These drugs, also called Angiotensin II receptor antagonists, inhibit the effects of angiotensin II, whereas ACE inhibitors block the formation of angiotensin II. In this way, it prevents the constriction of blood vessels and retention of salt and water, thereby lowering blood pressure.
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These drugs are also vasodilators that have many of the same features as the ACE inhibitors, and are also of particular value in patients with heart failure. The angiotensin II receptor blockers should also be avoided during pregnancy and in patients with high blood levels of potassium.
Unlike ACE inhibitors, these drugs do not cause an increase in bradykinin and do not produce a dry cough. It is quite a new drug and the beneficial effect on the cardiovascular risk of patients is not yet as clear.
A few Angiotensin II receptor blockers:
Losartan in Cozaar.
Irbesartan in Aprovel.
Telmisartan in Micardis.
Indications for use as anti-hypertensive drug:
ACE inhibitor cough.
Heart failure.
Safe for diabetic patients, and may have a protective effect on kidney, similar to ACE inhibitors.
Contraindications:
Pregnancy, or if planning to become pregnant.
Hyperkalaemia – high blood levels of potassium.
Bilateral renal artery stenosis – narrowing of the arteries supplying the kidneys, on both sides.
Possible side-effects:
Side-effects and allergic reactions are rare. This may lead to better adherence to treatment. One advantage over ACE inhibitors is that it does not cause a dry cough as side effect. (About 10 to 20 % of patients using ACE inhibitors may develop a dry hacking cough.)
Dizziness, headache, upper-respiratory and gastrointestinal disturbance can occur. Some patients experience a decrease in libido.
Possible drug interactions:
Similar to ACE inhibitors.
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