From the Guidelines
The equivalent dose of other Angiotensin II Receptor Blockers (ARBs) to Azilsartan 80mg is approximately Candesartan 32mg, Irbesartan 300mg, Losartan 100mg, Olmesartan 40mg, Telmisartan 80mg, and Valsartan 320mg, as per the guidelines outlined in the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
Key Considerations for Equivalent Doses
- The equivalencies are based on the usual dose ranges provided in the guideline, which are Candesartan 8–32mg, Irbesartan 150–300mg, Losartan 50–100mg, Olmesartan 20–40mg, Telmisartan 20–80mg, and Valsartan 80–320mg.
- These equivalent doses are crucial when switching between ARBs due to side effects, cost considerations, or formulary restrictions.
- Azilsartan is considered one of the more potent ARBs, with greater blood pressure lowering effects at its maximum dose compared to some others in the class.
Clinical Implications
- When transitioning between ARBs, it's advisable to monitor blood pressure closely for 2-4 weeks after the switch to ensure adequate control is maintained.
- Patients should take these medications consistently, typically once daily, with or without food depending on the specific ARB.
- If switching from Azilsartan to a less potent ARB, additional antihypertensive medication might be needed to maintain the same level of blood pressure control.
Monitoring and Adjustment
- Regular monitoring of blood pressure and potential side effects is necessary to adjust the treatment plan as needed.
- The choice of ARB should be individualized based on patient characteristics, comorbidities, and potential drug interactions, as outlined in the guideline 1.
From the Research
Equivalent Dose of Other Angiotensin II Receptor Blockers (ARBs) to Azilsartan 80mg
- The equivalent dose of other ARBs to Azilsartan 80mg can be determined by comparing their blood pressure reduction effects in clinical studies 2, 3, 4, 5.
- Azilsartan 80mg has been shown to be superior to Valsartan 320mg and Olmesartan 40mg in lowering systolic blood pressure in short-term studies 2, 5.
- In a study comparing Azilsartan medoxomil with Valsartan, Azilsartan 80mg lowered 24-hour mean systolic BP by 15.3 mm Hg, while Valsartan 320mg lowered it by 11.3 mm Hg 4.
- Another study found that Azilsartan medoxomil 80mg had superior efficacy to Olmesartan 40mg, with a greater reduction in 24-hour mean systolic BP (-14.3 mm Hg vs -11.7 mm Hg) 5.
- Based on these studies, it can be inferred that Azilsartan 80mg is equivalent to a higher dose of other ARBs, such as Valsartan and Olmesartan, in terms of blood pressure reduction effects 3, 4, 5.
Comparison with Other ARBs
- Azilsartan has been compared with other ARBs, including Candesartan, in terms of its antihypertensive effects 6.
- A study found that Azilsartan had a more potent 24-hour sustained antihypertensive effect than Candesartan, with equivalent safety 6.
- The unique pharmacological profile of Azilsartan, with its tighter and longer-lasting binding to the AT1 receptor, may contribute to its superior efficacy compared to other ARBs 3.