Losartan vs. Atenolol
See how Losartan and Atenolol compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Losartan is an ARB that lowers blood pressure and also protects the kidneys in type 2 diabetes, while atenolol is a beta-blocker that also treats angina and helps after a heart attack.
Losartan tends to be better tolerated overall, with lower rates of fatigue and mood changes than atenolol.
Atenolol must never be stopped abruptly, since sudden discontinuation can trigger chest pain or a heart attack, a risk losartan does not carry.
Losartan vs. Atenolol Drug Summary
Losartan
Losartan is an angiotensin receptor blocker (ARB) that lowers blood pressure by blocking the effects of a hormone that narrows blood vessels. It is taken as a tablet once a day and is also used to protect the kidneys in type 2 diabetes and to lower stroke risk in certain heart conditions.
Atenolol
Atenolol is a beta-1 selective beta-blocker that lowers blood pressure by slowing the heart rate and reducing how hard the heart works. It is taken as a tablet once a day and is also approved for angina and for use after a stable heart attack.
Losartan vs. Atenolol Side Effects
Losartan
Atenolol
Losartan vs. Atenolol Dosage
Losartan
Atenolol
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 100 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Losartan
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 100 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Atenolol
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Losartan vs. Atenolol Indications
Losartan
Losartan is an angiotensin receptor blocker (ARB) that lowers blood pressure in adults and children over 6. It also slows kidney damage in type 2 diabetes and lowers stroke risk in people with high blood pressure and an enlarged heart muscle.
Hypertension in adults and children over 6 years old
Diabetic nephropathy with type 2 diabetes and protein in the urine
Stroke risk reduction in hypertension with an enlarged heart muscle
Sometimes used off-label for heart failure
Atenolol
Atenolol is a beta-blocker that lowers blood pressure and treats angina, the chest pain caused by reduced blood flow to the heart. It is also used after a stable heart attack to help protect the heart from further damage.
Hypertension
Angina pectoris (chest pain from reduced heart blood flow)
Acute myocardial infarction, once hemodynamically stable
Off-label for migraine prevention
Losartan vs. Atenolol Pros and Cons
Losartan
Losartan has a favorable side effect profile with low rates of fatigue and mood-related complaints, and it adds kidney-protective benefits for people with diabetes. It is available as a low-cost generic and is covered by most insurance plans.
Pros
Well tolerated, with low rates of fatigue and depression
Also protects the kidneys in type 2 diabetes with protein in the urine
Reduces stroke risk in hypertension with an enlarged heart muscle
Does not worsen asthma or COPD the way beta-blockers can
Cons
Can raise blood potassium levels, requiring monitoring
Not safe during pregnancy
Takes several weeks to reach full blood-pressure-lowering effect
Kidney function should be checked after starting or increasing the dose
Atenolol
Atenolol also treats angina and helps protect the heart after a heart attack, giving it uses beyond blood pressure control. It is inexpensive and widely available, but it carries added precautions around abrupt discontinuation and certain heart rhythm conditions.
Pros
Also approved for angina and for use after a heart attack
Long-established option with decades of clinical use
Can be combined with other heart medications after a heart attack
Also used off-label for migraine prevention and hand tremor
Cons
Cannot be stopped suddenly without risking chest pain or heart attack
Contraindicated in certain slow heart rhythms and heart block
More likely to cause fatigue and mood changes such as depression
Caution needed in asthma or COPD due to airway-tightening risk
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