Table 1.

Comparison of the eight currently available angiotensin-receptor blockers

Generic name	Brand name	Dose (mg)	Cost (28-tab pack)	Metabolism	Half-life (h)	Primary function	Dosing	AT1/AT2 receptor selectivity	Pressor inhibition at 24 hours
Azilsartan	Edarbi (Takeda)	40 80	£54.19 £54.19	Hepatic: mainly CYP2C9 (also CYP2B6 and CYP2C8); no CYP inhibition; inhibits p-glycoprotein	11	Hypertension	80 mg once daily for hypertension	>10,000-fold	32 mg 60%
Candesartan	Atacand	4 32	£9.78 £16.13	Ester hydrolysis within gastrointestinal wall	9	Hypertension, heart failure	8–32 mg once daily over 4-(for hypertension) or 2-(for heart failure) week intervals	>10,000-fold	8 mg 50%
Eprosartan	Teveten	300 600	£7.31 £14.31	Not metabolized and eliminated unchanged	20	Hypertension	400–800 mg once daily, increase after 2–3 weeks	1000-fold	350 mg 30%
Irbesartan	Aprovel (Bristol-Myers Squibb) (Sanofi-Aventis)	75 300	£9.69 £15.93	Hepatic: glucuronidation and oxidation by CYP2C9	11–15	Hypertension, diabetic nephropathy	150–300 mg once daily for hypertension and renal disease in hypertensive type 2 diabetes mellitus	>8500-fold	150 mg 40% 300 mg 60%
Losartan	Losartan Potassium, Cozaar	25 100	£1.45 £16.18 £1.47 £16.18	Hepatic: CYP2C9 and CYP3A4	2	Hypertension, diabetic nephropathy	25–100 mg once daily over several weeks for hypertension and diabetic nephropathy; 12.5–150 mg once daily over weekly intervals for chronic heart failure	1000-fold	100 mg 25%–40%
Olmesartan	Olmetec	20 40	£12.95 £17.50	Ester hydrolysis within gastrointestinal wall	13	Hypertension	10–40 mg once daily for hypertension	>12,500-fold	20 mg 61% 40 mg 74%
Telmisartan	Micardis (Boehringer Ingelheim)	40 80	£8.00 £17.00	Minimally conjugated, no CYP450 activation	24	Hypertension	40–80 mg once daily after 4 weeks for hypertension; 80 mg once daily to prevent cardiovascular events	>3000-fold	80 mg 40%
Valsartan	Diovan (Novartis)	40 160	£13.97 £18.41	Minimal metabolism (CYP2C9) and eliminated largely unchanged	6	Hypertension, heart failure, myocardial infarction	80–320 mg once daily over 4 weeks for hypertension; 40 mg twice daily, up to 160 mg twice daily, over 2-week intervals for heart failure; 20 mg twice daily, up to 160 mg twice daily, over 2-week intervals for myocardial infarction	20,000-fold	80 mg 30%

Notes: Data drawn from Zaiken K, Cheng JW. Azilsartan medoxomil: a new angiotensin receptor blocker. Clin Ther. 2011;33(11):1577–1589.²³