ANGIOTENSIN II RECEPTOR BLOCKER (ARB) DOSING

All dosing is for ADULTS unless otherwise specified. P = drugs with pediatric dosing recommendations.
References:
PRICING INFO


Drug Dosage form Dosing Generic/Price Food/Other
Azilsartan

(Edarbi®)
Tablet
  • 40 mg
  • 80 mg
Hypertension
  • Starting: 80 mg once daily
  • Maintenance: 40 - 80 mg once daily
  • Max: 80 mg once daily
  • See precautions for dosing in kidney and liver disease
NO/$$$$ FOOD
  • May take without regard to food

OTHER
  • Consider starting dose of 40 mg a day if on high doses of diuretics

Drug Dosage form Dosing Generic/Price Food/Other
Candesartan

(Atacand®)
Tablet
  • 4 mg
  • 8 mg
  • 16 mg
  • 32 mg
Adults
    Hypertension
    • Starting: 16 mg once daily
    • Maintenance: 8 - 32 mg/day
    • Max: 32 mg/day
    • May be given in one or two divided doses
    Heart failure
    • Starting: 4 mg once daily
    • Target dose: 32 mg once daily
    • Max: 32 once daily
    • Dose may be doubled every 2 weeks as tolerated

See precautions for dosing in kidney and liver disease
Pediatric
    Hypertension (1 to <6 years)
    • Starting: 0.20 mg/kg/day
    • Maintenance: 0.05 to 0.4 mg/kg/day
    • May be given in one or two divided doses
    • See Atacand PI [sec 2.2] for instructions on compounding a 1 mg/ml suspension
    Hypertension (6 to <17 years)
    • Starting (< 50 kg): 4 - 8 mg/day
    • Starting (≥ 50 kg): 8 - 16 mg/day
    • Maintenance (< 50 kg): 2 - 16 mg/day
    • Maintenance (≥ 50 kg): 4 - 32 mg/day
    • May be given in one or two divided doses
YES/$-$$ FOOD
  • May take without regard to food

OTHER
  • In moderate liver disease, starting dose is 8 mg for hypertension
  • Lower starting dose may be appropriate in patients taking diuretics
  • Most of the blood pressure effect is seen within 2 weeks
  • Maximum blood pressure effect is seen within 4 - 6 weeks
  • See Atacand PI [sec 2.2] for instructions on compounding a 1 mg/ml suspension

Drug Dosage form Dosing Generic/Price Food/Other
Eprosartan

(Teveten®)
Tablet
  • 400 mg
  • 600 mg
Hypertension
  • Starting: 600 mg once daily
  • Maintenance: 400 - 800 mg/day
  • Max: 800 mg/day
  • May be given in one or two divided doses
  • See precautions for dosing in kidney and liver disease
YES/$$ FOOD
  • May take without regard to food

OTHER
  • Moderate-to-severe kidney disease - dose should not exceed 600 mg a day
  • Lower starting dose may be appropriate in patients taking diuretics
  • Maximum blood pressure effect is seen within 2 - 3 weeks

Drug Dosage form Dosing Generic/Price Food/Other
Irbesartan

(Avapro®)
Tablet
  • 75 mg
  • 150 mg
  • 300 mg
Adults
    Hypertension
    • Starting: 150 mg once daily
    • Maintenance: 150 - 300 mg once daily
    • Max: 300 mg once daily
    Diabetic nephropathy
    • Target dose: 300 mg once daily

See precautions for dosing in kidney and liver disease
Pediatric
    Hypertension (6 - 12 years)
    • Starting: 75 mg once daily
    • Max: 150 mg once daily
    • AAP recommended dosing [2]
    Hypertension (≥ 13 years)
    • Starting: 150 mg once daily
    • Max: 300 mg once daily
    • AAP recommended dosing [2]
YES/$ FOOD
  • May take without regard to food

OTHER
  • Lower starting dose may be appropriate in patients taking diuretics

Drug Dosage form Dosing Generic/Price Food/Other
Losartan

(Cozaar®)
Tablet
  • 25 mg
  • 50 mg
  • 100 mg
Adults
    Hypertension
    • Starting: 50 mg once daily
    • Maintenance: 25 - 100 mg once daily
    • Max: 100 mg once daily
    Diabetic nephropathy
    • Starting: 50 mg once daily
    • Maintenance: 50 - 100 mg once daily
    • Max: 100 mg once daily
    Hypertension with Left Ventricular Hypertrophy
    • Starting: 50 mg once daily
    • Maintenance: 50 - 100 mg once daily
    • Max: 100 mg once daily

See precautions for dosing in kidney and liver disease
Pediatric
    Hypertension (≥ 6 years)
    • Starting: 0.7 mg/kg (max 50 mg) once daily
    • Max: 1.4 mg/kg (max 100 mg) once daily
    • See Cozaar PI [sec 2.5] for instructions on compounding a 2.5 mg/ml suspension
YES/$ FOOD
  • May take without regard to food

OTHER
  • Lower starting dose may be appropriate in patients taking diuretics
  • Liver disease - starting dose should be 25 mg
  • May take 3 - 6 weeks for maximum effect
  • See Cozaar PI [sec 2.5] for instructions on compounding a 2.5 mg/ml suspension

Drug Dosage form Dosing Generic/Price Food/Other
Olmesartan

(Benicar®)
Tablet
  • 5 mg
  • 20 mg
  • 40 mg
Adults
    Hypertension
    • Starting: 20 mg once daily
    • Maintenance: 20 - 40 mg once daily
    • Max: 40 mg once daily
    • See precautions for dosing in kidney and liver disease

Pediatric
    Hypertension (6 - 16 years)
    • Starting (20 to <35 kg): 10 mg once daily
    • Starting (≥ 35 kg): 20 mg once daily
    • Max (< 35 kg): 20 mg once daily
    • Max (≥ 35 kg): 40 mg once daily
    • Increase dose at intervals of 2 weeks
    • See Benicar PI [sec 2.2] for instructions on compounding a 2 mg/ml suspension
YES/$-$$ FOOD
  • May take without regard to food

OTHER
  • Lower starting dose may be appropriate in patients taking diuretics
  • See Benicar PI [sec 2.2] for instructions on compounding a 2 mg/ml suspension

Drug Dosage form Dosing Generic/Price Food/Other
Telmisartan

(Micardis®)
Tablet
  • 20 mg
  • 40 mg
  • 80 mg
Hypertension
  • Starting: 40 mg once daily
  • Maintenance: 20 - 80 mg once daily
  • Max: 80 mg once daily
Cardiovascular risk reduction
  • Target: 80 mg once daily
  • Max: 80 mg once daily

See precautions for dosing in kidney and liver disease
YES/$ FOOD
  • May take without regard to food

OTHER
  • Lower starting dose may be appropriate in patients taking diuretics
  • Maximum blood pressure effect seen within 4 weeks

Drug Dosage form Dosing Generic/Price Food/Other
Valsartan

(Diovan®)
Tablet
  • 40 mg
  • 80 mg
  • 160 mg
  • 320 mg
Adults
    Hypertension
    • Starting: 80 - 160 mg once daily
    • Maintenance: 80 - 320 mg once daily
    • Max: 320 mg once daily
    Heart failure
    • Starting: 40 mg twice daily
    • Maintenance: 80 - 160 mg twice daily
    • Max: 160 mg twice daily
    Post-Myocardial infarction
    • Starting: 20 mg twice daily
    • Maintenance: 40 - 160 mg twice daily
    • Max: 160 mg twice daily

See precautions for dosing in kidney and liver disease
Pediatric
    Hypertension (6 - 16 years)
    • Starting: 1.3 mg/kg (max 40 mg) once daily
    • Max: 2.7 mg/kg (max 160 mg) once daily
    • See Diovan PI [sec 2.2] for instructions on compounding a 4 mg/ml suspension
YES/$ FOOD
  • May take without regard to food

OTHER
  • Lower starting dose may be appropriate in patients taking diuretics
  • Maximum blood pressure effect seen within 4 weeks
  • When the suspension is replaced by a tablet, the dose of valsartan may have to be increased. The exposure to valsartan with the suspension is 1.6 times greater than with the tablet.
  • See Diovan PI [sec 2.2] for instructions on compounding a 4 mg/ml suspension

  • COMBINATION PRODUCTS WITH HCTZ

Drug Dosage form Dosing Generic/Price Food/Other
Atacand HCT®

(Candesartan + HCTZ)
Candesartan - HCTZ
  • 16 mg - 12.5 mg
  • 32 mg - 12.5 mg
  • 32 mg - 25 mg
Hypertension
  • Dosing: HCTZ 12.5 - 50 mg/day; candesartan 8 - 32 mg/day
  • May be given once daily or divided into two doses
YES/$$ FOOD
  • May take without regard to food

OTHER
  • Maximal effect seen within 4 weeks

Drug Dosage form Dosing Generic/Price Food/Other
Avalide®

(Irbesartan + HCTZ)
Irbesartan - HCTZ
  • 150 mg - 12.5 mg
  • 300 mg - 12.5 mg
Hypertension
  • Starting: 150/12.5 mg once daily
  • Max: 300/25 mg once daily
  • Titrate dose at intervals of 1 - 2 weeks
YES/$ FOOD
  • May take without regard to food

OTHER

Drug Dosage form Dosing Generic/Price Food/Other
Benicar HCT®

(Olmesartan + HCTZ)
Olmesartan - HCTZ
  • 20 mg - 12.5 mg
  • 40 mg - 12.5 mg
  • 40 mg - 25 mg
Hypertension
  • Starting: 20/12.5 - 40/12.5 mg once daily
  • Max: 40/25 mg once daily
YES/$ FOOD
  • May take without regard to food

OTHER

Drug Dosage form Dosing Generic/Price Food/Other
Diovan HCT®

(Valsartan + HCTZ)
Valsartan - HCTZ
  • 80 mg - 12.5 mg
  • 160 mg - 12.5 mg
  • 160 mg - 25 mg
  • 320 mg - 12.5 mg
  • 320 mg - 25 mg
Hypertension
  • Starting: 160/12.5 mg once daily
  • Max: 320/25 mg once daily
  • Titrate dose at intervals of 1 - 2 weeks
YES/$ FOOD
  • May take without regard to food

OTHER
  • Maximum effect seen within 2 - 4 weeks

Drug Dosage form Dosing Generic/Price Food/Other
Hyzaar®

(Losartan + HCTZ)
Losartan - HCTZ
  • 50 mg - 12.5 mg
  • 100 mg - 12.5 mg
  • 100 mg - 25 mg
Hypertension
  • Starting: 50/12.5 mg once daily
  • Max: 100/25 mg once daily
  • Increase dose at intervals of 3 weeks
Hypertension with LVH to reduce the risk of stroke
  • Starting: 50/12.5 mg once daily
  • Max: 100/25 mg once daily
YES/$ FOOD
  • May take without regard to food

OTHER

Drug Dosage form Dosing Generic/Price Food/Other
Micardis HCT®

(Telmisartan + HCTZ)
Telmisartan - HCTZ
  • 40 mg - 12.5 mg
  • 80 mg - 12.5 mg
  • 80 mg - 25 mg
Hypertension
  • Starting: 80/12.5 mg once daily
  • Max: 160/25 mg once daily
  • Titrate dose at intervals of 2 - 4 weeks
YES/$$ FOOD
  • May take without regard to food

OTHER
  • Do not remove from blister pack until ready to take

  • COMBINATION PRODUCTS WITH AMLODIPINE

Drug Dosage form Dosing Generic/Price Food/Other
Azor®

amlodipine + olmesartan
Amlodipine - Olmesartan
  • 5 mg - 20 mg
  • 5 mg - 40 mg
  • 10 mg - 20 mg
  • 10 mg - 40 mg
Hypertension
  • Starting: 5 mg/20 mg once daily
  • Maintenance: 5 mg/20 mg - 10 mg/40 mg once daily
  • Max: 10 mg/40 mg once daily
  • Titrate dose at intervals of 1 - 2 weeks
YES/$-$$ FOOD
  • May take without regard to food

OTHER

Drug Dosage form Dosing Generic/Price Food/Other
Exforge®

amlodipine + valsartan
Amlodipine - Valsartan
  • 5 mg - 160 mg
  • 5 mg - 320 mg
  • 10 mg - 160 mg
  • 10 mg - 320 mg
Hypertension
  • Starting: 5 mg/160 mg once daily
  • Maintenance: 5 mg/160 mg - 10 mg/320 mg once daily
  • Max: 10 mg/320 mg once daily
  • Full antihypertensive effect typically seen within 2 weeks
YES/$ FOOD
  • May take without regard to food

OTHER

Drug Dosage form Dosing Generic/Price Food/Other
Twynsta®

amlodipine + telmisartan
Telmisartan - Amlodipine
  • 40 mg - 5 mg
  • 40 mg - 10 mg
  • 80 mg - 5 mg
  • 80 mg - 10 mg
Hypertension
  • Starting: 40 mg/5 mg once daily
  • Maintenance: 40 mg/5 mg - 80 mg/10 mg once daily
  • Max: 80 mg/10 mg once daily
  • Most of the antihypertensive effect is typically seen within 2 weeks
YES/$$-$$$ FOOD
  • May take without regard to food

OTHER

  • THREE-DRUG PRODUCTS

Drug Dosage form Dosing Generic/Price Food/Other
Exforge HCT®

amlodipine + valsartan + HCTZ
Amlodipine - Valsartan - HCTZ
  • 5 mg - 160 mg - 12.5 mg
  • 5 mg - 160 mg - 25 mg
  • 10 mg - 160 mg - 12.5 mg
  • 10 mg - 160 mg - 25 mg
  • 10 mg - 320 mg - 25 mg
Hypertension
  • Starting: 5/160/12.5 once daily
  • Maintenance: 5/160/12.5 mg - 10/320/25 mg once daily
  • Max: 10/320/25 mg once daily
  • Titrate dose at intervals of 2 weeks
  • Full antihypertensive effect is seen after 2 weeks
YES/$$-$$$ FOOD
  • May take without regard to food

OTHER

Drug Dosage form Dosing Generic/Price Food/Other
Tribenzor®

amlodipine + olmesartan + HCTZ
Amlodipine - Olmesartan - HCTZ
  • 5 mg - 20 mg - 12.5 mg
  • 5 mg - 40 mg - 12.5 mg
  • 5 mg - 40 mg - 25 mg
  • 10 mg - 40 mg - 12.5 mg
  • 10 mg - 40 mg - 25 mg
Hypertension
  • Starting: 5/20/12.5 mg once daily
  • Maintenance: 5/20/12.5 mg - 10/40/25 mg once daily
  • Max: 10/40/25 mg once daily
  • Titrate dose at intervals of 2 weeks
YES/$$-$$$ FOOD
  • May take without regard to food

OTHER

  • ENTRESTO

Drug Dosage form Dosing Generic/Price Food/Other
Entresto®

sacubitril + valsartan
Sacubitril - Valsartan
  • 24 mg - 26 mg
  • 49 mg - 51 mg
  • 97 mg - 103 mg
Heart failure
  • Patients currently taking an ACE or ARB at standard doses
    • Starting: 49 mg/51 mg twice a day
    • Target: 97 mg/103 mg twice a day
    • Double starting dose after 2 - 4 weeks to reach target dose
    • Allow 36 hours to pass after the last dose of an ACE inhibitor before starting Entresto

  • Patients not currently taking an ACE or ARB or previously taking low doses of these agents
    • Starting: 24 mg/26 mg twice a day
    • Target: 97 mg/103 mg twice a day
    • Double dose every 2 - 4 weeks to reach target dose
    • Allow 36 hours to pass after the last dose of an ACE inhibitor before starting Entresto
NO/$$$$ FOOD
  • May take without regard to food

OTHER
  • According to the manufacturer, the valsartan in Entresto is more bioavailable than the valsartan in other marketed tablet formulations; 26 mg, 51 mg, and 103 mg of valsartan in Entresto is equivalent to 40 mg, 80 mg, and 160 mg of valsartan in other marketed tablet formulations, respectively
  • See Entresto for more