Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
TEVETEN vs AZILSARTAN MEDOXOMIL
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Selective angiotensin II receptor type 1 (AT1) antagonist, blocking the vasoconstrictor and aldosterone-secreting effects of angiotensin II.
Angiotensin II receptor blocker (ARB) that selectively inhibits angiotensin II binding to AT1 receptors, reducing vasoconstriction, aldosterone secretion, and sympathetic activity.
Hypertension,Treatment of hypertension (alone or in combination with other antihypertensive agents)
Treatment of hypertension (FDA-approved),Off-label: heart failure, diabetic nephropathy
400-800 mg orally once daily; can be divided twice daily if needed for adequate blood pressure control.
40 mg orally once daily. May increase to 80 mg once daily if needed.
Terminal elimination half-life is approximately 7-8 hours in patients with normal renal function, supporting once-daily dosing.
Terminal half-life approximately 11 hours; supports once-daily dosing with sustained antihypertensive effect over 24 hours.
Primarily metabolized by glucuronidation (UGT1A3, UGT2B7); minimal CYP450 metabolism.
Primarily metabolized by CYP2C9 to inactive metabolites; also undergoes esterase-mediated hydrolysis to azilsartan.
Renal (approximately 60% as unchanged drug) and biliary/fecal (approximately 40%).
Biliary/fecal (55% unchanged), renal (42% as inactive metabolites, <1% unchanged)
Approximately 99% bound to plasma proteins, primarily albumin.
High (>99%) to serum albumin.
Approximately 0.3 L/kg, indicating distribution mainly in extracellular fluid.
Vd of about 16 L (0.23 L/kg for a 70 kg individual); indicates limited extravascular distribution.
Oral: approximately 15-20% due to extensive first-pass metabolism; absorption is not significantly affected by food.
Oral bioavailability approximately 60% under fed conditions (food reduces absorption); absolute bioavailability not determined in humans.
Cr Cl 30-59 m L/min: no adjustment; Cr Cl <30 m L/min: 200-400 mg once daily; hemodialysis: not studied, use with caution.
No dose adjustment required for GFR ≥15 m L/min/1.73 m². Not recommended for GFR <15 m L/min/1.73 m² due to lack of data.
No adjustment required for mild to moderate impairment; not studied in severe impairment (Child-Pugh C).
No dose adjustment required for mild to moderate hepatic impairment (Child-Pugh A and B). Not recommended for severe hepatic impairment (Child-Pugh C) due to lack of data.
Safety and efficacy not established in pediatric patients <18 years.
Not approved for use in pediatric patients (safety and efficacy not established).
No specific adjustment needed, but start at lower end of dosing range (400 mg once daily) due to potential renal impairment and increased sensitivity.
No specific dose adjustment recommended; initiate at 40 mg once daily. Monitor renal function and blood pressure carefully due to increased sensitivity.
None
none
Avoid use in pregnancy (fetal toxicity/neonatal morbidity/mortality),Hypotension in volume-depleted patients (e.g., diuretic therapy, dialysis),Hyperkalemia in patients with renal impairment or potassium-sparing diuretics/supplements,Acute renal failure in patients with bilateral renal artery stenosis or solitary kidney,Monitor renal function and serum potassium periodically
Fetal toxicity: avoid use in pregnancy,Hypotension in volume-depleted patients,Renal impairment: monitor renal function,Hyperkalemia: monitor potassium levels
Concomitant use with aliskiren in patients with diabetes mellitus (type 2) or moderate to severe renal impairment (e GFR <60 m L/min/1.73 m²),Hypersensitivity to eprosartan or any component,Pregnancy (especially second and third trimesters)
Pregnancy (second and third trimesters),Concomitant use with aliskiren in patients with diabetes or renal impairment (e GFR <60 m L/min)
No specific food interactions. Avoid excessive potassium intake (e.g., potassium-rich foods like bananas, oranges, tomatoes, spinach) as TEVETEN may increase serum potassium. No restrictions with alcohol, but limit intake as it may lower blood pressure and increase side effects. Grapefruit juice has no known interaction.
No significant food interactions; can be taken with or without food. Avoid excessive potassium intake from high-potassium foods (e.g., bananas, oranges, spinach, potatoes) or potassium-containing salt substitutes. Limit alcohol intake as it may increase blood pressure or cause dizziness.
Drugs acting directly on the renin-angiotensin system (RAS) can cause fetal and neonatal morbidity and death when used in pregnancy. First-trimester exposure is associated with a low risk of congenital anomalies, but second- and third-trimester exposure is associated with oligohydramnios, fetal renal dysfunction, skull ossification defects, and neonatal hypotension, anuria, and renal failure. TEVETEN (eprosartan mesylate) is an angiotensin II receptor blocker, and its use is contraindicated in pregnancy, especially during the second and third trimesters.
First trimester: Limited human data; animal studies show no teratogenicity. Second and third trimesters: Drugs acting directly on the renin-angiotensin system can cause fetal oligohydramnios, fetal renal dysfunction, skull ossification defects, and neonatal anuria, hypotension, and death.
Eprosartan is excreted in rat milk at concentrations approximately 2.4 times higher than maternal plasma. No data exist on its excretion in human breast milk. Due to the potential for adverse effects in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. The M/P ratio in humans is unknown.
No data on presence in human milk. Manufacturer recommends discontinuing breastfeeding or drug due to potential risk. M/P ratio unknown.
TEVETEN is contraindicated in pregnancy, and no dose adjustments are recommended because the drug should not be used. If pregnancy is detected, discontinue the drug as soon as possible. Pharmacokinetic changes in pregnancy, such as increased plasma volume, may alter the drug's effect, but use is not advised.
No dose adjustments during pregnancy; however, use is contraindicated in second and third trimesters due to fetal toxicity. If exposure occurs, discontinue as soon as possible.
TEVETEN (eprosartan mesylate) is an angiotensin II receptor blocker (ARB) with a high affinity for the AT1 receptor. It has a dose-dependent antihypertensive effect. Avoid use in pregnancy; discontinue as soon as pregnancy is detected. Monitor renal function and serum potassium in patients with renal impairment, diabetes, or those on potassium-sparing diuretics. May cause angioedema, though rare. Use with caution in patients with unilateral or bilateral renal artery stenosis due to risk of acute renal failure.
Azilsartan medoxomil has the highest affinity for AT1 receptors among ARBs; may cause a rapid decrease in blood pressure in volume-depleted patients; avoid use in pregnancy (Category D); monitor renal function and serum potassium; less CYP450 interaction potential than losartan or irbesartan; can be taken without regard to meals; dose adjustment not required in mild-to-moderate hepatic impairment.
Take TEVETEN exactly as prescribed, usually once daily, with or without food.,Do not stop taking this medication without consulting your doctor, as it may worsen your condition.,Avoid becoming pregnant while on TEVETEN; use effective contraception and inform your doctor immediately if you think you are pregnant.,Report any signs of angioedema (swelling of face, lips, throat, difficulty breathing) or fainting to your doctor immediately.,Inform all healthcare providers that you are taking TEVETEN, especially before surgery or any procedure requiring anesthesia.,Stay hydrated, but do not use potassium supplements or salt substitutes containing potassium without medical advice.,Monitor your blood pressure regularly as directed and keep a log to share with your doctor.
Take once daily at the same time each day with or without food.,Avoid becoming dehydrated; drink adequate fluids unless directed otherwise.,Do not use if pregnant or planning to become pregnant; notify your doctor immediately if pregnancy occurs.,Do not take with aliskiren if you have diabetes or renal impairment.,Report any signs of angioedema (swelling of face, lips, tongue, difficulty breathing) or severe dizziness.,May cause dizziness, especially during first few days; avoid driving until you know how the medication affects you.,Avoid potassium supplements and salt substitutes containing potassium unless approved by your doctor.,Do not stop taking the medication without talking to your doctor.
No interactions on record
"The combination of azilsartan medoxomil, an angiotensin II receptor blocker (ARB), and fenbufen, a nonsteroidal anti-inflammatory drug (NSAID), can lead to a significant reduction in the antihypertensive and cardioprotective effects of azilsartan. NSAIDs inhibit cyclooxygenase enzymes, reducing prostaglandin synthesis, which diminishes the vasodilatory and natriuretic actions that support blood pressure control mediated by ARBs. This interaction may result in loss of blood pressure control, increased risk of renal impairment (especially in volume-depleted or elderly patients), and potential antagonism of the renal protective effects of ARBs in conditions like heart failure or chronic kidney disease."
"Oxprenolol, a non-selective beta-blocker, may attenuate the compensatory sympathetic response to Azilsartan medoxomil-induced hypotension, potentially leading to an excessive drop in blood pressure. This combination can also result in reduced cardiac output due to additive negative chronotropic effects, increasing the risk of bradycardia and heart block. Clinically, patients may experience severe hypotension, dizziness, syncope, or exacerbated heart failure symptoms."
"The combination of timolol, a non-selective beta-blocker, with azilsartan medoxomil, an angiotensin II receptor blocker (ARB), may lead to an increased risk of hypotension, bradycardia, and additive antihypertensive effects. Timolol can antagonize the compensatory sympathetic response to azilsartan-induced vasodilation, potentially resulting in excessive blood pressure reduction. Additionally, both drugs can affect renal perfusion, raising the risk of renal impairment in susceptible patients."
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about TEVETEN vs AZILSARTAN MEDOXOMIL, answered by our medical review team.
TEVETEN is a Angiotensin II Receptor Blocker that works by Selective angiotensin II receptor type 1 (AT1) antagonist, blocking the vasoconstrictor and aldosterone-secreting effects of angiotensin II.. AZILSARTAN MEDOXOMIL is a Angiotensin II Receptor Blocker that works by Angiotensin II receptor blocker (ARB) that selectively inhibits angiotensin II binding to AT1 receptors, reducing vasoconstriction, aldosterone secretion, and sympathetic activity.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between TEVETEN and AZILSARTAN MEDOXOMIL depend on the specific clinical indication. These are both Angiotensin II Receptor Blocker agents and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of TEVETEN is: 400-800 mg orally once daily; can be divided twice daily if needed for adequate blood pressure control.. The standard adult dose of AZILSARTAN MEDOXOMIL is: 40 mg orally once daily. May increase to 80 mg once daily if needed.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between TEVETEN and AZILSARTAN MEDOXOMIL in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. TEVETEN is classified as Category C. Drugs acting directly on the renin-angiotensin system (RAS) can cause fetal and neonatal morbidity and death when used in pregnancy. First-trimester exposure is associated with a l. AZILSARTAN MEDOXOMIL is classified as Category C. First trimester: Limited human data; animal studies show no teratogenicity. Second and third trimesters: Drugs acting directly on the renin-angiotensin system can cause fetal oligo. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.