Losartan vs. Valsartan

See how Losartan and Valsartan compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Losartan and valsartan are both angiotensin II receptor blockers (ARBs) that work the same way, so they carry similar risks of low blood pressure and high potassium.

  • Losartan has a specific FDA approval for slowing kidney damage in type 2 diabetes, while valsartan is also approved for heart failure and for improving survival after a heart attack.

  • Both are sold as inexpensive generic tablets, and doctors often switch a patient from one to the other if side effects appear or blood pressure control is not good enough.

Losartan vs. Valsartan Drug Summary

Losartan

Losartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure, lower stroke risk in some patients, and slow kidney damage in type 2 diabetes. It is taken as a once-daily tablet, usually starting at 50 mg.

Valsartan

Valsartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure, heart failure, and to improve survival after a heart attack. It is taken once daily for hypertension, usually starting at 80 mg or 160 mg.

Losartan vs. Valsartan Side Effects

Losartan

Most common
upper respiratory infection (up to 8%)
dizziness (up to 3%)
nasal congestion (up to 2%)
back pain (up to 2%)

Valsartan

Most common
dizziness (up to 8%)
viral infection (up to 3%)
fatigue (up to 2%)
abdominal pain (up to 2%)

Losartan vs. Valsartan Dosage

Losartan

Dosage
Dosage Table
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

Valsartan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 80 mg once daily At the start
Maximum dose 320 mg once daily If needed
Dose changes 2 increases As tolerated

Losartan vs. Valsartan Indications

Losartan

Losartan is FDA-approved to treat high blood pressure in adults and children age 6 and up. It also has specific approvals to reduce stroke risk in people with hypertension and enlarged heart muscle, and to slow kidney damage in type 2 diabetes with hypertension.

  • High blood pressure in adults and children 6 and older

  • Stroke risk reduction with hypertension and heart enlargement

  • Slowing kidney damage in type 2 diabetes with hypertension

  • Often combined with a diuretic for added blood pressure control

Valsartan

Valsartan is FDA-approved to treat high blood pressure in adults and children age 6 and up. It also has specific approvals to treat heart failure and to improve survival in people with reduced heart function after a heart attack.

  • High blood pressure in adults and children 6 and older

  • Heart failure, NYHA class II through IV

  • Post-heart attack care with reduced heart function

  • Often combined with a diuretic for added blood pressure control

Losartan vs. Valsartan Pros and Cons

Losartan

Losartan has a long track record as a generic ARB and is one of the least expensive options in its class. It carries a specific FDA-approved indication for slowing kidney damage in type 2 diabetes, a use valsartan does not have.

Pros

  • FDA-approved specifically for diabetic kidney disease protection

  • Also lowers uric acid, a plus for patients prone to gout

  • One of the least expensive ARBs as a generic tablet

Cons

  • Not FDA-approved for heart failure or post-heart attack care

  • Needs a lower starting dose in patients who are volume-depleted

  • Lower maximum dose than valsartan if more control is needed

Valsartan

Valsartan carries broader FDA approvals than losartan, covering heart failure and post-heart attack care in addition to hypertension. It also offers a higher top-end dose for patients who need more blood pressure control.

Pros

  • FDA-approved for heart failure, not just hypertension

  • FDA-approved to improve survival after a heart attack

  • Higher top-end dose (320 mg) for harder-to-control blood pressure

Cons

  • Not FDA-approved for diabetic kidney disease protection

  • Twice-daily dosing required for heart failure and post-MI use

  • No uric acid-lowering effect reported like losartan's

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