are valsartan and losartan the same?
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are valsartan and losartan the same?
There are many similarities between losartan and valsartan, for example:
- Both belong to the same class of medicine, called ARBs (angiotensin receptor blockers). They work by blocking a substance called angiotensin II that causes blood vessels to narrow (constrict). Blocking this substance means blood vessels can widen (dilate), which lowers blood pressure
- Both are used to treat high blood pressure
- Side effects that are common to both losartan and valsartan include diarrhea, dizziness, and fatigue
- Both are available as cheap generics, so cost should be similar
- Research has shown that both losartan and valsartan (and all other ARBs) are beneficial at controlling blood pressure, slowing the progression of kidney disease in people with diabetes (diabetic nephropathy), and decreasing the risk of stroke in patients with left ventricular hypertrophy
- Both losartan and valsartan can increase levels of potassium in your blood, which means you may require regular blood tests to monitor for this
- they are available as a combination pill with the diuretic hydrochlorothiazide (Losartan/HCTZ and valsartan/HCTZ). Both drugs work together to lower blood pressure, and the combination may cause fewer potassium abnormalities because hydrochlorothiazide lowers potassium while losartan/valsartan raises it
- Both may interact with lithium, other blood pressure medications, potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, nonsteroidal anti-inflammatory drugs (NSAIDs: example ibuprofen [Advil, Motrin], naproxen [Aleve], celecoxib, or diclofenac).
- Neither losartan nor valsartan should be used during pregnancy and they are not recommended during breastfeeding.
What are the main differences between losartan vs. valsartan?
Active ingredients
Losartan and valsartan are ARB medications used for high blood pressure. However, they contain different active ingredients and have different brand names. Losartan is available under the brand name Cozaar and valsartan is available under the brand name Diovan.
Metabolism
Losartan, also known as losartan potassium, is a prodrug that is converted to an active form (metabolite) in the liver. The active metabolite provides most of the drug’s blood pressure lowering effects and reaches peak levels in the blood within three to four hours. Effects of the drug generally last for up to 24 hours, although the exact duration of action can vary based on the dosage prescribed.
Valsartan is not a prodrug. It does not need to be converted into an active metabolite to provide maximal blood pressure lowering effects. Peak levels of valsartan are reached within two to four hours, and antihypertensive effects typically last for around 24 hours.
Strengths and dosage
Losartan is available as an oral tablet in strengths of 25 mg, 50 mg, and 100 mg. The usual starting dose in adults for hypertension is 50 mg once daily, which can be increased or decreased depending on the person’s response to treatment. People with liver problems may start losartan on a lower dose than usual.
Valsartan is available as an oral tablet in strengths of 40 mg, 80 mg, 160 mg, and 320 mg. The starting dose in adults for hypertension is 80 or 160 mg once daily, and the usual dose range is 80 to 320 mg once daily. The strength and dosage may vary depending on the condition being treated. In some cases, valsartan may be prescribed to be taken twice daily. No dose adjustments are needed for people with liver problems.
What are losartan and valsartan?
Losartan
Losartan is a type of drug called an angiotensin receptor blocker (ARB). ARBs block a substance called angiotensin II that causes blood vessels to constrict. When angiotensin II is prevented from binding to angiotensin II receptors, blood vessels can widen (dilate) and relax. This helps reduce blood pressure and makes it easier for the heart to pump blood throughout the body.
Valsartan
Valsartan is also an angiotensin receptor blocker (ARB). It works in the same way as losartan, by preventing angiotensin II from binding to angiotensin II receptors, causing blood vessels to relax and dilate. This helps lower blood pressure and reduces strain on the heart.
What are the uses for losartan and valsartan?
Losartan uses
Itis used for treating hypertension, reducing the risk of stroke in patients with hypertension, and left ventricular hypertrophy (over developed heart muscle), and treating people with type 2 diabetes, and hypertensive patients with diabetic nephropathy (kidney disease). it’s may be used alone or in combination with other drugs.
Valsartan uses
Valsartan is used to treat high blood pressure and heart failure. It also is prescribed after heart attacks since valsartan may reduce deaths in patients who developed congestive heart failure after a heart attack. Valsartan also may reduce hospitalizations in patients with congestive heart failure.
What’s Better?
- Both valsartan and losartan are ARBs (angiotensin receptor blockers), and losartan has been around the longest. Both are available as cheap generic medications, so cost should not be a problem.
- The benefits of both losartan and valsartan include controlling blood pressure, slowing the progression of diabetic kidney disease (nephropathy), and decreasing stroke risk in patients with left ventricular hypertrophy. This is true for all of the ARBs (olmesartan, irbesartan, telmisartan).
- Losartan is different from other ARBs including valsartan and irbesartan because it has a shorter duration of action.
- This is important. Losartan, taken once daily, does not last the full 24 hours at lower doses like 25 or 50 mg. At 100 mg daily losartan does last the full 24 hours. If you take Losartan 50 mg in the morning, you may notice your blood pressure rises at night, because it’s not covering you for a full 24 hours.
- Valsartan does provide 24-hour coverage with once-daily dosing.
- Both losartan and valsartan may raise your potassium and require blood test monitoring after you’ve started on it.
- Both losartan and valsartan are available in a combination pill with hydrochlorothiazide a diuretic. Losartan/HCTZ and valsartan/HCTZ in different dose combinations are available and these combos are great because the two meds work together to lower blood pressure. Another bonus of the combination pills is that hydrochlorothiazide lowers potassium while losartan/valsartan raises it so the end result is less risk of potassium abnormalities as they “cancel” each other out.
- Valsartan also comes in a combination with sacubitril in a medication called Entresto, which has been shown to reduce hospitalizations and save lives from heart failure in certain patients. Entresto is a mixture of valsartan and sacubitril which is a neprilysin inhibitor.
Why are the drugs being recalled?
In each case, a recalled drug was contaminated with N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA) or N-Nitroso N-Methyl 4-amino butyric acid (NMBA).
Thosechemicals are believed to cause cancer in humans. Research also suggests NDEA can cause liver and blood cell damage.
NDEA is used to make rocket fuel and can also be found in some food and drinking water, but at low levels. It can also be created through certain chemical reactions and as a byproduct of industrial processes.
Valsartan vs Losartan and Lisinopril
A study published in Clinical Therapeutics in 2001 found valsartan and losartan were similarly effective in reducing blood pressure in patients with mild to moderate hypertension.
Losartan was also associated with a decrease in serum uric acid levels. Valsartan did not decrease those levels. High levels of uric acid are associated with gout.
A different study published in Clinical Therapeutics in 2004 found both valsartan and lisinopril were highly effective in controlling blood pressure in patients with mild to severe hypertension. But valsartan was associated with a considerably lower risk for adverse events, especially cough.
Valsartan May Be More Effective Than Losartan
Studies have shown that although both drugs are effective at reducing a patient’s blood pressure, when taken at higher doses (e.g., 160mg or 320mg), valsartan is more effective at lowering blood pressure than losartan at its highest dose of 100mg.
However, in another study, losartan displayed one additional advantage over valsartan. Patients in the study taking losartan experienced a drop in blood pressure and in serum uric acid levels. The effect reported by this study may prove attractive for patients dealing with hypertension and gout because gout symptoms decrease concurrently with serum uric acid levels.
What is the risk of getting cancer from one of these drugs?
The FDA says it is very small. The amount of NDMA found in the recalled valsartan drugs exceeds acceptable levels. Records from drug manufacturers show the impurity may have been in the valsartan products for up to 4 years. The FDA estimates that if 8,000 people took the highest valsartan dose, which is 320 milligrams, from recalled batches every day for 4 years, there would likely only be one additional case of cancer over the life of those 8,000 people.
For context, 1 in 3 people in the United States will be diagnosed with cancer in their lifetime.
Is the Cost of Valsartan the Same as Losartan?
Generic options can be found for valsartan and losartan, making either drug relatively inexpensive for patients. At face value, the cost of the two drugs is fairly comparable. However, most insurance companies and some Medicare plans cover generic losartan but not other name brand alternatives, making generic losartan cheaper for the consumer and thus more popular.
Drug prices for both medications may also be affected by drug shortages in light of the recent recalls.
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