ARB Comparison Table

Angiotensin Receptor Blockers are one of the most commonly used drug classes to manage hypertension. Many clinicians prefer using these medications even over ACE inhibitors to reduce the risk of running into the ACE inhibitor-related cough. This is the primary advantage of ARBs over ACE Inhibitors. We wanted to put together an ARB comparison table to help you identify the differences between some of the agents in this important medication class.

Drug NameHTN DosingIndicationsHalf-LifeEliminationMiscellaneous
Losartan50-100mg/day divided

Up to 150 mg/day in HF
HTN, diabetic nephropathy; Off-label: HFrEF, NSTEMI ACS, posttransplant erythrocytosis, nondiabetic proteinuric CKD, Gout, hyperuricemia1.5-2.5 hoursPrimarily fecal and significant renalAvailable in combination with HCTZ

QD-BID dosing
Valsartan80-320mg QDHTN, HFrEF, Post-MI; Off-label:proteinuric CKD6 hoursPrimarily fecal and some renalAvailable in combination with HCTZ, amlodipine
Irbesartan150-300mg QDHTN, diabetic nephropathy; Off-label: NSTEMI ACS11-15 hoursPrimarily fecal and some renalAvailable in combination with HCTZ
Telmisartan20-80mg QDHTN, CV risk reduction24 hoursFecalAvailable in combination with HCTZ, amlodipine
Candesartan8-32mg QDHTN, HFrEF; Off-label: migraine ppx, NSTEMI ACS, proteinuric CKD5-9 hoursPrimarily fecal and significant renalAvailable in combination with HCTZ
Olmesartan20-40mg QDHTN; Off-label: NSTEMI ACS, proteinuric CKD, STEMI13 hoursFecal and RenalAvailable in combination with amlodipine and HCTZ
Rare cases of enteropathy reported
Azilsartan40-80mg QDHTN11 hoursFecal and RenalNo generic currently available, brand drug Edarbi
Available in combination with chlorthalidone
ARB Comparison Table

Losartan is probably the most common ARB that I see used in practice. It is important to look at the half-life of this medication and ensure that your patients are receiving adequate blood pressure lowering all throughout the day. With a relatively short half-life, BID dosing may be necessary for your patient. If twice daily dose is an issue, you want to look elsewhere.

One unique effect noted in the ARB comparison table of losartan is that it has been shown to lower uric acid. While not necessarily used for this indication, it may be a consideration in gout patients known to have higher uric acid acid levels.

Another thing to note in the ARB comparison table is olmesartan. Olmesartan is an interesting ARB and does have a nice half-life that is conducive to once-daily dosing. One rare adverse effect to note is that it has been associated with enteropathy. If you have a patient who has a GI diagnosis where diarrhea and other GI symptoms are problematic, it may be advisable to avoid this ARB. In patients who report diarrhea or other GI symptoms after using olmesartan, it would be important to rule out this medication as a potential contributing factor.

This table was put together by Amy Van Loon, PharmD Candidate.

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  1. Jim Heinz

    I really enjoy reading your blogs. I find your objectivity as refreshing as the “Pharmacist Letter.” I use your insights almost daily when consulting.

    • Eric Christianson

      Thanks so much Jim! Appreciate it!


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Written By Eric Christianson

September 27, 2023

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