TITLE

Equivalent dosing of irbesartan, valsartan, and losartan identified through formulary switch at a Veterans Affairs medical center

AUTHOR(S)
Sease, Julie; Williams, A. Maurice
PUB. DATE
January 2008
SOURCE
Formulary;Jan2008, Vol. 43 Issue 1, p14
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Until 2005, irbesartan was the only ARB available on the Veterans Affairs (VA) healthcare system's national formulary. In 2005, irbesartan was removed from the formulary and was replaced with valsartan and losartan. For those patients who were to continue ARB therapy via a switch to either losartan or valsartan, dosing guidelines were created by the Veterans Integrated System Network 7 to facilitate the change. These guidelines suggested that patients taking irbesartan 150 mg once daily be treated with either valsartan 80 mg or losartan 50 mg once daily and that patients taking irbesartan 300 mg once daily be treated with either valsartan 160 mg or losartan 100 mg once daily. To determine if the dosing guidelines resulted in equal antihypertensive effectiveness, we carned out a retrospective chart review, examining the cases of 86 patients at the William Jennings Bryan Dorn VA Medical Center in Columbia, South Carolina, who had switched from irbesartan to either losartan or valsartan; 11 of these patients had been taking irbesartan 75 mg once daily and were switched to valsartan 40 mg or losartan 25 mg once daily based on an extrapolation of the guidelines. The 4 most recent consecutive blood pressure (BP) measurements before the switch were compared with the first 4 consecutive BP measurements after the switch. Additionally, the 3 most recent serum creatinine and serum potassium values before the switch were compared with the first 3 values after the switch. No statistically significant difference was observed between the BP measurements taken before and after the switch (F [3,209]=.11; P=.95). No significant changes were observed in serum potassium (P=.42) or serum creatinine (P=.71) values. Although the generalizability of these results may be limited, as the study was restricted to a small, mostly male population of veterans, we believe that the results demonstrate the therapeutic equivalence of specific doses of irbesartan, losartan, and valsartan.
ACCESSION #
28725562

 

Related Articles

  • Effect of olmesartan on blood pressure in patients with hypertension: specification on causality. Kawada, T // Journal of Human Hypertension;Jan2015, Vol. 29 Issue 1, p69 

    A letter to the editor is presented in response to the article "Effect of the angiotensin II receptor antagonist olmesartan on morning home blood pressure in hypertension: HONEST Study at 16 weeks" by K. Kario, I. Saito, T. Kushiro, S. Teramukai, Y. Ishikawa and K. Hiramatsu in the previous issue.

  • Angiotensin II receptor antagonist has beneficial effect on hypertensive stroke patients? Kobayashi, S. // Journal of Human Hypertension;Oct2004, Vol. 18 Issue 10, p685 

    Comments on studies involving the effect of angiotensin II receptor antagonists on hypertensive stroke patients. Treatment with angiotensin converting enzyme inhibitor to normalize dysautoregulation of cerebral circulation; Evaluation of acute candesartan cilexetil therapy in stroke survivors.

  • Losartan, an angiotensin II (AT1) receptor antagonist, preserves cerebral blood flow in hypertensive patients with a history of stroke. Moriwaki, H.; Uno, H.; Nagakane, Y.; Hayashida, K.; Miyashita, K.; Naritomi, H. // Journal of Human Hypertension;Oct2004, Vol. 18 Issue 10, p693 

    In patients with severe hypertension, chronic heart failure or a history of stroke, the lower limit of autoregulation of cerebral blood flow (CBF) is shifted to higher levels of blood pressure (BP) than those observed in healthy subjects. The aim of pharmacotherapy for hypertensive patients with...

  • losartan. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p475 

    An encyclopedia entry for "losartan" is presented. It refers to an angiotensin II antagonist drug used as treatment against hypertension or high blood pressure. Side effects of the drug include dizziness, diarrhea and fatigue.

  • Telmisartan: A Viewpoint by Wilbert S. Aronow. Aronow, W.S. // Drugs;Dec1998, Vol. 56 Issue 6, p1045 

    Comments on a study on the use of the nonpeptide angiotensin II receptor antagonist telmisartan in the management of hypertension. Details on the dosage and administration of telmisartan; Information on the effectiveness of telmisartan.

  • Angiotensin II receptor antagonists in hypertension. Burnier, Michel; Brunner, Hans R. // Kidney International Supplement;Dec1998, Issue 68, pS-107 

    Examines the efficacy of angiotensin II receptor antagonist for the treatment of hypertension. Route of administration; Therapeutic dosage of angiotensin; Sensitivity of angiotensin.

  • Clinical pharmacokinetics of angiotensin II (AT1) receptor blockers in hypertension. Israili, Z H // Journal of Human Hypertension;Apr2000 Supplement, Vol. 14 Issue 4, pS73 

    Angiotensin II receptor blockers (ARBs) represent a new class of effective and well tolerated orally active antihy-pertensive agents. Recent clinical trials have shown the added benefits of ARBs in hypertensive patients (reduction in left ventricular hypertrophy, improvement in diastolic...

  • AT [sub1] receptor antagonist combats oxidative stress and restores nitric oxide signaling in the SHR. Welch, William J.; Wilcox, Christopher S. // Kidney International;Apr2001, Vol. 59 Issue 4, p1257 

    AT1 receptor antagonist combats oxidative stress and restores nitric oxide signaling in the SHR. The tubuloglomerular feed- back (TGF) responses of the spontaneously hypertensive rat (SHR) are under exaggerated regulation by angiotensin II (Ang II) type 1 receptors (AT1-R). Since AT1-Rs enhance...

  • Telmisartan: A Review of its Use in Hypertension. Sharpe, M.; Jarvis, B.; Goa, K.L. // Drugs;Jul2001, Vol. 61 Issue 10, p1501 

    Telmisartan is an angiotensin II receptor antagonist that is highly selective for type 1 angiotensin II receptors. It was significantly more effective than placebo in large (n >100), double-blind, randomised, multicentre clinical trials in patients with mild to moderate hypertension. Telmisartan...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics