Oral Angiotensin II Receptor Blockers (ARBs) for Hypertension in Children

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Common adverse effects: Headache, dizziness

Severe adverse effects: Fetal toxicity, hyperkalemia, acute kidney injury

Contraindications include pregnancy and angioedema.

The blood pressure–lowering ability of ARBs is equal to that of angiotensin-converting enzyme inhibitors (which are usually used first because there is more clinical experience).

ARBs do not cause cough, and angioedema is less frequent.

ARBs are usually given once a day, but twice daily dosing at a lower dose may be considered when an adverse effect, such as dizziness resulting from hypotension, occurs after a single larger daily dose.

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