From the Guidelines
Valsartan 160 mg is generally considered more potent than losartan 100 mg in terms of blood pressure lowering effects. The primary reason for this difference in potency is due to the pharmacokinetic properties of each medication, including bioavailability and half-life. According to the 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure 1, the maximum doses and mean doses achieved in clinical trials for valsartan and losartan are 160 mg BID and 50-150 mg QD, respectively. Key points to consider when comparing these medications include:
- Valsartan has a higher mean dose achieved in clinical trials, 254 mg QD, compared to losartan, 129 mg QD 1
- The maximum recommended dose for valsartan is 160 mg BID, while losartan's maximum recommended dose is 50-150 mg QD 1
- Individual patient response to these medications can vary, and factors such as side effect profile, dosing schedule, cost, and specific health conditions should be considered when choosing between valsartan and losartan It is essential to follow the healthcare provider's recommendations regarding dosage and medication choice, as they will consider the patient's specific health needs when prescribing either of these medications.
From the Research
Comparison of Valsartan and Losartan
- Valsartan 160mg and losartan 100mg are both angiotensin II receptor antagonists used to treat hypertension.
- Studies have compared the efficacy of these two drugs in reducing blood pressure.
Efficacy Comparison
- A study published in 1999 2 found that the response rate to valsartan 160mg was significantly greater than to losartan 100mg in patients with mild-to-moderate hypertension.
- Another study from 1999 3 compared the efficacy of valsartan and losartan in treating essential hypertension, and found that valsartan produced a significantly higher number of responders (62%) than losartan (55%) at the 8-week treatment endpoint.
- However, a study from 2001 4 found that losartan and valsartan were similarly effective in reducing blood pressure in patients with mild to moderate hypertension, with no significant difference in the percentage of patients reaching the diastolic blood pressure goal.
Dosage and Blood Pressure Reduction
- A study from 2011 5 compared the effect of a moderate dose of angiotensin receptor blocker/calcium channel blocker (ARB/CCB) combined with a diuretic versus a maximal dose of ARB with a diuretic on 24-hour ambulatory blood pressure monitoring (ABPM).
- The study found that initiating antihypertensive treatment with moderate doses of ARB/CCB with a diuretic is more effective in lowering nighttime and daytime ABP and reducing ABP load than a maximal dose of an ARB with a diuretic.
- A study from 1997 6 compared the efficacy, safety, and tolerability of valsartan to an angiotensin-converting enzyme (ACE) inhibitor, lisinopril, and found that valsartan 80mg daily, with titration to 160mg daily as required, provides similar antihypertensive efficacy to lisinopril 10mg daily with titration to 20mg daily.
Tolerability and Safety
- All the studies found that both valsartan and losartan were well tolerated, with similar incidence of adverse events.
- A study from 1997 6 found that valsartan was associated with a reduced incidence of cough compared to lisinopril.
- A study from 2001 4 found that losartan, but not valsartan, was associated with a decrease in serum uric acid levels.