- Side Effects
- Generic & Brand Names
- Types of ARBs
- Drug Interactions
- Precautions & Warnings
What are angiotensin receptor blockers (ARBs? How do they work (mechanism of action)?
Angiotensin II is a very potent chemical formed in the blood that causes muscles surrounding blood vessels to contract, thereby narrowing the vessels. This narrowing increases the pressure within the vessels and can cause high blood pressure (hypertension).
Angiotensin II receptor blockers (ARBs) are medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on the muscles surrounding blood vessels. As a result, blood vessels enlarge (dilate), and blood pressure is reduced. Reduced blood pressure makes it easier for the heart to pump blood and can improve heart failure.
In addition, the progression of kidney disease caused by high blood pressure or diabetes is slowed. ARBs have effects that are similar to angiotensin-converting enzyme (ACE) inhibitors, but ACE inhibitors act by preventing the formation of angiotensin II rather than by blocking the binding of angiotensin II to muscles on blood vessels.
What are the uses for ARBs?
- ARBs are used for controlling high blood pressure, treating heart failure, and preventing kidney failure in people with diabetes or high blood pressure.
- ARBs also may prevent diabetes and reduce the risk of stroke in patients with high blood pressure and an enlarged heart.
- ARBs also may prevent the recurrence of atrial fibrillation.
Since ARB medications have effects that are similar to those of ACE inhibitors, they often are used when ACE inhibitors are not tolerated by patients (for example, due to excessive coughing).
What are the side effects of ARBs?
ARBs are well tolerated by most people. The most common side effects are:
- elevated potassium levels in the blood (hyperkalemia),
- low blood pressure,
- abnormal taste sensation (metallic or salty taste),
- orthostatic hypotension (low blood pressure upon standing),
- increased blood glucose levels,
- flu-like symptoms,
- sinusitis (sinus infection),
- bronchitis, and
- upper respiratory tract infections.
Compared to ACE inhibitors, cough occurs less often with ARBs.
Serious side effects of ARBs
- The most serious, but rare, side effects are
- kidney failure,
- liver failure (hepatitis),
- serious allergic reactions,
- a decrease in white blood cells,
- a decrease in blood platelets, and
- swelling of tissues (angioedema).
- There have been reports of rhabdomyolysis (destruction of skeletal muscle) in patients receiving ARBs.
- Individuals who have a narrowing of both arteries that supply the kidneys or have had a severe reaction to ARBs should avoid them.
- Like other antihypertensives, ARBs have been associated with sexual dysfunction.
List of generic and brand names for ARBs
The ARBs that are currently available are:
- azilsartan (Edarbi)
- candesartan (Atacand)
- eprosartan (Teveten)
- irbesartan (Avapro)
- telmisartan (Micardis)
- valsartan (Diovan, Prexxartan)
- losartan (Cozaar)
- olmesartan (Benicar)
- entresto (sacubitril/valsartan)
- byvalson (nebivolol/valsartan)
Are there any differences among the different types of ARBs?
ARBs are similar in actions and side effects. They differ in how they are eliminated from the body and the extent to which they are distributed throughout the body.
- Some ARBs need to be converted to an active form in the body before they can lower blood pressure. In addition, some ARBs are better at lowering blood pressure.
- In some studies, irbesartan (Avapro) and candesartan (Atacand) reduced blood pressure better than losartan (Cozaar).
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What drugs and supplements cause drug interactions with ARBs?
- ARBs have few interactions with other drugs.
- Since ARBs may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase potassium may result in excessive blood potassium levels and cardiac arrhythmias.
- ARBs may also increase the blood concentration of lithium (Eskalith, Lithobid) and lead to an increase in side effects from lithium.
- Rifampin (Rifadin) reduces the blood levels of losartan, and fluconazole (Diflucan) reduces the conversion of losartan to its active form. These effects could decrease the effects of losartan.
- ARBs should not be combined with ACE inhibitors because such combinations increase the risk of hypotension, hyperkalemia, and renal impairment.
- ARBs should not be combined with aliskiren (Tekturna) because such combinations increase the risk of kidney failure, excessive low blood pressure, and hyperkalemia.
Are ARBs safe to take if I'm pregnant or breastfeeding?
ARBs are not prescribed for women during pregnancy because they may cause a serious condition called oligohydramnios, which may result in injury and even death of the fetus.
Angiotensin II receptor blockers (ARBs) are a class of drugs prescribed to control blood pressure, treat heart failure, and prevent kidney failure in people with diabetes or high blood pressure. Examples of ARBs include candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis), valsartan (Diovan), losartan (Cozaar), and olmesartan (Benicar). Side effects, drug interactions, and patient safety information should be reviewed before taking any medication.
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Kidney (Renal) Failure
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Diabetes Symptoms in Women
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Type 2 Diabetes
Type 2 diabetes is a chronic condition that may be reversible with diet and lifestyle changes. Symptoms include excessive thirst, frequent urination, weight loss, fatigue, and an unusual odor to your urine. Most people don't know they have type 2 diabetes until they have a routine blood test. Treatment options include medications, a type 2 diabetes diet, and other lifestyle changes.
Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Things to Know About High Blood Pressure Treatment
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Diabetes Symptoms in Men
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Type 1 vs. Type 2 Diabetes: Differences
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Type 1 Diabetes (Symptoms, Causes, Diet, Treatment, Life Expectancy)
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Types of Diabetes Type 2 Medications
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and exercise. There are nine classes of drugs approved for the treatment of type 2 diabetes. Examples of type 2 oral diabetes medications include acarbose (Precose), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), and metformin (Glucophage). Side effects, drug interactions, warnings and precautions, dosage, and breastfeeding and pregnancy safety information should be reviewed prior to taking any medication.
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
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