Valsartan vs. Carvedilol

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

Key Takeaways

  • Valsartan is an ARB taken once daily, while Carvedilol is an alpha/beta-blocker taken twice daily with food.

  • Both drugs treat high blood pressure and heart failure, but Carvedilol also slows heart rate, which helps people with angina.

  • Valsartan's most common side effects are headache and dizziness, while Carvedilol's are dizziness, fatigue, and low blood pressure.

Valsartan vs. Carvedilol Drug Summary

Valsartan

Valsartan is an angiotensin receptor blocker (ARB) used for high blood pressure, heart failure, and to improve survival after a heart attack that has weakened the heart. It works by relaxing blood vessels and is taken as a tablet once a day.

Carvedilol

Carvedilol is a combined alpha- and beta-blocker used for high blood pressure, chronic heart failure, and heart damage after a heart attack. It slows the heart rate and relaxes blood vessels, and it is taken twice daily with food.

Valsartan vs. Carvedilol Side Effects

Valsartan

Most common
Dizziness (up to 14%)
Fatigue (up to 2%)
Headache (up to 14%)
Viral infection (up to 3%)

Carvedilol

Most common
Dizziness (up to 32%)
Fatigue (up to 24%)
Hypotension (up to 14%)
Diarrhea (up to 12%)

Valsartan vs. Carvedilol Dosage

Valsartan

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

Carvedilol

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 3.125 mg twice daily At the start
Maximum dose 25 mg twice daily If needed
Dose changes 3 increases As tolerated

Valsartan vs. Carvedilol Indications

Valsartan

Valsartan is FDA-approved to lower blood pressure, treat heart failure, and reduce cardiovascular death after a heart attack that has weakened the heart. It is approved for adults and children as young as 6 for blood pressure control.

  • Hypertension in adults and children 6 and older

  • Heart failure (NYHA class II-IV)

  • Post-heart attack with left ventricular dysfunction

  • Lowers risk of stroke and heart attack from high blood pressure

Carvedilol

Carvedilol is FDA-approved for essential hypertension, chronic heart failure, and to lower the risk of death after a heart attack that has weakened the heart. It is typically added to other heart failure medications like diuretics and ACE inhibitors.

  • Essential hypertension, alone or combined

  • Chronic heart failure, mild to severe

  • Left ventricular dysfunction after a heart attack

  • Often added to diuretics and ACE inhibitors for heart failure

Valsartan vs. Carvedilol Pros and Cons

Valsartan

Valsartan blocks angiotensin II without affecting heart rate, which makes it a fit for people who also have asthma or a naturally slower pulse. It is available as an inexpensive generic and is usually well tolerated, though heart failure patients need potassium monitoring.

Pros

  • Taken once a day instead of twice

  • Does not slow heart rate, so no bradycardia monitoring needed

  • Fewer restrictions for people with asthma or COPD

Cons

  • Carries a boxed warning against use during pregnancy

  • Can raise potassium levels, especially in heart failure

  • Does not help with angina or fast heart rhythms

Carvedilol

Carvedilol's combined alpha- and beta-blocking action lowers both blood pressure and heart rate, giving it an added benefit for people with angina or a prior heart attack. It has strong outcomes data in severe heart failure, but the twice-daily dosing and heart-rate effects call for closer monitoring.

Pros

  • Also slows heart rate, helpful for angina or a fast pulse

  • Backed by major heart failure survival trials

  • Can ease chest pain from reduced heart oxygen demand

Cons

  • Must be taken twice daily with food

  • Can cause bradycardia and should not be stopped abruptly

  • Not recommended for people with severe asthma or bronchospasm

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