What is the equivalent valsartan dose to 16 milligrams of candesartan (Angiotensin II Receptor Antagonist) daily?

From the Guidelines

The equivalent valsartan dose to 16 mg of candesartan daily is approximately 160 mg of valsartan daily. When switching between these angiotensin II receptor blockers (ARBs), this dose conversion provides similar blood pressure lowering effects, as indicated by the 2020 ACC/AHA clinical performance and quality measures for adults with heart failure 1. Valsartan is typically taken once daily, though some patients may be prescribed divided doses. When making this medication change, patients should maintain their usual schedule for taking blood pressure medications and continue monitoring their blood pressure regularly. The difference in dosing reflects the varying potencies of these medications - candesartan is more potent on a milligram-per-milligram basis than valsartan, which is why a higher dose of valsartan is needed to achieve the same therapeutic effect. Both medications work by blocking the action of angiotensin II, a hormone that causes blood vessels to narrow, but they have slightly different pharmacological properties that account for the dosing differences.

Some key points to consider when making this conversion include:

• The goal dose of valsartan should be at the higher end of the dose range when possible, as indicated by the kdoqi clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease 1.
• The target dose of valsartan is 160 mg, once daily, as recommended by the 2020 ACC/AHA clinical performance and quality measures for adults with heart failure 1.
• Patients should be monitored regularly for changes in blood pressure and kidney function, as angiotensin II receptor blockers can affect these parameters.
• The conversion from candesartan to valsartan should be made with caution, as individual patient responses may vary, and close monitoring of blood pressure and kidney function is necessary to ensure optimal outcomes.

From the Research

Equivalent Valsartan Dose

To determine the equivalent valsartan dose to 16 mg candesartan daily, we need to consider the studies that compared the efficacy of different angiotensin II receptor blockers (ARBs).

• The study 2 compared the efficacy of valsartan with other ARBs, including candesartan, in reducing systolic and diastolic blood pressure.
• The study 3 compared the AT(1)-receptor blockade induced by different doses of valsartan with that obtained with other ARBs, including candesartan.
• According to the study 3, 160 mg valsartan was equivalent to 8 mg candesartan in terms of AT(1)-receptor blockade, as measured by plasma renin activity on day 8.

Dose Comparison

Based on the available evidence, the equivalent valsartan dose to 16 mg candesartan daily can be estimated as follows:

• Since 160 mg valsartan is equivalent to 8 mg candesartan, doubling the dose of candesartan to 16 mg would require doubling the dose of valsartan to approximately 320 mg.
• Therefore, the equivalent valsartan dose to 16 mg candesartan daily is approximately 320 mg, as supported by the studies 2 and 3.