If you’ve been on Diovan or the generic version valsartan, and are being told by your insurance it will no longer be covered—you need a plan. Can you switch to losartan (Cozaar) or another medication to save money?
Here are some simple things to know if you’ve been told to switch your ARB to losartan:
- The benefits of losartan include controlling blood pressure, slowing the progression of diabetic kidney disease (nephropathy), and decreasing stroke risk in patients with left ventricular hypertrophy. This is true for all the ARBs.
- Losartan is different from other ARBs (valsartan, irbesartan) because it has a shorter duration of action.
- This is important. Losartan, taken once daily, does not last the full 24 hours at lower doses like 25 or 50 mg. At 100 mg daily losartan does last the full 24 hours.
- Telmisartan (generic Micardis) and valsartan do provide 24 hour coverage with once daily dosing but are more expensive than Losartan.
What about an ACE Inhibitor?
They work, are cheap, and ARBs are basically ACE Inhibitors without the cough side effect. For blood pressure control lisinopril (Prinivil, Zestril) is a very good choice and a once daily dose goes the full 24 hours. The maximum dose of lisinopril is 20 mg daily because after that it isn’t much more effective. A dry, tickly cough is the most common adverse effect of ACE inhibitors (this doesn’t happen with the ARBs listed above) that may develop in around 10% of folks. Oh, and lisinopril is cheap. Really cheap.