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Angiotensin II receptor blockers

Angiotensin II receptor blockers are medications that are prescribed to treat high blood pressure, often when other drugs have caused problematic side effects.

  1. Prescribed to treat hypertension
  2. Also known as ARBs
  3. May be combined with other treatments

If you have any concerns about your blood pressure levels, you can speak with one of our registered clinicians via our online video consultation service, from 9.30am-4.30pm, five days a week. 

Angiotensin II receptor blockers
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Product information

What are angiotensin II receptor blockers?

ARBs are prescribed to treat hypertension, also known as high blood pressure. These drugs are primarily given to people who have issues tolerating other hypertension medications, such as ACE inhibitors. Some of the most commonly prescribed ARB medications include valsartan, candesartan, irbesartan and losartan. 

Hypertension is a condition that rarely presents with any symptoms, and so many people are unaware that they have it. Estimates suggest that as many as a third of adults in the UK have high blood pressure, making it one of the most common conditions in the country. While hypertension itself is not thought to present any direct health risks, it can lead to serious health events, such as vascular dementia, kidney disease, heart attacks and strokes.

How is hypertension diagnosed?

Tests for hypertension are quick, painless and available at your doctor’s surgery. Some pharmacies and workplaces may also offer it for free. The test measures two numbers, the force with which blood is propelled around the body (systolic pressure) and the resistance within the body’s arteries to this force (diastolic pressure). Healthy numbers for these pressures should 

measure between 90/60mmHg and 120/80mmHg. Hypertension is diagnosed when these numbers reach beyond 140/90mmHg (150/90mmHg if you are over 80 years of age). If you are over the age of 40, you should be tested at least every five years.

What causes hypertension?

The causes of hypertension are varied, and it is difficult to pinpoint one trigger, as it is likely a combination of risk factors contribute. The chances of it occurring increases greatly with age, hence why regular check-ups over the age of 40 are essential. Genetics are thought to be another major factor, and people with an African or Caribbean ethnic background are more likely to have the condition, as well as people who have family members with it. Lifestyle is arguably the most important factor, with high levels of salt, being overweight, a lack of exercise, consuming large amounts of alcohol regularly and prolonged poor sleep all shown to have a great effect on blood pressure.

Underlying health conditions may also play a major role in hypertension, although they are thought to make up only around 5% of cases. These may include diabetes, kidney conditions, narrowing arteries, hormonal issues and lupus. If you are taking the following medications, the risks of hypertension are also greatly increased: the contraceptive pill, steroids, NSAIDs (non-steroidal anti-inflammatory drugs), herbal remedies containing liquorice, amphetamines and selective serotonin reuptake inhibitors (SSRIs). If you experience any of these conditions or are taking any of these medications, you should have your blood pressure checked regularly to ensure that it remains under control, regardless of you age.

How is hypertension managed?

Many people can address hypertension by making lifestyle changes, such as taking regular exercise, quitting smoking, cutting down on alcohol, lowering salt intake to below 6g a day, losing weight and/or consuming less caffeine. 

If lifestyle changes don’t help to regulate hypertension, medications may be prescribed. In some cases, this can include a combination of drugs. People under the age of 55 are likely to be offered ACE inhibitors in the first instance, although they may not be suitable in all cases due to their side effects. In these circumstances, ARBs are prescribed.

If you are over the age of 55 or from an African or Caribbean background, you may be prescribed calcium channel blockers. Diuretics and beta blockers are other medications that may be issued for hypertension.

Our GMC-registered clinicians can issue advice about hypertension via our online video consultation service. They are available for consultation between 9.30am-4.30pm, Monday to Friday, and can also provide fit notes and referrals to specialists for treatment, where suitable.   

Page last reviewed:  22/06/2020
Side effects and warnings

What side effects can ARBs have?

If you experience the following side effects you should seek immediate medical attention, as it may be a sign of an allergic reaction: difficulty breathing, swelling of the face, lips, tongue and/or throat, difficulty swallowing and severe itching of the skin.

Common (affects up to 1 in 10 users): dizziness, headache, respiratory infection, low blood pressure and changes in blood test results.

Very rare (affects up to 1 in 10,000 users): swelling of the face, lips, tongue and/or throat, a reduced red or white blood cell count, an infection or fever, rashes, itching, back pain, pain in joints and muscles, changes in how your liver is working, yellowing of skin and the whites of eyes, flu like symptoms, nausea, changes in blood test results, coughing and reduced amount of sodium in your blood.

Are ARBs suitable for everyone?

Certain medications and conditions make treatment with ARBs unsuitable. It is therefore essential that you inform your doctor of any treatments or ailments you are currently, or have previously, suffered from before starting treatment. The following conditions make ARBs unsuitable for use: Allergies to any of the medication’s ingredients, pregnancy, severe liver disease or biliary obstruction, being under the age of one, diabetes or impaired kidney function while being treated with aliskiren.

Should I inform my doctor if I am taking any other medications?

You should discuss with your doctor if you are currently taking any of the following medications: other medicines that help to lower your blood pressure, including beta-blockers, diazoxide and ACE inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin (if you are taking more than 3g each day), Potassium supplements or salt substitutes containing potassium, heparin, diuretics or lithium.

Page last reviewed:  22/06/2020
Questions and Answers

Is it safe to take ARBs during pregnancy? 

This medication should not be taken beyond the first three months of pregnancy, and is not recommended for use at any point during your pregnancy. If you are pregnant, planning on becoming pregnant or suspect you may be pregnant, you should inform your doctor before starting treatment so that a suitable alternative can be identified.

What are the most common forms of ARBs?

There are many forms of ARBs, most of which have the same functionality but with slight differences in how quickly they take effect, or their half-life (how long the drug stays in the system). Some of the most commonly prescribed examples in the UK include candesartan, irbesartan, losartan and valsartan. 

Are there any common allergens in ARBs?

Some ARB tablets contain lactose. If you have an intolerance to or are allergic to lactose, you should inform your doctor before starting treatment.

Can I consume alcohol whilst talking ARBs?

Consuming alcohol during treatment with ARBs may cause moderate to severe dizziness, and should be avoided.

Will my ability to drive be impaired with ARBs? 

This treatment can result in you feeling fatigued or dizzy, so it is essential that you fully understand how it affects you before operating any heavy machinery.

Can I buy angiotensin II receptor blockers over the counter?

No. They are available via prescription only. 

How can I buy angiotensin II receptor blockers online?

You can book a consultation with one of our GPhC-registered clinicians about angiotensin II receptor blockers via our online video service, between 9.30am-4.30pm, Monday to Friday. Our registered clinicians can also provide fit notes and referral to specialists for treatment, where suitable. 

Page last reviewed:  22/06/2020

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