logo

Angiotensin II Receptor Blockers:

<Drug Comparisons>
azilsartan medoxomil - (EDARBI®) --®
candesartan (Atacand ®) eprosartan mesylate (Teveten®)
irbesartan (Avapro ®) losartan (Cozaar ®)
olmesartan (Benicar ®) telmisartan (Micardis ®)
valsartan (Diovan ®) Mechanism

Combination Products

ENTRESTO™- sacubitril and valsartan --®
Please see package insert for additional information and possible updates. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.    [  Read the disclaimer    |   <<Back     ]

azilsartan medoxomil - (EDARBI ®) top of page

Initial U.S. Approval: 2011
DESCRIPTION
Edarbi (azilsartan medoxomil), a prodrug, is hydrolyzed to azilsartan in the gastrointestinal tract during absorption. Azilsartan is a selective AT1 subtype angiotensin II receptor antagonist.

INDICATIONS AND USAGE
Edarbi is an angiotensin II receptor blocker indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. Edarbi may be used, either alone or in combination with other antihypertensive agents.

DOSAGE AND ADMINISTRATION
The recommended dose in adults is 80 mg taken once daily. Consider a starting dose of 40 mg for patients who are treated with high doses of diuretics.

Edarbi may be administered with or without food.
Edarbi may be administered with other antihypertensive agents.

HOW SUPPLIED
Tablets: 40 mg and 80 mg.

candesartan (Atacand ®) top of page

 Supplied:  4 mg, 8 mg, 16 mg, 32 mg
Dosing

Hypertension
: Oral: Initial: 16 mg once daily.   Range: 4 to 32 mg once daily. Dosage must be individualized.  It can be administered once or twice daily with total daily doses ranging from 8-32 mg.  
CHF
: Oral: Initial: 4 mg once daily.   Double the dose at 2-week intervals, as tolerated; target dose: 32 mg.

eprosartan mesylate (Teveten) ® top of page

 Supplied:  400 mg, 600 mg
Dosing

Hypertension
: Oral: Usual initial dose is 600 mg once daily. Dosage must be individualized. Can administer once or twice daily with total daily doses of 400 to 800 mg.  Limited clinical experience with doses greater than 800 mg.

irbesartan (Avapro ®):  top of page

Supplied:  75 mg, 150 mg, 300 mg
Dosing
Hypertension: Oral: 150 mg once daily ... patients may be titrated to 300 mg once daily. Note: Starting dose in volume-depleted patients should be 75 mg.

losartan (Cozaar ®):  top of page

Dosing: Oral: 
Hypertension
:

Children 6-16 years: 0.7 mg/kg once daily (maximum: 50 mg/day); adjust dose based on response; doses >1.4 mg/kg (maximum: 100 mg) have not been studied

Adults: Usual starting dose: 50 mg once daily; can be administered once or twice daily with total daily doses ranging from 25-100 mg

Patients receiving diuretics or with intravascular volume depletion:
Usual initial dose: 25 mg

Nephropathy in patients with type 2 diabetes and hypertension: Adults: Initial: 50 mg once daily; can be increased to 100 mg once daily based on blood pressure response

Stroke reduction (HTN with LVH): Adults: 50 mg once daily (maximum daily dose: 100 mg); may be used in combination with a thiazide diuretic

Dosing adjustment in renal impairment :
Children: Use is not recommended if cr<30 mL/minute.
Adults: No adjustment necessary.

Dosing adjustment in hepatic impairment : Reduce the initial dose to 25 mg/day; divide dosage intervals into two.

Supplied25 mg, 50 mg, 100 mg

olmesartan (Benicar ®):  top of page

Supplied:  5 mg, 20 mg, 40 mg
Dosing
Hypertension: Oral: Initial: Usual starting dose is 20 mg once daily.  If initial response is inadequate, may be increased to 40 mg once daily after 2 weeks. Consider lower starting dose in patients with possible volume deficits.

telmisartan (Micardis ®): top of page

Supplied:  20 mg, 40 mg, 80 mg
Dosing
Hypertension: Oral: Initial: 40 mg once daily.  Usual maintenance dose range: 20 to 80 mg per day. Patients with volume depletion should be initiated on the lower dosage with close supervision. 

valsartan (Diovan ®):  top of page

Supplied:  40 mg, 80 mg, 160 mg, 320 mg
Dosing

Hypertension
: Initial: 80 mg or 160 mg once daily (in patients who are not volume depleted). Dose may be increased to achieve desired effect ... maximum recommended dose: 320 mg per day.

CHF: Initial: 40 mg twice daily. Titrate dose to 80 to 160 mg twice daily, as tolerated.  Maximum daily dose: 320 mg.   
Left ventricular dysfunction after MI
: Initial: 20 mg twice daily. Titrate dose to target of 160 mg twice daily as tolerated.

Decreased renal perfusion  top of page

RAA cascade





ENTRESTO™- sacubitril and valsartan tablet  top of page

Drug UPDATES:  ENTRESTO™- sacubitril and valsartan tablet
[Drug information  /  PDFled  -Click link for the latest monograph
Dosing:  Click (+) next to Dosage and Administration section (drug info link)

Initial U.S. Approval:  2015

Mechanism of Action:
ENTRESTO contains a neprilysin inhibitor, sacubitril, and an angiotensin receptor blocker, valsartan. ENTRESTO inhibits neprilysin (neutral endopeptidase; NEP) via LBQ657, the active metabolite of the prodrug sacubitril, and blocks the angiotensin II type-1 (AT1) receptor via valsartan. The cardiovascular and renal effects of ENTRESTO in heart failure patients are attributed to the increased levels of peptides that are degraded by neprilysin, such as natriuretic peptides, by LBQ657, and the simultaneous inhibition of the effects of angiotensin II by valsartan. Valsartan inhibits the effects of angiotensin II by selectively blocking the AT1 receptor, and also inhibits angiotensin II-dependent aldosterone release.

INDICATIONS AND USAGE:
1.1 Heart Failure
ENTRESTO is indicated to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction.
ENTRESTO is usually administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other ARB.
 

HOW SUPPLIED:
ENTRESTO is supplied as unscored, ovaloid, film-coated tablets in the following strengths:
ENTRESTO 24/26 mg, (sacubitril 24 mg and valsartan 26 mg) are violet white and debossed with "NVR" on one side and "LZ" on the other side.
ENTRESTO 49/51 mg, (sacubitril 49 mg and valsartan 51 mg) are pale yellow and debossed with "NVR" on one side and "L1" on the other side.
ENTRESTO 97/103 mg, (sacubitril 97 mg and valsartan 103 mg) are light pink and debossed with "NVR" on one side and "L11" on the other side.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.
more Career Center image description
Medical Calculators - A thru Z
Lab Values - A thru Z