Sartan: mechanism, record, negative effects

Definition: what’s a sartan drug?

It’s a drug with a property antihypertensive. It’s notably prescribed when hygiene and dietary guidelines (common bodily exercise, weight-reduction plan wealthy in vegatables and fruits, discount of salt consumption) are inadequate to scale back blood strain in a hypertensive affected person. Molecules belonging to this household are additionally referred to as angiotensin II receptor antagonists. They exert an motion on the coronary heart, blood vessels and kidneys.

What’s the mechanism of motion of a sartan?

A sartan is a molecule that blocks the angiotensin II receptor (substance decreasing the diameter of blood vessels). Thus, the drug prevents the discount within the caliber of blood vessels and reduces the manufacturing of sure hormones resembling aldosterone and vasopressin. The ensuing results are primarily a lower in blood strain, water and salt retention, and blood quantity circulating within the physique. As well as, a sartan ends in elevated blood circulate to the kidneys.

What are the indications for a sartan?

All sartans are indicated within the therapy of hypertension in adults. Some sartans (candesartan, losartan, olmesartan, valsartan) could be prescribed in kids from the age of 6 years. There are different indications that differ relying on the molecule prescribed:

• Remedy of persistent coronary heart failure (in case of intolerance to really useful first-line therapies)
• Lowered threat of stroke in case of hypertension in sufferers with an enlarged left ventricle (within the coronary heart)
• Remedy of kidney injury in sufferers with sort 2 diabetes taking antihypertensive treatment
• Preventive therapy of cardiovascular penalties in sufferers with heart problems that obstructs a blood vessel or with sort 2 diabetes related to organ illness

Generally, the usage of sartans is envisaged in coronary heart failure or in case of intolerance and even contraindication to ACE inhibitors (different medication utilized in cardiology and cheaper than sartans). Intolerance to ACE inhibitors is manifested by extreme coughing.

What’s the record of various sartans?

The sartans at present marketed in France are:

• Candesartan (Atacand®, Kenzen®)
• Irbesartan (Aprovel®)
• Losartan (Cozaar®)
• Olmesartan (Alteis®, Olmetec®)
• Telmisartan (Micardis®, Pritor®)
• Valsartan (Tareg®)

Generics are additionally accessible, aside from olmesartan. A number of industrial specialties embrace a sartan mixed with one other molecule (calcium channel blocker, diuretic). That is the case, for instance, of Coaprovel (irbesartan + hydrochlorothiazide), Exforge® (valsartan + amlodipine), Twynsta® (telmisartan + amlodipine). Their prescription is taken into account when sartan alone just isn’t sufficiently efficient. All medicines containing olmesartan (alone or together) are now not reimbursed as a result of threat of great intestinal illness that would result in hospitalization in intensive care. This threat has not been demonstrated with the opposite sartans.

What are the negative effects of sartans?

Relying on the sartan and the therapeutic indication, the negative effects should not the identical and don’t happen with the identical frequency. Usually, essentially the most continuously reported with sartans are dizziness, vertigo and headache. Extra hardly ever, a cough and a rash had been noticed. Observe that these results are quite common in kids handled with candesartan. As well as, a kidney failure, extra potassium, low white blood cells, low blood strain can happen. These results are frequent with losartan and irbesartan, however rarer with olmesartan. As well as, sartans can result in extreme anaphylactic response referred to as bradykine angioedema. This aspect impact could be very uncommon however may cause severe penalties resembling asphyxia (if positioned within the larynx) and result in loss of life. Signs manifest as a violent look of edema within the face, tongue, mouth and throat. When initiating therapy, shut monitoring of those signs is required. In case of incidence, it will likely be interrupted and contraindicated for all times.

What are the contraindications of sartans?

Sartans are contraindicated in case allergy to any of the parts of the drug. Administration is strictly prohibited in the course of the 2nd and third trimester of being pregnantand never really useful within the 1st trimester. Losartan, candesartan and telmisartan shouldn’t be administered in extreme hepatic impairment. As well as, olmesartan and telmisartan are contraindicated in sufferers with obstructed bile ducts.

Sources:
– Public drug database
– Pharmacology.org
– Bradykinic angioedema: think about ACE inhibitors but in addition angiotensin II receptor antagonists (sartans) and gliptins, ANSM, 30/12/2020