Valsartan vs. Olmesartan
See how Valsartan and Olmesartan compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Valsartan and olmesartan are both angiotensin II receptor blockers (ARBs) that relax blood vessels to lower blood pressure.
Valsartan has broader FDA approval, covering chronic heart failure and reducing cardiovascular death after a heart attack, while olmesartan is approved only for hypertension.
Generic valsartan typically costs far less per month than olmesartan, which can matter for people paying out of pocket.
Valsartan vs. Olmesartan Drug Summary
Valsartan
Valsartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure, chronic heart failure, and to reduce the risk of death after a heart attack. For blood pressure it's usually taken once daily as a tablet, though heart failure and post-heart attack dosing is typically split into two daily doses.
Olmesartan
Olmesartan is an angiotensin II receptor blocker (ARB) approved only for treating high blood pressure in adults and children 6 and older. It's taken as a once-daily oral tablet, either alone or combined with other blood pressure medications.
Valsartan vs. Olmesartan Side Effects
Valsartan
Olmesartan
Valsartan vs. Olmesartan Dosage
Valsartan
Olmesartan
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | Week 3 onward |
| Maximum dose | 40 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Valsartan
| 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 |
Olmesartan
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | Week 3 onward |
| Maximum dose | 40 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Valsartan vs. Olmesartan Indications
Valsartan
Valsartan treats high blood pressure in adults and children 6 and older. It's also approved for chronic heart failure to help reduce hospital stays, and for lowering the risk of cardiovascular death after a heart attack in people with reduced heart function.
Hypertension in adults and children 6 and older
Chronic heart failure (NYHA class II-IV), to reduce hospitalizations
Post-heart attack with reduced left ventricular function, to lower cardiovascular death risk
Can be combined with other blood pressure medications
Olmesartan
Olmesartan is FDA-approved only for treating high blood pressure in adults and children 6 and older, either alone or combined with other blood pressure drugs. It is not approved as a first medication for people 75 or older or for those with significant liver problems.
Hypertension in adults and children 6 and older
Can be combined with other blood pressure medications
Not approved as initial therapy in patients 75 or older
Not approved as initial therapy in liver impairment
Valsartan vs. Olmesartan Pros and Cons
Valsartan
Valsartan's clinical profile extends beyond blood pressure into heart failure and post-heart attack care, giving it a wider role than a typical ARB. Its generic version has been on the market for years and is widely available at low cost.
Pros
Also approved for heart failure and reducing death risk after a heart attack, not just blood pressure
Long-established generic with low typical cost, roughly $20 to $50 per month without insurance
Dosing can go up to 320 mg daily for patients who need more blood pressure control
Cons
Heart failure and post-heart attack dosing requires twice-daily tablets, unlike a simple once-daily regimen
Higher reported rates of headache and dizziness (up to 14% each) than olmesartan's label
Multiple dose strengths and schedules depending on the condition being treated can make titration more complex
Olmesartan
Olmesartan's clinical profile is narrower, with FDA approval limited to blood pressure, but its dosing is simple and consistent across all patients. It carries a distinct warning not shared with valsartan.
Pros
Same once-daily dosing schedule at every approved use, since it only treats hypertension
Only three dose strengths, making titration straightforward
Lower reported rates of headache and dizziness in its label compared with valsartan's rates
Cons
Not approved for heart failure or post-heart attack care, unlike valsartan
Carries a specific warning for severe sprue-like enteropathy, a rare cause of chronic diarrhea and weight loss
Higher typical monthly list price, roughly $115 to $205, versus valsartan's lower-cost generic
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