Key takeaways:
Valsartan and losartan are angiotensin II receptor blockers (ARBs). They’re one of many first-choice medication options for treating high blood pressure in many cases. Most experts consider them equally effective.
The best time to take losartan or valsartan is the time of day you will always remember to take it. If you’re taking it once daily, it usually doesn’t matter if this is in the morning or at night.
The most common side effect of valsartan and losartan is dizziness. More serious side effects include low blood pressure, kidney problems, and high potassium levels.
High blood pressure (hypertension) happens when the force of the blood pushing against your blood vessel walls is too high. Long term, this can lead to serious health problems, like heart attack or stroke. Luckily, hypertension can often be treated with lifestyle changes and medications.
One group of medications, called angiotensin II receptor blockers (ARBs), are a first-choice medication option for hypertension. Although many medications treat blood pressure, ARBs might be a good choice for people with certain medical problems. We’ll talk more about this below.
Two of the most common ARBs are valsartan (Diovan) and losartan (Cozaar). But is one better than the other? Here, we’ll cover the similarities and differences between valsartan and losartan.
What’s Valsartan?
Valsartan is an ARB. It comes as an oral tablet and liquid. It’s FDA-approved to treat hypertension and heart failure.
Off-label uses of ARBs include the treatment of kidney problems caused by diabetes (diabetic nephropathy), with or without hypertension. They can also be helpful for people who’ve had a heart attack.
Valsartan is also available in combination with sacubitril, another medication used to treat heart failure. The brand name for the medication is called Entresto. It’s a first-choice medication option for some types of heart failure.
What’s Losartan?
Losartan is also an ARB. Like valsartan, it’s FDA-approved to treat hypertension. It’s also FDA-approved to treat diabetic nephropathy in people with hypertension. There is also evidence to suggest it could lower the risk of having a stroke in people with a thickened heart and hypertension. But it’s unclear if it’s better than any other blood pressure medications at lowering stroke risk.
Losartan is also used off-label for people with high blood pressure and Marfan syndrome. Marfan syndrome is an inherited condition that can lead to problems with some of the body’s tissues. This can cause heart problems like aortic aneurysms.
How do valsartan and losartan work for hypertension?
To understand how valsartan and losartan work, we first need to learn about a hormone called angiotensin II.
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Angiotensin II causes your blood vessels body to contract and become narrower. This happens when it attaches to specific receptors (binding sites) called angiotensin II type 1 receptors. Angiotensin II also causes your body to keep salt and water. This further raises your blood pressure.
Some people with hypertension have too much angiotensin II. ARBs like valsartan and losartan work by blocking angiotensin II from binding to angiotensin II type 1 receptors. The end result is lowered blood pressure.
How are valsartan and losartan dosed?
Valsartan and losartan are usually taken once a day for hypertension. You'll typically start at a lower dose, then raise it if you need more blood pressure control.
Valsartan: The recommended starting dose is 80 mg or 160 mg once a day. Doses may be raised up to 320 mg daily if needed.
Losartan: The usual starting dose is 50 mg once daily which can be raised to 100 mg.
The best time to take losartan or valsartan is whenever you’re most likely to remember your dose. If you experience dizziness when first starting valsartan or losartan, taking it at night may be best. But otherwise, you can take the medication at any time of the day.
Keep in mind: Valsartan and losartan doses aren’t interchangeable. This means the losartan to valsartan conversion isn’t straightforward. For example, 100 mg of valsartan doesn’t equal 100 mg of losartan. If your healthcare provider recommends switching between the two medications, they'll let you know what dose to take.
How effective are valsartan and losartan at treating hypertension?
ARBs like valsartan and losartan are both effective at treating hypertension.
A study of almost 500 people found that valsartan and losartan were similarly effective at lowering blood pressure.
And another study of almost 700 people found that valsartan, losartan, and olmesartan (Benicar) were all effective at lowering blood pressure after 3 months of treatment. But in this study, losartan was given twice daily. Valsartan and olmesartan were both given once daily.
This may be because losartan lasts for a shorter amount of time in the body. So in some cases, twice daily dosing might be a good idea if your healthcare provider recommends it.
On the other hand, some research has shown that valsartan is more effective than losartan. For example, a large review of 31 studies and over 13,000 people compared valsartan to other ARBs, including losartan. The review found that valsartan 160 mg was better at lowering blood pressure than losartan 100 mg.
Still, most experts think that all ARBs are similarly effective in most cases. So if your provider recommends an ARB, talk to them about which one is best for you.
Are ARBs better than other medications for hypertension?
ARBs are considered one of the first-choice medications for hypertension in many adults. They work similarly to another group of first-choice medications called angiotensin-converting enzyme (ACE) inhibitors. Examples include lisinopril (Zestril) and benazepril (Lotensin). ARBs are a good alternative for people who have had side effects from an ACE inhibitor.
But there are specific instances where ARBs and ACE inhibitors aren’t the best option. For example, in black adults, calcium channel blockers and thiazide diuretics are more effective at lowering blood pressure than ARBs or ACE inhibitors. But there are many factors that go into choosing which blood pressure medication is right for you.
If your healthcare provider recommends an ARB, make sure they know whether you have other medical conditions and if you take other medications. This will help them and you choose which blood pressure medication is best for you.
Valsartan and losartan side effects
When taken for hypertension, dizziness is one of the most common side effects that valsartan and losartan may cause. Otherwise, ARBs are generally well-tolerated.
Rarely, more serious side effects can occur. This may include:
Low blood pressure (hypotension): ARBs may cause a drop in blood pressure.
Kidney problems: People with existing kidney problems may be at risk of worsening kidney function when taking ARBs.
High potassium levels (hyperkalemia): ARBs may raise potassium levels in the blood, especially if you have a history of kidney problems.
Birth defects in an unborn child: Pregnant women shouldn’t take ARBs during pregnancy. Using ARBs during pregnancy can be fatal and lead to birth defects. If you become pregnant while taking valsartan or losartan, talk with your provider right away. They can help you safely switch to another medication.
Valsartan and losartan drug interactions
People taking valsartan or losartan should avoid taking certain medications. Examples include ACE inhibitors and aliskiren (Tekturna). Combining ARBs with ACE inhibitors or aliskiren can raise the risk of side effects like hyperkalemia.
Other valsartan and losartan drug interactions may just need closer monitoring. This includes:
Lithium (Lithobid): Valsartan and losartan may raise lithium levels in your blood. Your healthcare provider will help you watch your lithium levels more closely if you take an ARB.
Medications that raise potassium levels: This includes potassium-sparing diuretics and potassium supplements. Combining ARBs with these medications can cause hyperkalemia.
Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin): There’s a greater risk of kidney problems if you take these medications with ARBs.
Lastly, you may be wondering if any foods should be avoided while taking valsartan or losartan.
For example, can foods that are high in potassium, like bananas, be taken with valsartan and losartan
In people with normal kidney function, eating potassium-rich foods is likely safe. But in people with chronic kidney disease, your healthcare provider may want you to limit your potassium intake.
How to save on valsartan and losartan
Valsartan and losartan are both available as lower-cost generics. GoodRx can help you save over 70% off the average retail price of generic valsartan and losartan.
Generic valsartan’s price at certain pharmacies is less than $15.46 with a free GoodRx discount. And generic losartan’s price at certain pharmacies is less than $7.30 with a free GoodRx discount.
The bottom line
Valsartan and losartan are ARBs that are both effective at treating hypertension and can be used to treat other medical problems, like diabetic nephropathy. When taken for hypertension, they’re both usually taken once a day. In most cases, it doesn’t matter if you take it in the morning or at night.
When it comes to comparing valsartan versus losartan, they’re considered equally effective at lowering blood pressure. The most common side effect is dizziness. More serious side effects include hypotension and kidney problems. But, these are rare.
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