ARB Alternatives
Valsartan and other blood pressure medications in the same class (ARBs) have recently been found to contain cancer causing impurities. Learn more about the history of the valsartan contamination at our valsartan timeline page. Now that numerous ARBs have been confirmed to be contaminated, many patients and doctors are looking for an alternative to ARBs. Luckily, there are tons of other blood pressure medications that are not contaminated. Speak to your doctor about what medication is best for you, but rest assured that there are alternatives. A patient’s blood pressure is impacted by two primary variables; the force exerted by the blood and the diameter of the blood vessels. Most blood pressure medications work by either dilating the blood vessels or reducing the amount of force from the blood, which can be decreased by reducing the force of each heart beat or reducing fluid volume. Blood pressure medications that reduce the fluid volume are known as diuretics. Some combination blood pressure medications both dilate blood vessels and reduce fluid volume.
ACE Inhibitors
An alternative type of blood pressure medication to an ARB are angiotensin-converting-enzyme (ACE) inhibitors. However, ARBs are generally prescribed to patients who are intolerant to ACE inhibitors. ACE inhibitors work by dilating or enlarging the blood vessels, which causes blood pressure to decrease. The generic names of all ACE inhibitors end in “pril.” The following are a list of generic and brand name Ace inhibitors:
- lisinopril (Zestril and Prinivil)
- benzaepril (Lotensin)
- quinapril (Accupril)
- captopril (Capoten)
- enalapril (Vasotec)
- perindopril (Aceon)
- ramipril (Altace)
- trandolapril (Mavik)
- fosinopril (Monopril)
- moexipril (Univasc)
Beta-Blockers
Beta-blockers work by blocking forms of adrenaline from binding to beta receptors of the muscles and organs. By blocking the effects of adrenaline, the patient’s blood vessels don’t constrict or narrow and their heart rate doesn’t increase as much as it would. As a result, the patient’s blood pressure is reduced. The generic names of all beta-blockers end in “lol.” The following are a list of generic and brand name beta-blockers:
- carvedilol (Coreg)
- metoprolol (Lopressor)
- nebivolol (Bystolic)
- acebutolol (Sectral)
- atenolol (Tenormin)
- betaxolol
- bisoprolol (Zebeta)
- carteolol
- esmolol
- labetalol (Trandate)
- nadolol (Corgard)
- penbutolol
- pindolol
- propranolol (Hemangeol)
- timolol
Alpha-Blockers
Alpha-blockers work by blocking forms of adrenaline form binding to alpha receptors of the muscles and organs. Similar the beta-blockers, alpha-blockers inhibit the impact adrenaline has on the blood vessels and heart. Alpha-blockers are typically only utilized after a patient has failed most other classes of blood pressure medications. The following are alpha-blockers:
- doxazosin (Cardura)
- terazosin (Hytrin)
Calcium Channel Blockers
Calcium is needed for muscle cells to contract. Calcium channel blockers reduce the movement of calcium into muscle cells, including the heart. The force at which the heart beats is reduced by decreasing the calcium to the heart, thereby decreasing the blood pressure. The generic name of many calcium channel blockers end in “pine.” The following are calcium channel blockers:
- amlodipine (Norvasc)
- clevidipine (Cleviprex)
- diltiazem (Cardizem)
- felodipine
- isradipine
- nifedipine
- nicardipine
- nimodipine
- nisoldipine
- nisoldipine (Sular)
- verapamil (Calan)
Diuretics
Diuretics cause the kidneys to get rid of additional salt. Water is known to “follow salt.” By getting rid of additional salt, the body will also reduce the total fluid volume. Diuretics are also thought to cause the muscles surrounding blood vessels to relax, further decreasing blood pressure. Those on diuretics should be monitored, as dehydration is a possible side effect. The following are generic and name brand diuretics:
- furosemide (Lasix
- bumetanide (Bumex)
- torsemide (Demadex)
- hydrochlorothiazide (Hydrodiuril)
- chlorthalidone
- metolazone (Zaroxolyn)
