drug interaction(s) of ACE inhibitors with angiotensin II receptor antagonists
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Drug interactions
- ARBs potentiate adverse effects of ACE inhibitors:[1]
- symptomatic hypotension
- renal failure
- hyperkalemia
- combining ACE inhibitor with ARB does not improve outcomes[2][5][6]
- addition of ARB to ACE inhibitor + beta-blocker worsens outcomes in patients with systolic heart failure[7]
- combination results in small increase in risk of cancer (14%)[3]
Management
- ARB as effective as ACE inhibitor in management of patients at high risk for cardiovascular events[2]
More general terms
References
- ↑ 1.0 1.1 Phillips CO, Kashani A, Ko DK, Francis G, Krumholz HM. Adverse effects of combination angiotensin II receptor blockers plus angiotensin-converting enzyme inhibitors for left ventricular dysfunction: a quantitative review of data from randomized clinical trials. Arch Intern Med. 2007 Oct 8;167(18):1930-6. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17923591
- ↑ 2.0 2.1 2.2 Yusuf S et al for the ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008, 358:1547 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18378520
- ↑ 3.0 3.1 Bangalore S et al Antihypertensive drugs and risk of cancer: network meta- analyses and trial sequential analyses of 324 168 participants from randomised trials The Lancet Oncology, Early Online Publication, 30 November 2010 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21123111 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(10)70260-6/fulltext
- ↑ Makani H et al Efficacy and safety of dual blockade of the renin-angiotensin system: meta-analysis of randomised trials. BMJ 2013;346:f360 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23358488 <Internet> http://www.bmj.com/content/346/bmj.f360
- ↑ 5.0 5.1 Fernandez Juarez G et al. Effect of dual blockade of the renin-angiotensin system on the progression of type 2 diabetic nephropathy: A randomized trial. Am J Kidney Dis 2013 Feb; 61:211 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22939518
- ↑ 6.0 6.1 Fried LF et al Combined Angiotensin Inhibition for the Treatment of Diabetic Nephropathy. N Engl J Med. 2013 Nov 9. [Epub ahead of print] PMID: https://www.ncbi.nlm.nih.gov/pubmed/24206457
de Zeeuw D. The End of Dual Therapy with Renin-Angiotensin-Aldosterone System Blockade? N Engl J Med. 2013 Nov 9. [Epub ahead of print] PMID: https://www.ncbi.nlm.nih.gov/pubmed/24206456 - ↑ 7.0 7.1 Prescriber's Letter 10(5):26 2003