Cozaar vs. Avapro for Hypertension and Diabetic Nephropathy: Important Differences and Potential Risks.

Key takeaways

Losartan (Cozaar) and irbesartan (Avapro) are both angiotensin II receptor blockers (ARBs) used to treat high blood pressure and protect kidney function in people with diabetes. Losartan is also used to lower the risk of stroke in people with high blood pressure and thickened heart walls. Both medications are taken orally once a day and are available in generic forms, making them more affordable. However, the starting dose for losartan is typically 50 mg, while for Irbesartan, it is 150 mg. Common side effects for both include dizziness and tiredness, but losartan can also cause upper respiratory infections. Neither medication is safe to use during pregnancy, and both can raise potassium levels, requiring regular blood tests to monitor kidney health.

Losartan

(Cozaar)

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Irbesartan

(Avapro)

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Summary for Cozaar

Prescription only

Losartan, also known by the brand name Cozaar, is a first-choice medication that's used to lower blood pressure. It's also shown to protect against stroke in certain people. In addition, this medication can slow down the worsening of kidney problems in certain people with diabetes. Losartan (Cozaar) belongs to the drug class called angiotensin II receptor blockers (ARBs). This medication is taken by mouth once daily and is available as a lower-cost generic. Side effects can include dizziness, fatigue, and upper respiratory infections.

Indications for Cozaar

High blood pressure
Lower the risk of stroke in people with high blood pressure who have a thickened heart (left ventricular hypertrophy)
Slow down the worsening of kidney problems in people with Type 2 diabetes and high blood pressure

Pros and Cons for Cozaar

Pros

A first-choice blood pressure medication, including for those with heart failure, diabetes, and kidney problems
Taken once per day
Can be taken by children as young as 6 years old
Works similarly to angiotensin-converting enzyme (ACE) inhibitors, but with fewer side effects, like cough and swelling

Cons

Might cause dizziness
Might not work as well for Black people as other blood pressure medications do
Not safe to use during pregnancy
Can interact with medications like lithium and nonsteroidal anti-inflammatory drugs (NSAIDs)

Common Side Effects for Cozaar

Upper respiratory infection (e.g., common cold; 8%)
Dizziness (3%)
Stuffy nose (2%)
Back pain (2%)

Warnings for Cozaar

Harm to unborn baby
Low blood pressure
Kidney damage
High potassium levels

Summary for Avapro

Prescription only

Irbesartan (Avapro) is a medication that's used to treat high blood pressure; it's also used to treat diabetic kidney disease. It's a part of a drug class called angiotensin II receptor blockers (ARB). The dosage for irbesartan (Avapro) can differ if you've kidney problems or are taking diuretics ("water pills"). Common side effects include dizziness and tiredness. Irbesartan (Avapro) is available in both brand name (Avapro) and generic tablet.

Indications for Avapro

Treatment of high blood pressure
Slow the worsening of kidney disease from diabetes

Pros and Cons for Avapro

Pros

Available as a lower-cost generic medication
Typically taken once a day
Less likely to cause dry cough compared to ACE Inhibitors

Cons

Not safe for use while pregnant
High risk of raising potassium levels
Requires regular blood work to make sure your kidneys are healthy

Common Side Effects for Avapro

Dizziness (up to 10%)
Low blood pressure when going from sitting to standing position (5%)
Feeling tired (4%)
Diarrhea (3%)
Heartburn (2%)

Please note: People who took irbesartan (Avapro) for high blood pressure were more likely to experience tiredness, diarrhea, and heartburn. People who took this medication for diabetic kidney disease were more likely to experience dizziness.