Angiotensin II Receptor Blockers:

<Drug Comparisons>
candesartan (Atacand ®) eprosartan mesylate (Teveten®)
irbesartan (Avapro ®) losartan (Cozaar ®)
olmesartan (Benicar ®) telmisartin (Micardis ®)
valsartan (Diovan ®) Mechanism

candesartan (Atacand ®) top of page icon
 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 icon
 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 icon
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 icon
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.

Supplied:  25 mg, 50 mg, 100 mg

olmesartan (Benicar ®):  top of page icon
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.

telmisartin (Micardis ®): top of page icon
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 icon
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 icon
RAA cascade
 

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.

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