Notes for: Angiotensin-II Receptor AntagonistsLast edited [26/06/2012 09:37:13]1. No studies have shown that angiotensin-II receptor antagonists are more effective than ACE inhibitors. Angiotensin-II antagonists should be reserved for those patients who suffer from unacceptable side effects with ACE inhibitors. Cough is common in patients with chronic heart failure, and cough is also a symptom of pulmonary oedema which should be excluded when a new or worsening cough develops. Care should therefore be taken when attributing 'worsening' cough as a side effect of ACE inhibitor treatment.
2. Candesartan has been included because it is licensed for the treatment of hypertension and patients with heart failure and impaired left ventricular systolic dysfunction.
3. Aliskiren is not included in the formulary for routine prescribing, though there may be specialised circumstances for its use. Drug Safety Update March 2012 advises of contraindications and cautions when used in combination with ACEI or ARB, and when aliskiren is used in patients with renal impairment.