Angiotensin II receptors blockers (ARBs) are a class of drugs used for the treatment of high blood pressure and heart failure. Angiotensin II causes constriction of blood vessels which can lead to an increase in blood pressure. It also stimulates the release of a chemical called aldosterone, which will cause the reabsorption of sodium and water in the body. This will also result in an increase in the blood pressure. ARBs will block these effects, lowering the blood pressure. The ARBs include candesartan (Atacand), olmesartan (Benicar), losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), telmisartan (Micardis) and eprosartan (Teveten). Many side effects are seen with these medications. Discuss any major concerns with a health care provider before starting therapy.
Hypotension
Hypotension may occur with the ARBs in many individuals. According to the "Drug Information Handbook," Diovan (valsartan) is associated with the highest frequency of hypotension in the general population; it occurs in up to 7 percent of individuals. In people with congestive heart failure (CHF), Atacand may cause hypotension in about 19 percent of users. Teveten and Benicar do not display this side effect. Orthostatic hypotension, a sudden drop in blood pressure upon rising from a sitting or lying position, may also be present with ARBs, particularly Avapro. Rise slowly when standing from a sitting or lying position to avoid possible falls and injuries. If you experience severe symptoms, inform your physician; perhaps you may require a change in therapy.
Hyperkalemia
ARBs have the potential to cause hyperkalemia, which is an increase in potassium levels in the body. ARBs cause sodium to be eliminated from the body in exchange for potassium. This may lead to an increase in potassium, seen more commonly with Atacand and Avapro. An increased risk of hyperkalemia is seen in higher doses of ARBs. If you experience fast or uneven heart beat, chest pain or muscle tightness or pain, discontinue the medication and seek immediate medical attention.
Dizziness
Dizziness is a common side effect seen with the administration of ARBs. The "Drug Information Handbook" reports that Avapro causes dizziness in about 10 percent of users, the highest of all ARBs. It may take some time until the drug adjusts to your body and you learn how it affects your normal function. Be careful driving or engaging in activities that require alertness.
Angioedema
Angioedema is an adverse reaction characterized by swelling of the mouth, lips, tongue and throat. This may occur rarely with the use of ARBs. However, it is life-threatening and requires emergency medical care.
References
- "Drug Information Handbook 15th Edition"; Charles F. Lacy, RPh, PharmD, FCSHP, Lora L. Armstrong, RPh, PharmD, BCPS. et al; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al; 2008
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