angiotensin II receptor antagonist (ARB)

From Aaushi
Jump to navigation Jump to search

Indications

* No reduction in mortality.[8]

# only candesartan shown to have beneficial effects[4]

Contraindications

* 8% of patients with angioedema from ACE inhibitor will experience angioedema with ARB[7]

Monitor

* hold ARB if serum potassium >= 5.5 meq/L

* cut dose of ARB in 1/2 or hold if serum creatinine increases by > 30%[21][24]

  • monitor with ARBs

Adverse effects

* nitrosamines NDEA & NMBA found in certain lots of losartan & valsartan (2018)

* FDA list nitrosamine-free ARBs[31]

Drug interactions

Laboratory

Mechanism of action

More general terms

More specific terms

Additional terms

Component of

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, Update 9/99
  2. 2.0 2.1 2.2 Prescriber's Letter 9(4):19 2002
  3. 3.0 3.1 Prescriber's Letter 9(11):61 2002
  4. 4.0 4.1 4.2 Journal Watch 23(4):34, 2003 Tronvik E et al, JAMA 289:65, 2003
  5. Prescriber's Letter 10(10):59 2003
  6. Journal Watch 23(21):165, 2003
  7. 7.0 7.1 7.2 Prescriber's Letter 11(7):37 2004
  8. 8.0 8.1 Journal Watch 24(23):173, 2004 Strippoli GF, Craig M, Deeks JJ, Schena FP, Craig JC. Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy: systematic review. BMJ. 2004 Oct 9;329(7470):828. Epub 2004 Sep 30. Review. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15459003 <Internet> http://bmj.bmjjournals.com/cgi/content/full/329/7470/828
  9. 9.0 9.1 9.2 Prescriber's Letter 12(6): 2005 Comparison of Outcomes Between Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210613&pb=PRL (subscription needed) http://www.prescribersletter.com
  10. 10.0 10.1 Prescriber's Letter 12(7): 2005 Evidence for Preventing Type 2 Diabetes Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210707&pb=PRL (subscription needed) http://www.prescribersletter.com
  11. 11.0 11.1 Demers C, McMurray JJ, Swedberg K, Pfeffer MA, Granger CB, Olofsson B, McKelvie RS, Ostergren J, Michelson EL, Johansson PA, Wang D, Yusuf S; CHARM Investigators. Impact of candesartan on nonfatal myocardial infarction and cardiovascular death in patients with heart failure. JAMA. 2005 Oct 12;294(14):1794-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16219883
    McDonald MA, Simpson SH, Ezekowitz JA, Gyenes G, Tsuyuki RT. Angiotensin receptor blockers and risk of myocardial infarction: systematic review. BMJ. 2005 Oct 15;331(7521):873. Epub 2005 Sep 23. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16183653
  12. 12.0 12.1 Casas JP, Chua W, Loukogeorgakis S, Vallance P, Smeeth L, Hingorani AD, MacAllister RJ. Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis. Lancet. 2005 Dec 10;366(9502):2026-33. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16338452
  13. 13.0 13.1 FDA Medwatch http://www.fda.gov/medwatch/safety/2006/safety06.htm#Angiotensin
  14. 14.0 14.1 Li NC et al Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis BMJ 2010;340:b5465 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20068258 <Internet> http://www.bmj.com/cgi/content/full/340/jan12_1/b5465
  15. Prescriber's Letter Comparison of Angiotensin Receptor Blockers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210613&pb=PRL (subscription needed) http://www.prescribersletter.com
    Prescriber's Letter 17(3): 2010 CHART: Comparison of Angiotensin Receptor Blockers CHART: Angiotensin Receptor Blocker (ARB) Antihypertensive Dose Comparison CHART: Target Doses of Heart Failure Medications Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260301&pb=PRL (subscription needed) http://www.prescribersletter.com
  16. 16.0 16.1 Sipahi I et al Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials Lancet Oncol. 2010 Jul;11(7):627-36. Epub 2010 Jun 11. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20542468 doi:10.1016/S1470-2045(10)70106-6 http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2810%2970106-6/abstract
    FDA MedWatch, 07/15/2010 Angiotensin Receptor Blockers (ARBs): Ongoing Safety Review for Cancer Risk http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm219185.htm
    FDA Drug Safety Communication: 06/02/2011 No increase in risk of cancer with certain blood pressure drugs- Angiotensin Receptor Blockers (ARBs) http://www.fda.gov/Drugs/DrugSafety/ucm257516.htm
    Bhaskaran K et al. Angiotensin receptor blockers and risk of cancer: Cohort study among people receiving antihypertensive drugs in UK General Practice Research Database. BMJ 2012 Apr 24; 344:e2697 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22531797
  17. Prescriber's Letter 18(4): 2011 Comparison of Angiotensin Receptor Blockers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=270403&pb=PRL (subscription needed) http://www.prescribersletter.com
  18. 18.0 18.1 Rim MY et al. The effect of renin-angiotensin-aldosterone system blockade on contrast-induced acute kidney injury: A propensity-matched study. Am J Kidney Dis 2012 Oct; 60:576. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22658321
  19. 19.0 19.1 Hajjar I et al Effect of antihypertensive therapy on cognitive function in early executive cognitive impairment: a double-blind randomized clinical trial. Arch Intern Med. 2012 Mar 12;172(5):442-4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22412114
  20. Taylor AA, Siragy H, Nesbitt S. Angiotensin receptor blockers: pharmacology, efficacy, and safety. J Clin Hypertens (Greenwich). 2011 Sep;13(9):677-86. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21896150
  21. 21.0 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2021.
  22. 22.0 22.1 22.2 Deprecated Reference
  23. 23.0 23.1 23.2 23.3 23.4 Cheng J, Zhang W, Zhang X et al Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on All-Cause Mortality, Cardiovascular Deaths, and Cardiovascular Events in Patients With Diabetes MellitusA Meta-analysis. JAMA Intern Med. Published online March 31, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24687000 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1847572
  24. 24.0 24.1 Prescriber's Letter 21(6): 2014 Safe Use of ACE Inhibitors or ARBs Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=300618&pb=PRL (subscription needed) http://www.prescribersletter.com
  25. 25.0 25.1 Yang JH et al Angiotensin receptor blocker in patients with ST segment elevation myocardial infarction with preserved left ventricular systolic function: prospective cohort study. BMJ 2014;349:g6650 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25398372 <Internet> http://www.bmj.com/content/349/bmj.g6650
  26. 26.0 26.1 Heran BS, Musini VM, Bassett K, Taylor RS, Wright JM Angiotensin receptor blockers for heart failure. Cochrane Database Syst Rev. 2012 Apr 18;4:CD003040 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22513909
  27. 27.0 27.1 Yoon HE1, Ghee JY, Piao S et al Angiotensin II blockade upregulates the expression of Klotho, the anti-ageing gene, in an experimental model of chronic cyclosporine nephropathy. Nephrol Dial Transplant. 2011 Mar;26(3):800-13 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20813770
  28. 28.0 28.1 Bullo M, Tschumi S, Bucher BS et al Pregnancy outcome following exposure to angiotennists: a systematic review. Hypertension. 2012 Aug;60(2):444-50. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22753220 Free Article
  29. 29.0 29.1 29.2 Schmidt M et al Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study. BMJ 2017;356:j791 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28279964 Free full text <Internet> http://www.bmj.com/content/356/bmj.j791
  30. 30.0 30.1 Leclerc J, Blais C, Rochette L, Hamel D, Guenette L, Poirier P. Impact of the Commercialization of Three Generic Angiotensin II Receptor Blockers on Adverse Events in Quebec, Canada. A Population-Based Time Series Analysis. Circulation: Cardiovascular Quality and Outcomes. 2017; 10:e003891. Published October 3, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28974512 <Internet> http://circoutcomes.ahajournals.org/content/10/10/e003891
    Alter DA When Do We Decide That Generic and Brand-Name Drugs Are Clinically Equivalent? Perfecting Decisions With Imperfect Evidence. Circulation: Cardiovascular Quality and Outcomes. 2017; 10:e004158. Published October 3, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28974513 <Internet> http://circoutcomes.ahajournals.org/content/10/10/e004158
  31. 31.0 31.1 FDA Statement. April 4, 2019 Statement from FDA Commissioner Scott Gottlieb, M.D., and Janet Woodcock, M.D., director of the Center for Drug Evaluation and Research on the agency's list of known nitrosamine-free valsartan and ARB class medicines, as part of agency's ongoing efforts to resolve ongoing safety issue. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm635251.htm
    FDA Drug Safety and Availability. FDA's Assessment of Currently Marketed ARB drug product. https://www.fda.gov/Drugs/DrugSafety/ucm634620.htm
  32. 32.0 32.1 Nelson R Antihypertensives Linked to Reduced Risk of Colorectal Cancer Medscape - Jul 06, 2020. https://www.medscape.com/viewarticle/933438
    Cheung KS, Chan EW, Seto WK et al ACE (Angiotensin-Converting Enzyme) Inhibitors/Angiotensin Receptor Blockers Are Associated With Lower Colorectal Cancer Risk. Hypertension. July 6, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32623923 https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15317
  33. 33.0 33.1 Pass W Memory benefit seen with antihypertensives crossing blood-brain barrier. Internal Medicine News. 2021. June 21. https://www.mdedge.com/internalmedicine/article/241878/neurology/memory-benefit-seen-antihypertensives-crossing-blood-brain
  34. 34.0 34.1 Chen R, Suchard MA, Krumholz HM et al. Comparative first-line effectiveness and safety of ACE (angiotensin- converting enzyme) inhibitors and angiotensin receptor blockers: A multinational cohort study. Hypertension 2021 Sep; 78:591. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34304580 PMCID: PMC8363588 (available on 2022-09-01) https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16667