Angiotensin 2 Receptor Blocking Agent

Aka: Angiotensin 2 Receptor Blocking Agent, Angiotensin Receptor Blocker, Angiotensin Blocker, Losartan, Cozaar, Irbesartan, Avapro, Candesartan, Atacand, Eprosartan, Teveten, Telmisartan, Micardis, Valsartan, Diovan, Olmesartan, Benicar, Entresto, Exforge, Azor

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II. Indications

  1. Intolerance to ACE Inhibitor
  2. See ACE Inhibitor for indications

III. Contraindications

  1. See ACE Inhibitor for contraindications
  2. Angioedema with ACE Inhibitor (relative contraindication)
    1. Bradykinin related reaction that recurs with ARBs in 2% of patients who had Angioedema on ACE Inhibitor
    2. Do not use ARB if ACE Inhibitor induced Angioedema was severe
    3. Precautions given to patient to stop ARB immediately and seak emergency care for signs of Angioedema recurrence
    4. Wait at least 4 weeks between stopping ACE Inhibitor and starting ARB
    5. (2013) J Allergy Clin Immunol 131:1491-3 [PubMed]

IV. Mechanism

  1. Renin-Angiotensin System

V. Preparations: ARB alone

  1. Losartan (Cozaar)
    1. Start: 50 mg orally daily or 25 mg daily if volume depleted (MAX 100 mg/day)
    2. Consider twice daily divided dosing
  2. Irbesartan (Avapro)
    1. Start 150 mg orally daily (max 300 mg/day)
  3. Candesartan (Atacand)
    1. Start 8 mg orally daily (maximum 32 mg/day)
  4. Eprosartan (Teveten)
    1. Start 400 mg orally daily (maximum 800 mg/day)
  5. Telmisartan (Micardis)
    1. Start 40 mg orally daily (maximum 80 mg/day)
  6. Valsartan (Diovan)
    1. Start 80 mg orally daily (maximum 320 mg/day)
  7. Olmesartan (Benicar)
    1. Start 20 mg orally daily (maximum 40 mg/day)
  8. Azilsartan (Edarbi)
    1. Start 40 mg orally daily (maximum 80 mg/day)

VI. Preparations: Combination

  1. Amlodipine (and ARB)
    1. Exforge (Amlodipine and Valsartan)
    2. Azor (Amlodipine and Olmesartan)
  2. Hydrochlorothiazide (and ARB)
    1. Most ARB agents are available in combination with Hydrochlorothiazide (Hctz)
  3. Sacubitril and Valsartan (Entresto)
    1. Indicated in Systolic Dysfunction
    2. Sacubitril (neprilysin inhibitor) increases vasodilation and Sodium excretion
    3. Risk of Hypotension (Number needed to harm 21)
    4. Risk of Angioedema (Number needed to harm 200)
    5. See Systolic Dysfunction for dosing and references

VII. Protocol: Equivalent dosing (switching between agents)

  1. Losartan (Cozaar) 100 mg daily or divided twice daily
  2. Irbesartan (Avapro) 300 mg daily
  3. Candesartan (Atacand) 16 mg daily
  4. Eprosartan (Teveten) 800 mg daily
  5. Telmisartan (Micardis) 40 mg daily
  6. Valsartan (Diovan) 160 mg daily
  7. Olmesartan (Benicar) 20 mg daily
  8. Azilsartan (Edarbi) 40 mg daily

VIII. Efficacy

  1. Peak effect may require 4-6 weeks
  2. Proteinuria control is equivalent to ACE Inhibitors
    1. Kunz (2008) Ann Intern Med 148:30-48. [PubMed]
  3. Evidence as of 2015 shows similar efficacy of ARBs as ACE Inhibitors in Myocardial Infarction prevention
    1. (2016) Presc Lett 23(3): 13
  4. Avoid in combination with ACE Inhibitors
    1. No advantage to combinations in Hypertension, vascular disease, Diabetes Mellitus, Coronary Artery Disease
    2. Moderate benefit of combination therapy in Congestive Heart Failure
    3. (2013) Prescr Lett 20(3): 13
  5. Reduce cardiovascular death, Cerebrovascular Accident and Myocardial Infarction risk
    1. Higher level cardiovascular protection than Atenolol
      1. However Atenolol is not the best Beta Blocker for cardiovascular disease prevention
      2. Dahlof (2002) Lancet 359:995-1003 [PubMed]
    2. ARBs do not effect Angiotensin II type 2 receptors
      1. Results in less effect on fibrosis and blood flow
      2. Unlike ACE Inhibitors, ARBs don't effect nitric oxide
      3. (2005) Prescriber's Letter 12:31-2

IX. Adverse Effects

  1. Valsartan (Diovan), Irbesartan (Avapro) and Losartan (Cozaar)
    1. N-Nitrosodimethylamine (NMDA) or N-nitrosodiethylamine (NDEA) product contamination (FDA recall 2018)
      1. https://www.fda.gov/Drugs/DrugSafety/ucm613916.htm
      2. https://www.fda.gov/Safety/Recalls/ucm624593.htm
      3. https://www.fda.gov/Safety/Recalls/ucm625492.htm
      4. Product contamination may have been for as long as 4 years
      5. Cancer risk 1 in 8000 patients taking Valsartan for 8 years at 320 mg/day
      6. (2018) Presc Lett 25(9): 49
  2. Olmesartan (Benicar)
    1. Sprue-like Enteropathy
      1. Presents with progressive, severe Chronic Diarrhea, weight loss and sprue-like intestinal changes
      2. May be a delayed Hypersensitivity Reaction (typically months to years after starting Olmesartan)
      3. Rubio-Tapia (2012) Mayo Clin Proc 87(8):732-8 [PubMed]

X. References

  1. Burnier (2000) Lancet 355(9204):637-45 [PubMed]
  2. Califf (2000) Am Heart J 139:S15-22 [PubMed]
  3. Jacobsen (2001) Geriatrics 56(2):20-28 [PubMed]

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Cost: Medications

losartan (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
LOSARTAN POTASSIUM 100 MG TAB Generic $0.06 each
LOSARTAN POTASSIUM 25 MG TAB Generic $0.04 each
LOSARTAN POTASSIUM 50 MG TAB Generic $0.04 each
LOSARTAN-HYDROCHLOROTHIAZIDE 100-12.5 MG TAB Generic $0.09 each
LOSARTAN-HYDROCHLOROTHIAZIDE 100-25 MG TAB Generic $0.09 each
LOSARTAN-HYDROCHLOROTHIAZIDE 50-12.5 MG TAB Generic $0.07 each
cozaar (on 6/8/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
COZAAR 100 MG TABLET Generic $0.06 each
COZAAR 50 MG TABLET Generic $0.04 each
irbesartan (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
IRBESARTAN 150 MG TABLET Generic $0.16 each
IRBESARTAN 300 MG TABLET Generic $0.25 each
IRBESARTAN 75 MG TABLET Generic $0.17 each
IRBESARTAN-HYDROCHLOROTHIAZIDE 150-12.5 MG TB Generic $0.22 each
IRBESARTAN-HYDROCHLOROTHIAZIDE 300-12.5 MG TB Generic $0.31 each
avapro (on 4/7/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
AVAPRO 150 MG TABLET Generic $0.16 each
AVAPRO 300 MG TABLET Generic $0.25 each
candesartan (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CANDESARTAN CILEXETIL 16 MG TB Generic $1.75 each
CANDESARTAN CILEXETIL 32 MG TB Generic $2.66 each
CANDESARTAN CILEXETIL 4 MG TAB Generic $2.15 each
CANDESARTAN CILEXETIL 8 MG TAB Generic $1.89 each
CANDESARTAN-HYDROCHLOROTHIAZIDE 16-12.5 MG TB Generic $3.14 each
CANDESARTAN-HYDROCHLOROTHIAZIDE 32-12.5 MG TB Generic $3.22 each
CANDESARTAN-HYDROCHLOROTHIAZIDE 32-25 MG TAB Generic $3.90 each
atacand (on 9/21/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
ATACAND 16 MG TABLET Generic $1.75 each
ATACAND 32 MG TABLET Generic $2.66 each
telmisartan (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
TELMISARTAN 20 MG TABLET Generic $0.47 each
TELMISARTAN 40 MG TABLET Generic $0.45 each
TELMISARTAN 80 MG TABLET Generic $0.44 each
TELMISARTAN-AMLODIPINE 80-5 MG Generic $3.79 each
TELMISARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TB Generic $2.70 each
TELMISARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TB Generic $2.47 each
TELMISARTAN-HYDROCHLOROTHIAZIDE 80-25 MG TAB Generic $2.30 each
micardis (on 1/4/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
MICARDIS 20 MG TABLET Generic $0.47 each
MICARDIS 40 MG TABLET Generic $0.45 each
MICARDIS 80 MG TABLET Generic $0.44 each
MICARDIS HCT 40-12.5 MG TABLET Generic $2.70 each
MICARDIS HCT 80-12.5 MG TABLET Generic $2.47 each
MICARDIS HCT 80-25 MG TABLET Generic $2.30 each
valsartan (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
VALSARTAN 160 MG TABLET Generic $0.13 each
VALSARTAN 320 MG TABLET Generic $0.21 each
VALSARTAN 40 MG TABLET Generic $0.10 each
VALSARTAN 80 MG TABLET Generic $0.11 each
VALSARTAN-HYDROCHLOROTHIAZIDE 160-12.5 MG TAB Generic $0.18 each
VALSARTAN-HYDROCHLOROTHIAZIDE 160-25 MG TAB Generic $0.25 each
VALSARTAN-HYDROCHLOROTHIAZIDE 320-12.5 MG TAB Generic $0.27 each
VALSARTAN-HYDROCHLOROTHIAZIDE 320-25 MG TAB Generic $0.28 each
VALSARTAN-HYDROCHLOROTHIAZIDE 80-12.5 MG TAB Generic $0.17 each
diovan (on 1/4/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
DIOVAN 160 MG TABLET Generic $0.13 each
DIOVAN 320 MG TABLET Generic $0.21 each
DIOVAN 40 MG TABLET Generic $0.10 each
DIOVAN 80 MG TABLET Generic $0.11 each
DIOVAN HCT 160-12.5 MG TAB Generic $0.18 each
DIOVAN HCT 160-25 MG TABLET Generic $0.25 each
DIOVAN HCT 320-12.5 MG TAB Generic $0.27 each
DIOVAN HCT 320-25 MG TABLET Generic $0.28 each
DIOVAN HCT 80-12.5 MG TABLET Generic $0.17 each
olmesartan (on 6/14/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
OLMESARTAN MEDOXOMIL 20 MG TAB Generic $3.69 each
OLMESARTAN MEDOXOMIL 40 MG TAB Generic $5.11 each
OLMESARTAN MEDOXOMIL 5 MG TAB Generic $3.10 each
OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB Generic $3.75 each
OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB Generic $5.16 each
OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB Generic $5.61 each
benicar (on 12/30/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
BENICAR 20 MG TABLET Generic $3.69 each
BENICAR 40 MG TABLET Generic $5.11 each
BENICAR 5 MG TABLET Generic $3.10 each
BENICAR HCT 20-12.5 MG TABLET Generic $3.75 each
BENICAR HCT 40-12.5 MG TABLET Generic $5.16 each
BENICAR HCT 40-25 MG TABLET Generic $5.61 each
entresto (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
ENTRESTO 24 MG-26 MG TABLET $6.48 each
ENTRESTO 49 MG-51 MG TABLET $6.49 each
ENTRESTO 97 MG-103 MG TABLET $6.51 each
exforge (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
EXFORGE 10-160 MG TABLET Generic $0.61 each
EXFORGE 10-320 MG TABLET Generic $0.63 each
EXFORGE 5-160 MG TABLET Generic $0.40 each
EXFORGE 5-320 MG TABLET Generic $0.62 each
EXFORGE HCT 10-160-12.5 MG TAB Generic $2.54 each
EXFORGE HCT 10-160-25 MG TAB Generic $3.20 each
EXFORGE HCT 10-320-25 MG TAB Generic $3.05 each
EXFORGE HCT 5-160-12.5 MG TAB Generic $1.94 each
EXFORGE HCT 5-160-25 MG TAB Generic $2.93 each
azor (on 12/30/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
AZOR 10-20 MG TABLET Generic $0.88 each
AZOR 10-40 MG TABLET Generic $1.09 each
AZOR 5-20 MG TABLET Generic $0.91 each
AZOR 5-40 MG TABLET Generic $1.09 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Ontology: Losartan (C0126174)

Definition (CHV) a drug used to treat hypertension
Definition (CHV) a drug used to treat hypertension
Definition (NCI_NCI-GLOSS) A drug used to treat high blood pressure. Losartan blocks the action of chemicals that make blood vessels constrict (get narrower). It is a type of angiotensin II receptor antagonist.
Definition (NCI) The potassium salt form of losartan, a non-peptide angiotensin II antagonist with antihypertensive activity. Losartan potassium selectively and competitively blocks the binding of angiotensin II to the angiotensin I (AT1) receptor. Angiotensin II, formed from angiotensin I by angiotensin-converting enzyme (ACE), stimulates the adrenal cortex to synthesize and secrete aldosterone, which decreases the excretion of sodium and increases the excretion of potassium. Angiotensin II also acts as a vasoconstrictor in vascular smooth muscle. Losartan potassium, by blocking the binding of angiotensin II to the AT 1 receptor, promotes vasodilatation and decreases the effects of aldosterone.
Definition (MSH) An antagonist of ANGIOTENSIN TYPE 1 RECEPTOR with antihypertensive activity due to the reduced pressor effect of ANGIOTENSIN II.
Definition (CSP) antihypertensive agent; nonpeptide angiotension 1 subtype; angiotension 2 receptor antagonist/inhibitor.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D019808
SnomedCT 373567002, 96309000
LNC LP171619-2
English Losartan, lozartan, 2-Butyl-4-chloro-1-((2'-(1H-etrazol-5-yl) (1,1'-biphenyl)-4-yl)methyl)-1H-imidazole-5-methanol, 2-Butyl-4-chloro-1-[[2'-(1H-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1H-imidazole-5-methanol, Losartan [Chemical/Ingredient], LOSARTAN, losartan, Losartan (product), Losartan (substance)
Swedish Losartan
Czech losartan
Finnish Losartaani
Russian LOZARTAN, ЛОЗАРТАН
Japanese ロサルタン, ロザルタン
Croatian LOSARTAN
Spanish losartano, Losartán, losartano (sustancia), losartán (producto), losartán (sustancia), losartán
Polish Losartan
French Losartan
Portuguese Losartano, Losartan
German Losartan
Italian Losartan
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: valsartan (C0216784)

Definition (NCI) An orally active nonpeptide triazole-derived antagonist of angiotensin (AT) II with antihypertensive properties. Valsartan selectively and competitively blocks the binding of angiotensin II to the AT1 subtype receptor in vascular smooth muscle and the adrenal gland, preventing AT II-mediated vasoconstriction, aldosterone synthesis and secretion, and renal reabsorption of sodium, and resulting in vasodilation, increased excretion of sodium and water, a reduction in plasma volume, and a reduction in blood pressure.
Definition (PDQ) An orally active nonpeptide triazole-derived antagonist of angiotensin (AT) II with antihypertensive properties. Valsartan selectively and competitively blocks the binding of angiotensin II to the AT1 subtype receptor in vascular smooth muscle and the adrenal gland, preventing AT II-mediated vasoconstriction, aldosterone synthesis and secretion, and renal reabsorption of sodium, and resulting in vasodilation, increased excretion of sodium and water, a reduction in plasma volume, and a reduction in blood pressure. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=464172&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=464172&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C47781" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C081489
SnomedCT 108581009, 386876001
LNC LP171649-9
English N-valeryl-N-((2'-(1H-tetrazol-5-yl)biphenyl-4-yl)methyl)valine, valsartan, L-Valine, N-(1-oxopentyl)-N-((2'-(1H-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, N-(p-(o-1H-Tetrazol-5-ylphenyl)benzyl)-N-valeryl-L-valine, valsartan (medication), VALSARTAN, valsartan [Chemical/Ingredient], Valsartan, Valsartan (product), Valsartan (substance)
Spanish valsartano, valsartano (sustancia), valsartán (producto), valsartán (sustancia), valsartán
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: telmisartan (C0248719)

Definition (NCI) A benzimidazole derivative and a non-peptide angiotensin II receptor antagonist with antihypertensive property. Telmisartan selectively antagonizes angiotensin II binding to the AT1 subtype receptor, located in vascular smooth muscle and adrenal gland. The antagonism results in vasodilation and inhibits the angiotensin II-mediated aldosterone production, which in turn leading to a decrease in sodium and water as well as an increase in potassium excretion leading to a subsequent reduction in blood pressure.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C084178
SnomedCT 318985000, 129487008, 387069000
LNC LP171643-2
English (1,1'-Biphenyl)-2-carboxylic acid, 4'-((1,4'-dimethyl-2'-propyl(2,6'-bi-1H-benzimidazol)-1'-yl)methyl)-, 4'-((1,4'-dimethyl-2'-propyl(2,6'-bi-1H-benzimidazol)-1'-yl)methyl)-(1,1'-biphenyl)-2-carboxylic acid, 4'-((4-Methyl-6-(1-methyl-2-benzimidazolyl)-2-propyl-1-benzimidazolyl)methyl)-2-biphenylcarboxylic Acid, (1,1'-Biphenyl)-2-carboxylic Acid, 4'-((1,4'-dimethyl-2'-propyl(2,6'-bi-1H-benzimidazol)-1'-yl)methyl)-, telmisartan (medication), telmisartan, telmisartan [Chemical/Ingredient], TELMISARTAN, Telmisartan (product), Telmisartan (substance), Telmisartan
Spanish telmisartano (sustancia), telmisartano, telmisartán (producto), telmisartán (sustancia), telmisartán
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: eprosartan (C0287041)

Definition (NCI) A competitive and reversible angiotensin II receptor antagonist with anti-hypertensive property. Eprosartan blocks the binding of angiotensin II to the angiotensin (AT)1 receptor in vascular smooth muscle, thereby blocking the principal pressor action of angiotensin II on the renin-angiotensin system resulting in vascular dilatation. In addition, this agent blocks angiotensin II -induced stimulation of aldosterone synthesis and secretion by the adrenal cortex, cardiac contraction, renal resorption of sodium, activity of the sympathetic nervous system, and smooth muscle cell growth. Furthermore, eprosartan inhibits sympathetic norepinephrine production, thereby further reducing blood pressure.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C068373
SnomedCT 318990002, 396044005
English eprosartan, eprosartan [Chemical/Ingredient], EPROSARTAN, Eprosartan (product), Eprosartan (substance), Eprosartan, 2-Thiophenepropanoic acid, alpha-((2-butyl-1-((4- carboxyphenyl)methyl)-lH-imidazol-5-yl)methylene)-, (E)-
Spanish eprosartán (producto), eprosartán (sustancia), eprosartán
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: irbesartan (C0288171)

Definition (NCI) A nonpeptide angiotensin II antagonist with antihypertensive activity. Irbesartan selectively and competitively blocks the binding of angiotensin II to the angiotensin I receptor. Angiotensin II stimulates aldosterone synthesis and secretion by adrenal cortex, which decreases the excretion of sodium and increases the excretion of potassium. Angiotensin II also acts as a vasoconstrictor in vascular smooth muscle. (NCI05)
Definition (CSP) antihypertensive; nonpeptide angiotension 1 subtype; angiotension 2 receptor antagonist.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C081309
SnomedCT 108585000, 386877005
LNC LP171611-9
English 2-n-butyl-3-((2'-(1H-tetrazol-5-yl)biphenyl-4-yl)methyl)-1,3-diazaspiro(4,4)non-1-en-4-one, 1,3-Diazaspiro(4.4)non-1-en-4-one, 2-butyl-3-((2'-(1H-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, irbesartan, irbesartan (medication), IRBESARTAN, irbesartan [Chemical/Ingredient], Irbesartan, Irbesartan (product), Irbesartan (substance)
Spanish irbesartano (sustancia), irbesartano, irbesartán (producto), irbesartán (sustancia), irbesartán
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Cozaar (C0591301)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D019808
English cozaar, Cozaar
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Avapro (C0595301)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C081309
English irbesartan (Avapro), avapro, aprovel, karvea, Aprovel, Karvea, Sanofi Winthrop Brand of Irbesartan, BMS Brand of Irbesartan, Bristol Myers Brand of Irbesartan, Avapro
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: candesartan (C0717550)

Definition (NCI) A synthetic, benzimidazole-derived angiotensin II receptor antagonist prodrug with antihypertensive activity. Candesartan selectively competes with angiotensin II for the binding of the angiotensin II receptor subtype 1 (AT1) in vascular smooth muscle, blocking angiotensin II-mediated vasoconstriction and inducing vasodilatation. In addition, antagonism of AT1 in the adrenal gland inhibits angiotensin II-stimulated aldosterone synthesis and secretion by the adrenal cortex; sodium and water excretion increase, followed by a reduction in plasma volume and blood pressure.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C081643
SnomedCT 108587008, 372512008
LNC LP171390-0
English 2-ethoxy-7-carboxy-1-(2'-(1H-tetrazol-5-yl)biphenyl-4-yl)methylbenzimidazole, 1H-Benzimidazole-7-carboxylic acid, 2-ethoxy-1-((2'-(1H-tetrazol-5-yl)(1,1'-biphenyl)-4-yl)methyl)-, 2-Ethoxy-3-[[4-[2-(2H-tetrazol-5-yl)phenyl]phenyl]methyl]-3H-benzoimidazole-4-carboxylic Acid, candesartan [Chemical/Ingredient], CANDESARTAN, candesartan, Candesartan (product), Candesartan (substance), Candesartan
Spanish candesartano (sustancia), candesartano, candesartán (producto), candesartán (sustancia), candesartán
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Atacand (C0718711)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C077793
English Atacand, atacand, blopress, Amias, Blopress, Astra brand of candesartan cilexetil, AstraZeneca brand of candesartan cilexetil, Kenzen, Promed brand of candesartan cilexetil, Takeda brand of candesartan cilexetil
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Diovan (C0719949)

Definition (CHV) brand name of a high blood pressure medication
Definition (CHV) brand name of a high blood pressure medication
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C081489
English Diovan, valsartan (Diovan), diovan, diovan [brand name], Novartis brand of valsartan, Tareg
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Micardis (C0721704)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C084178
English Micardis, telmisartan (Micardis), micardis, Boehringer Ingelheim brand of telmisartan, Abbott brand of telmisartan
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Teveten (C0876891)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C068373
English Teveten, teveten
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: olmesartan (C1098320)

Definition (NCI) A synthetic imidazole derivative and angiotensin II receptor antagonist with antihypertensive activity. Olmesartan selectively binds to the angiotensin type 1 (AT1) receptor subtype in vascular smooth muscle and adrenal gland, thereby competing with angiotensin II for binding to the AT1 receptor. This prevents angiotensin II-induced vasoconstriction and interferes with angiotensin II-mediated aldosterone secretion, thereby decreasing aldosterone production and preventing aldosterone-stimulated sodium retention and potassium excretion.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C437965
SnomedCT 385540001, 412259001
English olmesartan [Chemical/Ingredient], omesartan, OLMESARTAN, Olmesartan (product), Olmesartan, Olmesartan (substance), olmesartan, 4-(hydroxy-1-methylethyl)-2-propyl-1-((2'-(1H-tetrazol-5-yl)-1,1'-biphenyl-4-yl)methyl)-1H-imidazole-5-carboxylic acid
Spanish olmesartán (producto), olmesartán, olmesartán (sustancia)
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Benicar (C1122245)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C097933
English benicar, Forest Brand of Olmesartan Medoxomil, Olmetec, Sankyo Brand of Olmesartan Medoxomil, Benicar
Derived from the NIH UMLS (Unified Medical Language System)

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