Also known as: ARBs, sartans, angiotensin II receptor antagonists
Medicines ending in -sartan that block the receptor angiotensin II acts on. They do the same job as ACE inhibitors without the cough, and are the usual alternative when an ACE inhibitor is not tolerated.
ARBs, sartans, angiotensin II receptor antagonists
Mechanism of action
Angiotensin II raises blood pressure by binding AT1 receptors on arterial muscle, the adrenal cortex and heart muscle. ARBs occupy those receptors so the hormone cannot act: arteries relax, aldosterone falls and the heart and kidneys are spared its growth-promoting effects. Because ACE is untouched, bradykinin is not raised and cough and angio-oedema are rare.
Monitor kidney function and potassium after starting and after dose changes
Class warnings
Kidney function and potassium are monitored as for ACE inhibitors; contraindicated in pregnancy; not combined with an ACE inhibitor or, in diabetes, with aliskiren. UK
Class interactions
With
Effect
Source
NSAIDs
Reduced antihypertensive effect and increased risk of acute kidney injury and hyperkalaemia.
Therapeutic duplication. An ARB with another ARB or with an ACE inhibitor duplicates renin-angiotensin blockade; UK guidance advises against combining them for hypertension. UK
Educational content. A drug class page describes what a family of medicines has in common. Individual medicines differ in dose, licensing and interactions; treatment choices belong to a prescriber.
