Angiotensin II receptor blockers (ARBs) are drugs that treat certain conditions affecting the heart and blood vessels as well as a kidney condition resulting from diabetes. People generally tolerate them well.
While the risk of side effects is low, they can still occur for some people. Some side effects can include experiencing headaches, drowsiness, and dizziness. Doctors do not recommend them for individuals who are pregnant or have high potassium levels or low blood pressure.
This article discusses ARBs, including conditions they treat, how they work, examples, dosages, contraindications, and side effects. It also answers some common questions.
- hypertension, which people also refer to as high blood pressure
- congestive heart failure, which refers to the inability of the heart to pump blood to the body adequately
- diabetic nephropathy, which is kidney damage stemming from issues with controlling diabetes — this goes on to harm the waste-filtering blood vessels in the kidneys
Additionally, the medications are a common alternative treatment for people who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors because of the side effect of a long-term, nonproductive cough.
Angiotensin II is a hormone that constricts blood vessels, an effect that narrows the space through which blood can flow and increases blood pressure. It can also stimulate water and salt retention, raising blood pressure further.
These medications block some receptors where angiotensin II binds, an effect that decreases the hormone’s actions. The blocked receptors involve AT1 receptors in the kidneys, heart, and blood vessels. Consequences of blocking the receptors include reduced blood pressure and prevention of damage to the kidneys and heart.
Some examples of angiotensin II receptor blockers and their brand name,
- azilsartan (Edarbi)
- eprosartan (Teveten)
- candesartan (Amias)
- olmesartan (Olmetec)
- telmisartan (Micardis)
- valsartan (Diovan)
- losartan (Cozaar)
- irbesartan (Aprovel)
The table below lists the
|Medication||Condition it treats||Initial dose||Maximum dose|
|high blood pressure||20 mg once daily||80 mg|
|high blood pressure||600 mg once daily||900 mg|
|high blood pressure||16 mg once daily||32 mg|
|heart failure||4–8 mg once daily||32 mg|
|high blood pressure||20 mg once daily||40 mg|
|high blood pressure||40 mg once daily||80 mg|
|reducing cardiovascular-related deaths in certain people||80 mg once daily||80 mg|
|high blood pressure||80–160 mg once daily||320 mg|
|heart failure||20 mg twice daily||160 mg twice daily|
|high blood pressure or stroke prevention or treating diabetic neuropathy or proteinuria (high protein levels in the urine)||50 mg once daily||100 mg|
|high blood pressure||150 mg once daily||300 mg|
|diabetic nephropathy||75 mg once daily||300 mg|
In some cases, doctors may not recommend ARBs. The contraindications, which are situations where using them is unsuitable,
- has high potassium
- has low blood pressure
- is pregnant
Generally, people tend to tolerate the medications well, with
- low blood pressure
- swelling under the skin
- low blood sugar
- high potassium levels
Below are answers to some commonly asked questions on the topic:
Are ARBs safe to take when pregnant?
They are not safe during pregnancy because they may lead to the following severe effects on the fetus:
- kidney conditions
- skull or bone deformities
- incomplete development of lung tissue
People who become pregnant or believe they have become pregnant when taking these medications need to discontinue them immediately. The only exception involves the necessity of taking them to save the life of the pregnant individual.
Do ARBs interact with other medications?
- high potassium
- low blood pressure
- acute kidney failure
Additionally, they can intensify the potassium-increasing effects of the following:
- potassium-sparing diuretics, drugs that increase urination without the loss of potassium, such as amiloride (Midamor)
- potassium supplements
- nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin)
What is the difference between ACE inhibitors and ARBs?
Both suppress the renin-angiotensin system, so they have similar uses. According to a
However, the two types of medications work in different ways. ARBs prevent angiotensin II from connecting to some of its receptors. In contrast,
Angiotensin II receptor blockers prevent angiotensin from reaching some of the sites it binds to in the kidneys, heart, and blood vessels. The results of this action lower blood pressure and help prevent damage to the heart and kidneys.
People generally tolerate them well, as the incidence of side effects is generally
However, they can worsen some conditions and interact negatively with certain drugs. For this reason, a person can consult their doctor about their health issues and all the medications they take.