smoothly and lowering high blood pressure levels. It is prescribed for treating hypertension and reducing cardiovascular risk. Micardis selectively blocks receptors for angiotensin II with minimal impact on other hormonal systems, leading to fewer side effects than older antihypertensive drugs that have broader actions on these systems.
What conditions is Micardis approved to treat?
Micardis is approved for the treatment of various cardiovascular conditions, including:
- Hypertension, also known as high blood pressure
- Cardiovascular risk reduction (in patients unable to take ACE inhibitors)
- Post-myocardial infarction (heart attack), to reduce morbidity in clinically stable patients with left ventricular systolic dysfunction or heart failure symptoms.
How does Micardis help with these illnesses?
Micardis helps to manage hypertension by blocking the action of angiotensin II, a hormone that causes blood vessels to constrict. It does this through its active ingredient, telmisartan, which binds with high affinity to the angiotensin II type 1 receptor and blocks it from being activated by the hormone. This results in relaxed, widened blood vessels and lower blood pressure levels. Angiotensin II plays an important role in regulating blood volume and systemic vascular resistance, both of which contribute significantly to arterial pressure. Thus by blocking its effects, Micardis aids patients in managing their hypertensive conditions and stabilizing their blood pressure levels.
On the other hand, Benicar (olmesartan) works similarly as Micardis but has been shown to be potentially more effective at reducing a type of proteinuria (excess proteins present in urine), especially beneficial for people with kidney disease alongside hypertension.
What is Benicar?
Benicar, also known by its generic name olmesartan, is an angiotensin II receptor antagonist. This means it works by blocking the action of a hormone in the body that causes blood vessels to tighten. As a result, Benicar helps relax and widen your blood vessels which can lower your blood pressure. It was first approved by the FDA in 2002 for managing hypertension.
Unlike some other medications used to treat high blood pressure, such as Micardis (telmisartan), Benicar does not inhibit the reuptake of certain neurotransmitters or hormones involved in regulating heart function and blood volume. This unique mechanism makes Benicar less likely to cause certain side effects like coughing - a common complaint with ACE inhibitors - yet still effective at lowering blood pressure.
Ultimately, this drug's effectiveness for controlling high-blood-pressure-related conditions makes it advantageous for patients who have been unresponsive or intolerant to other antihypertensive drugs.
What conditions is Benicar approved to treat?
Benicar, also known by its generic name Olmesartan, is authorized for the treatment of:
- High blood pressure or hypertension
- Kidney problems in patients with type 2 diabetes
Its effective role in controlling high blood pressure helps prevent strokes, heart attacks and kidney issues.
How does Benicar help with these illnesses?
Angiotensin II is a peptide hormone that plays an essential role in regulating blood pressure, electrolyte balance and systemic vascular resistance. This hormone can cause the constriction of blood vessels, resulting in increased blood pressure. Benicar works by blocking the reception of angiotensin II, therefore relaxing your blood vessels and lowering your blood pressure. Its action on aldosterone production also reduces fluid accumulation which further assists in managing hypertension. Since it does not significantly affect bradykinin levels - as some other antihypertensive drugs do - it is sometimes prescribed when a patient does not respond well to ACE inhibitors (like Micardis), or may be combined with them if necessary for effective control of high blood pressure.
How effective are both Micardis and Benicar?
Both telmisartan (Micardis) and olmesartan medoxomil (Benicar) are angiotensin II receptor blockers (ARBs), widely prescribed for the management of hypertension. They were initially approved by the FDA within a few years of each other, with Micardis being approved in 1998 and Benicar in 2002. As ARBs, they work by blocking the binding of angiotensin II to its receptors, thus helping relax blood vessels and lower blood pressure.
A direct comparison between Micardis and Benicar was made in a double-blind clinical trial conducted in 2004; both drugs exhibited comparable efficacy at lowering systolic blood pressure, with no significant differences noted across various metrics used to measure their efficacy as antihypertensive agents. However, it was observed that patients on Benicar experienced slightly fewer side effects related to dizziness or hypotension.
A systematic review carried out in 2010 reported that telmisartan is effective from the first week of treatment itself. It also stated that this drug has a favorable safety profile compared to many other ARBs due to its long half-life allowing for once-daily dosing which improves patient compliance.
Another meta-analysis study conducted in 2016 revealed that olmesartan seems equally effective as placebo when treating hypertension but appears similar in effectiveness when compared with other commonly used ARBs. Importantly though, it has been associated with rare cases of intestinal problems known as sprue-like enteropathy leading to severe chronic diarrhea resulting weight loss. This led FDA to issue a warning about such potential risk associated with olmesartan use.
Thus while both these medications perform comparably well for managing high blood pressure, patients may be prescribed one over the other depending on individual health profiles including tolerability concerns.
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At what dose is Micardis typically prescribed?
Oral dosages of Micardis range from 20-80 mg/day, but studies have indicated that a starting dose of 40mg/day is often sufficient for treating hypertension in most people. For Benicar, adults may start on 20 mg/day and if blood pressure remains uncontrolled after two weeks of therapy, doses may be increased to a maximum of 40mg daily. In either population, dosage can be adjusted based on the individual response. The maximum dosage for Micardis should not exceed 80 mg/day and for Benicar it's also recommended not to exceed the same limit.
At what dose is Benicar typically prescribed?
Benicar treatment typically begins at a dosage of 20 mg/day. If necessary, the dose can be increased to 40 mg/day after two weeks if blood pressure is not adequately controlled. This adjustment should only be made under close medical supervision. A single daily dose of Benicar effectively lowers blood pressure for over 24 hours due to its long half-life. As with any medication, it's essential that you follow your healthcare provider's instructions and monitor your response to therapy regularly when taking Benicar.
What are the most common side effects for Micardis?
While both Micardis and Benicar are used to control high blood pressure, their side effects can differ. Common side effects of Micardis include:
- Back pain
- Diarrhea
- Sinusitis (inflammation in the sinus cavities)
- Pharyngitis (inflammation in the back of the throat)
- Upper respiratory tract infections
On the other hand, common side effects of Benicar may include:
- Dizziness
- Lightheadedness as your body adjusts to the medication
- Stomach or abdominal pain
- Nausea or vomiting
- High potassium levels which could lead to a slow heart rate, weak pulse, muscle weakness.
It's important to note that people react differently to different medications, and what works best will depend on individual health circumstances and how one's body responds to treatment. Always consult with your healthcare provider for personalized advice.
Are there any potential serious side effects for Micardis?
While Micardis and Benicar are both used to treat high blood pressure, they may cause different side effects. In rare cases, Micardis can potentially lead to severe complications such as:
- Signs of an allergic reaction: hives; difficulty breathing or swallowing; swelling of the face, lips, tongue, or throat.
- Changes in vision (blurred vision)
- Rapid heart rate, feeling like your heart is pounding in your chest
- Shortness of breath or trouble breathing
- Symptoms related to low sodium levels: headache, confusion, slurred speech, severe weakness
- Severe muscle pain that comes on suddenly and without a clear reason.
In extremely rare instances it could also cause a breakdown of skeletal muscle tissue leading to kidney failure. Symptoms include unexplained muscle pain or tenderness.
If you experience any concerning symptoms while taking Micardis then seek medical attention immediately.
What are the most common side effects for Benicar?
While comparing Micardis to Benicar, it is noteworthy that Benicar can cause the following side effects:
- Dizziness or lightheadedness as a result of lowered blood pressure
- Increased urination
- Mild stomach pain, nausea, diarrhea or indigestion
- Dry cough and sore throat
- Stuffy nose or other flu-like symptoms
- Weakness or feeling tired
- Skin rash (though this occurs rarely) It's important to consult with your healthcare provider if any of these persist. However, remember that your doctor has prescribed Benicar because they judged the benefits outweigh the risks.
Are there any potential serious side effects for Benicar?
While Benicar is a widely-used medication for the treatment of high blood pressure, it's crucial to be aware of potential serious side effects that may occur, such as:
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face or throat.
- Severe skin reaction: fever, sore throat, burning eyes, skin pain or peeling and blistering rash.
- Kidney problems: little or no urination; painful or difficult urination; swelling in your feet or ankles.
- Liver issues: nausea and vomiting; loss of appetite; stomach pain (especially upper right part); tiredness; itching and yellowing eyes/skin.
- High potassium levels: nausea, weakness/tired feeling/tingling sensation/ chest pain/ irregular heartbeats.
If you experience any unusual symptoms while taking Benicar, it should be reported immediately to your healthcare provider.
Contraindications for Micardis and Benicar?
Both Micardis and Benicar, similar to other hypertension medications, may cause certain adverse effects. If you notice worsening symptoms such as fainting spells, irregular heartbeat or changes in the amount of urine produced, please seek immediate medical attention.
Neither Micardis nor Benicar can be taken if you are using aliskiren and have diabetes or kidney disease. Always inform your physician about any medication that you are taking; some drugs will require a careful dosage adjustment to prevent harmful interactions with Micardis and Benicar.
It is important to discuss all health conditions with your doctor before starting either of these medications. Persons suffering from liver disease, congestive heart failure, dehydration or electrolyte imbalances need to take special precautions when on these drugs. Pregnancy should also be avoided while taking these medicines as they could harm an unborn baby.
How much do Micardis and Benicar cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Micardis (40 mg) averages around $90, which works out to approximately $3/day.
- The price for a similar quantity and dosage of Benicar is about $130 or roughly $4.30/day.
Thus, if you are taking a common dose such as 40mg per day, then brand-name Micardis is less expensive on a per-day treatment basis compared to Benicar. Please note that cost should not be your primary consideration in determining which drug is right for you.
For the generic versions of Micardis (telmisartan) and Benicar (olmesartan), costs are significantly lower:
- Telmisartan is available in packs from 30 up to 90 tablets with approximate costs ranging from $0.50 to $1 per day depending on your daily dosage.
- Olmesartan comes similarly packaged with an estimated cost between $0.75 and $2 per day at typical dosages.
Both medications have their own set of benefits, side effects and interactions; therefore it's important to discuss these factors thoroughly with your healthcare provider before making a decision based purely on cost considerations.
Popularity of Micardis and Benicar
Telmisartan, sold under the brand name Micardis among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It was estimated that about 4 million prescriptions for Telmisartan were filled in the US in 2020. This accounted for approximately 6% of angiotensin receptor blocker (ARB) prescriptions in the country.
On the other hand, Olmesartan Medoxomil marketed as Benicar had around 2.5 million people prescribed this medication within USA during the same period of time. In terms of ARB prescription share within the US market, olmesartan accounts for just over 3%. Both medications have been documented to be effective antihypertensive agents with good tolerability profiles but Telmisartan has seen an increase in its prevalence since it's also recognized by WHO’s List of Essential Medicines whereas Olmesartan although effectively reduces blood pressure doesn't appear on that list.
Conclusion
Both Micardis (telmisartan) and Benicar (olmesartan) have a long history of usage in patients with hypertension, and are backed by numerous clinical studies indicating that they are more effective than placebo treatments. They belong to the class of drugs known as angiotensin receptor blockers (ARBs), which work by blocking the action of certain chemicals that tighten the blood vessels, allowing blood to flow more smoothly.
Micardis is also prescribed for cardiovascular risk reduction in patients unable to take ACE inhibitors, while Benicar doesn't carry this indication. Both medications may be used individually or combined with other antihypertensive agents such as diuretics.
Both medications are available in generic form, representing significant cost savings especially for those paying out of pocket. The effects might not be noticeable right away with both Micardis and Benicar requiring an adjustment period.
The side effect profile between these two drugs is quite similar, being generally well-tolerated with common side effects including dizziness or lightheadedness due to lowered blood pressure. For both drugs, patients must monitor their blood pressure regularly when starting treatment and seek immediate medical help if they experience symptoms like rapid weight gain, swelling or changes in urination patterns suggesting kidney problems.
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Refrences
- 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
- Battershill, A. J., & Scott, L. J. (2006). Telmisartan. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200666010-00004
- Frampton, J. E. (2011, April). Telmisartan. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11206710-000000000-00000
- Scott, L. J., & McCormack, P. L. (2008). Olmesartan Medoxomil. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868090-00005