191 - The Ultimate Guide to ARBs: An In-depth Drug Class Review

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 23 June 2025

⏱️ 33 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we review the pharmacology, indications, adverse effects, monitoring, and unique drug characteristics of angiotensin receptor blockers (ARBs).

Key Concepts

ARBs are equally efficacious as ACE inhibitors when used for hypertension, heart failure with reduced ejection fraction (HFrEF), chronic kidney disease (CKD) with proteinuria, and post-MI care. Some limited evidence suggests that they might be better in reducing albuminuria in patients with diabetes. ARBs are generally better tolerated than ACEi due to a lower risk of angioedema and dry cough.
While most ARBs are comparable to each other, small differences exists regarding hepatic metabolism (CYP metabolism for losartan, telmisartan, and azilsartan), degree of blood pressure lowering (generally better with azilsartan, olmesartan, valsartan, and candesartan), and additional pharmacological effects (telmisartan with PPAR-Y agonism, losartan with uricosuric effect).
ARBs are contraindicated in pregnancy, those with bilateral renal artery stenosis, and those with previous angioedema to ARBs. The most common adverse effects include hypotension and hyperkalemia, but in rare cases acute renal impairment can also occur.
Baseline serum creatinine and potassium should be monitored in patients taking ARBs. After initiation or dose adjustment, blood pressure, serum creatinine, and potassium should be repeated in 1-2 weeks. Signs and symptoms of hypotension as well as angioedema should be monitored throughout the treatment period.

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show.
0:31.1	Welcome to Helix Talk, episode 191. I'm your co-host, Dr. Kane. And I'm Dr. Patel. So in today's episode, title,
0:39.0	the ultimate guide to ARB's, Angiotensin Receptor Blockers, an in-depth drug class review.
0:45.8	We are going to review the drug class, the angiotensin receptor blockers, to kind of discuss
0:52.3	its pharmacology, indication, safety profile, monitoring,
0:57.1	and anything that's really unique about them, clinical evidence, you know, etc.
1:01.8	And Dr. Patel, we've done a number of these episodes historically where we talk about, you know,
1:06.5	what is the difference between inseds or beta blockers within the drug class?
1:10.4	And we're doing that today with ARBs in terms of what ARBs are out there on the market.
1:14.7	What do we need to know about them?
1:16.3	What makes them similar and different?
1:18.2	It's a great episode even for that beginning learner in pharmacy school, just starting to
1:22.5	learn about the top 200 drugs, or even that experienced clinician where maybe you hear the
1:27.3	term Darby and you know it's an ARB, but you don't know that much about it. drug or even that experienced clinician where maybe you hear the term
1:27.8	Darby and you know it's an R but you don't know that much about it and what's its claim to
1:32.2	fame and that's you know what we'll be talking about today. Yeah I think first and foremost
1:36.7	it's important to just go over some brand generics and what different agents are available
1:41.9	in this category. If you are listening brand name versus generic, the generics end in sarton.
	...

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