Which ARB Medication Should You Take? Comparing Losartan, Olmesartan, Telmisartan, and Valsartan
Key takeaways:
Angiotensin II receptor blocker medications (ARBs) treat high blood pressure and other health conditions, such as heart failure and chronic kidney disease.
Losartan (Cozaar) is the most commonly used ARB. But there are other options, including olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan).
In general, the different ARB medications are considered equally effective. But there are some differences among them to consider, including how long each ARB lasts in the body.
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Table of contents
One of the best medications for treating high blood pressure (hypertension) is losartan (Cozaar). Losartan is an angiotensin II receptor blocker (ARB). ARBs effectively lower blood pressure and can often be taken once a day. And they’re usually available as affordable generics.
But losartan isn’t the only ARB medication available on the market. Several others exist and may be a good treatment option for you, depending on your individual situation. Here, we’ll compare losartan to three other common ARB medications: olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan).
What’s an ARB?
ARBs are a group of medications that are commonly prescribed for hypertension. Some ARBs also treat other medical conditions like heart failure and chronic kidney disease. Examples of ARBs include:
Losartan
Olmesartan
Telmisartan
Valsartan
Irbesartan (Avapro)
Candesartan (Atacand)
Azilsartan (Edarbi)
Losartan was the first ARB to be FDA approved in 2010. And now, it's the most commonly used ARB.
ARBs like losartan may cause fewer side effects than another commonly used blood pressure medication group called angiotensin-converting enzyme (ACE) inhibitors. And ARBs are typically as effective as ACE inhibitors.
What is losartan used for?
As mentioned, ARBs like losartan commonly treat hypertension. Losartan is also FDA approved for the following reasons in people with hypertension:
Lower the risk of stroke in people with left ventricular hypertrophy (LVH)Â
Treat kidney damage in people with diabetes (diabetic nephropathy)Â
ARB side effects: From dizziness to tiredness, learn about ARB effects and how you can manage them.
ARBs vs. ACE inhibitors: Find out how these two blood pressure medications compare, including possible side effects and interactions.
FAQs about ARBs: Get your questions answered about how ARBs work, what they treat, and more.
Losartan is sometimes prescribed for off-label uses too, including preventing death in older people with heart failure and treating people with hypertension and Marfan syndrome (an inherited condition).
Losartan can be an effective medication. But there are other ARBs you may prefer to losartan for one reason or another. Below, we’ll compare losartan to three common ARBs: olmesartan, telmisartan, and valsartan.
Olmesartan vs. losartan
When comparing olmesartan versus losartan, they have several similarities. But they also have a few differences to consider.
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Similarities
Generic availability: Olmesartan and losartan are both available as generic products.
Combination products: Losartan and olmesartan can be combined with hydrochlorothiazide in tablet form. These products are Hyzaar (losartan / hydrochlorothiazide) and Benicar HCT (olmesartan / hydrochlorothiazide).
Dosing: Both are usually taken once daily for hypertension.
Differences
Combination products: Olmesartan is combined with the calcium channel blocker amlodipine in Azor. Olmesartan, amlodipine, and hydrochlorothiazide are also combined in a tablet called Tribenzor.
Effect on blood pressure: Olmesartan may be better than losartan at lowering blood pressure. This might be because olmesartan lasts longer in the body (meaning losartan’s half-life is shorter than olmesartan). However, it’s unclear whether olmesartan continues to lower blood pressure more than losartan over time. Some research shows that these medications may be equally effective after a few months.Â
Rare side effects: Taking olmesartan comes with a small risk of “sprue-like enteropathy.” This is a condition characterized by bouts of diarrhea and weight loss. But it usually goes away when you stop taking olmesartan. If you develop these symptoms, talk to your prescriber right away.
Telmisartan vs. losartan
Telmisartan is another ARB that’s comparable to losartan. But it’s approved to treat certain conditions that other ARBs aren’t approved to treat, among other differences.
Similarities
Generic availability: Telmisartan and losartan are both available as generic products.
Combination products: Like losartan, telmisartan is also combined with hydrochlorothiazide in a combination tablet called Micardis HCT (telmisartan / hydrochlorothiazide).
Dosing: Telmisartan and losartan are usually taken once a day for hypertension.
Differences
Combination products: Telmisartan is combined with amlodipine in a combination tablet (telmisartan / amlodipine). Â
Uses: Telmisartan is FDA approved to reduce the risk of heart attack, stroke, and death in people who are at high risk of heart problems and can’t take ACE inhibitors. But keep in mind that this doesn’t mean other ARBs don’t work for this reason. It just means they haven’t been FDA approved for it.
Effect on blood pressure: Telmisartan may be better at reducing blood pressure than losartan. Telmisartan also has better 24-hour coverage than losartan because it lasts longer in the body.
Effect on diabetic nephropathy: Research indicates that telmisartan may be better than losartan at preventing diabetic nephropathy from getting worse.
Valsartan vs. losartan
When comparing losartan versus valsartan, there are several differences and similarities.
Similarities
Generic availability: Valsartan and losartan are both available as cheaper generic products.
Combination products: Valsartan is also available in combination with hydrochlorothiazide in a tablet (Diovan HCT).
Dosing: Valsartan and losartan are usually taken once a day for hypertension.
Differences
Combination products: Valsartan is available in more combination products than losartan: Exforge (valsartan / amlodipine), Exforge HCT (valsartan / amlodipine / hydrochlorothiazide). It’s also available as Entresto (sacubitril / valsartan), a medication that’s FDA approved for heart failure.
Uses: Losartan and valsartan both show promise in treating heart failure. But only valsartan is FDA approved for this reason.
Effect on blood pressure: Much research shows that valsartan and losartan are similarly effective in treating hypertension. But some research shows that valsartan may be more effective.
Do ARBs like losartan have common side effects?
Though we discussed the differences between losartan and several ARBs below, ARBs mostly share the same side effects. Three common side effects of losartan and other ARBs include dizziness, headache, and tiredness. Nausea, back or joint pain, and upper respiratory infections may also occur with some ARBs.
More serious ARB side effects include high potassium levels (hyperkalemia) and kidney damage.Â
These medications should usually be avoided during pregnancy, as they can cause birth defects.
How to save on ARBs
All ARBs discussed here are available as lower-cost generic medications. GoodRx can help you save on the average retail price at some pharmacies:
Losartan may be as low as $7.30
Olmesartan may be as low as $11.70
Telmisartan may be as low as $11.00
Valsartan may be as low as $18.00
There are also ways to save on certain brand-name products. For instance, anyone with a valid prescription can use GoodRx to purchase a 30-day supply of Edarbi at an exclusive cash price as low as $120.
Frequently asked questions
There’s no single best ARB. And all ARB medications can cause side effects. However, these medications are generally well tolerated and don’t cause problems for most people, especially once your body gets used to them.
The best ARB for you depends on several factors, such as your medical history, other health conditions you have, and what other medications you take.
ARBs and beta blockers aren’t the same. Beta blockers, like ARBs, do treat conditions such as heart failure and hypertension. But beta blockers aren’t a first choice medication for hypertension, while ARBs are. And though both may be used to treat heart failure and after a heart attack, they have different effects on the heart. They also have some different side effects.
You and your cardiologist will decide whether a beta blocker, such as metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), or carvedilol (Coreg), is right for you.
When comparing ACE inhibitors versus ARBs, you’ll find they have a lot in common. They’re used to treat similar health conditions and share certain side effects. But there are a few different side effects that set each apart. For example, ACE inhibitors are more likely to cause cough or angioedema than ARBs. ACE inhibitors and ARBs also work slightly differently.
Neither ACE inhibitors or ARBs are typically considered safe in pregnancy.
The bottom line
Angiotensin II receptor blocker (ARB) medications treat high blood pressure. They’re also used to treat many other medical conditions, such as heart failure. Losartan (Cozaar) is the most commonly used ARB. But there are other options as well. These include olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan).
When comparing losartan versus valsartan, olmesartan, or telmisartan, there are many things to consider. In general, all ARBs are considered effective at lowering blood pressure. But the exact ARB medication that’s best for you depends on many factors. Your prescriber will consider what you’re treating, what other medical conditions you have, and other medications you take when choosing an ARB to recommend.
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References
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