Hypertension Treatments: ARBs

HYPERTENSION TREATMENTS: ARBs
Generic	Brand	Strength	Form	Usual Dose
ANGIOTENSIN II RECEPTOR BLOCKER (ARB)
azilsartan medoxomil	Edarbi	40mg, 80mg	tabs	≥18yrs: Monotherapy, not volume-depleted: 80mg once daily. Volume-depleted (eg, concomitant high-dose diuretics): initially 40mg once daily. <18yrs: Not established.
candesartan cilexetil	Atacand	4mg, 8mg, 16mg, 32mg	scored tabs	≥18yrs: Monotherapy and not volume-depleted: initially 16mg once daily; usual range: 8−32mg once daily or in 2 divided doses. Salt/volume depleted or moderate hepatic impairment: consider lower initial dose. May add diuretic if needed. <1yr or CrCl<30mL/min: Not recommended. Give once daily or in 2 divided doses. 1−<6yrs (may give oral susp if unable to swallow tabs): initially 0.2mg/kg/day; usual range: 0.05−0.4mg/kg/day. 6−<17yrs (<50kg): initially 4−8mg/day; usual range: 2−16mg/day; (>50kg): initially 8−16mg/day; usual range: 4−32mg/day. Salt/volume depletion: consider lower initial dose.
irbesartan	Avapro	75mg, 150mg, 300mg	tabs	≥16yrs: 150mg once daily; may increase to 300mg once daily. Or, may add a low dose of diuretic. Salt/volume depletion: initially 75mg once daily. Children: Not recommended.
losartan potassium	Cozaar	25mg, 50mg, 100mg	tabs	Adults: Hypertension (HTN): Initially 50mg once daily; may increase to max 100mg once daily. HTN with LVH: Initially 50mg once daily; then add HCTZ 12.5mg/day and/or increase losartan to 100mg/day, then may increase HCTZ to 25mg/day. Volume-depleted (eg, on a diuretic) or mild-moderate hepatic impairment: Initially 25mg once daily. <6yrs or CrCl<30mL/min: Not recommended. ≥6yrs: initially 0.7mg/kg (max 50mg) once daily; usual max 1.4mg/kg (100mg) once daily.
olmesartan medoxomil	Benicar	5mg, 20mg, 40mg	tabs	≥16yrs: Monotherapy, not volume-depleted: initially 20mg once daily; may increase to max 40mg once daily after 2wks. Volume depleted (eg, concomitant diuretic): consider lower initial dose. <1yr: Do not give. 6yrs: Not recommended. 6−16yrs: (20kg to <35kg): initially 10mg once daily; may increase to max 20mg once daily after 2wks; (≥35kg): initially 20mg once daily; may increase to max 40mg once daily after 2wks. Tabs may be prepared as an oral suspension if unable to swallow: see full labeling.
telmisartan	Micardis	20mg, 40mg, 80mg	tabs	Adults: Not volume-depleted: initially 40mg once daily; usual range 20−80mg/day. Salt/volume depleted: monitor closely or consider reduced dose. May add diuretic if insufficient response at 80mg/day. Children: Not established.
valsartan	Diovan	40mg+, 80mg, 160mg, 320mg	tabs	Adults: Monotherapy and not volume-depleted: initially 80mg or 160mg once daily; max 320mg once daily. Or, add a diuretic (more effective than increasing dose above 80mg). <1yr: Not recommended. 1–16yrs: Initially 1mg/kg once daily (up to 40mg total), may consider an initial dose of 2mg/kg if greater BP reduction is needed; max 4g/kg (up to 160mg) once daily. If aged 1–5yrs, >5yrs who are unable to swallow tabs, or calculated dose (mg/kg) does not correspond to available tablet strengths, use suspension.
ARB + CALCIUM CHANNEL BLOCKER (DIHYDROPYRIDINE) + THIAZIDE DIURETIC
olmesartan/ amlodipine/ HCTZ	Tribenzor	20mg/ 5mg/ 12.5mg, 40mg/ 5mg/ 12.5mg, 40mg/ 5mg/ 25mg, 40mg/ 10mg/ 12.5mg, 40mg/ 10mg/ 25mg	tabs	Adults: 1 tab once daily. May titrate at 2-week intervals; max one 40/10/25mg tab daily. ≥75yrs or severe hepatic impairment: use individual components (amlodipine 2.5mg). CrCl ≤30mL/min: avoid. Children: Not established.
valsartan/ amlodipine/ HCTZ	Exforge HCT	160mg/ 5mg/ 12.5mg, 160mg/ 5mg/ 25mg, 160mg/ 10mg/ 12.5mg, 160mg/ 10mg/ 25mg, 320mg/ 10mg/ 25mg	tabs	Adults: 1 tab once daily. May titrate at 2-week intervals; max one 320mg/10mg/25mg tab daily. May be substituted for individually titrated components. Add-on/switch therapy: may be used to provide additional BP lowering if not adequately controlled on doses of any two antihypertensive classes: ARBs, CCBS, and diuretics. Children: Not established.

Generic	Brand	Strength	Form	Usual Dose
ARB + THIAZIDE DIURETIC
azilsartan medoxomil/ chlortha– lidone	Edarby– clor	40mg/ 12.5mg, 40mg/ 25mg	tabs	≥18yrs: Initially 40/12.5mg once daily. May increase to 40/25mg after 2−4wks as needed. Max: 40/25mg. Patients titrated to the individual components: may give corresponding dose of Edarbyclor. See full labeling. <18yrs: Not established.
candesartan cilexetil/ HCTZ	Atacand HCT	16mg/ 12.5mg, 32mg/ 12.5mg, 32mg/ 25mg	scored tabs	Adults: Not for initial therapy. May be substituted for titrated components. BP not controlled on HCTZ 25mg once daily, or controlled but serum potassium decreased: one 16/12.5 tab once daily. BP not controlled on candesartan 32mg per day: initially one 32/12.5 tab once daily; may increase to 32/25 once daily. Moderate-to-severe hepatic impairment or CrCl≤30mL/min: not recommended. Children: Not established.
irbesartan/ HCTZ	Avalide	150mg/ 12.5mg, 300mg/ 12.5mg	tabs	Adults: Take once daily. Not controlled on monotherapy: initially 150/12.5mg, titrate to 300/12.5mg then 300/25mg if needed. Initial therapy: start at 150/12.5mg for 1–2wks, then titrate as needed up to max 300mg/25mg. May be substituted for titrated components. CrCl ≤30mL/min: not recommended. Children: Not established.
losartan potassium/ HCTZ	Hyzaar	50mg/ 12.5mg, 100mg/ 12.5mg, 100mg/ 25mg	tabs	Adults: Initially 50/12.5mg once daily (100/12.5mg if BP not controlled on losartan 100mg alone); may increase after 3wks as needed to max 100/25mg daily. HTN with LVH (BP not controlled on losartan alone): initially 50/12.5mg once daily; increase as needed to 100/12.5mg, then to max 100/25mg daily. Children: Not established.
olmesartan medoxomil/ HCTZ	Benicar HCT	20mg/ 12.5mg, 40mg/ 12.5mg, 40mg/ 25mg	tabs	Adults: BP not controlled on olmesartan alone: initially 40/12.5mg once daily. Intolerant to or BP not controlled on HCTZ alone: initially 20/12.5mg once daily. Both: may titrate at 2–4wk intervals up to max 40mg/25mg once daily. May substitute for individually titrated components. Children: Not established.
telmisartan/ HCTZ	Micardis HCT	40mg/ 12.5mg, 80mg/ 12.5mg, 80mg/ 25mg	tabs	Adults: Not for initial therapy. May be substituted for titrated components. BP not controlled on telmisartan 80mg/day: 80mg/12.5mg once daily. BP not controlled on HCTZ 25mg/day or BP controlled but hypokalemic: 80mg/12.5mg once daily. Both: may titrate up to 160mg/25mg after 2–4wks. Hepatic insufficiency or biliary obstruction: initially 40mg/12.5mg once daily; monitor closely. Severe renal or hepatic impairment: not recommended. Children: Not established.
valsartan/ HCTZ	Diovan HCT	80mg/ 12.5mg, 160mg/ 12.5mg, 160mg/ 25mg, 320mg/ 12.5mg, 320mg/ 25mg	tabs	Adults: Add-on or initial therapy and not volume-depleted: initially 160mg/12.5mg once daily; may increase after 1–2wks up to max 320mg/25mg daily. May be substituted for the titrated components. Children: Not established.
CALCIUM CHANNEL BLOCKER (DIHYDROPYRIDINE) + ARB
amlodipine besylate/ olmesartan medoxomil	Azor	5mg/ 20mg, 5mg/ 40mg, 10mg/ 20mg, 10mg/ 40mg	tabs	Adults: Initially 5/20mg once daily; may increase after 1–2wks up to max 10/40mg daily. ≥75yrs or hepatic impairment: initial therapy not recommended. Children: Not established.
amlodipine besylate/ telmisartan	—	5mg/ 40mg, 5mg/ 80mg, 10mg/ 40mg, 10mg/ 80mg	tabs	Adults: Take once daily. Initial therapy: 5/40mg or 5/80mg; may titrate at 2‑week intervals to max 10/80mg. Add‑on therapy: may be used if not controlled on monotherapy; if dose-limiting adverse reactions with amlodipine 10mg, switch to 5/40mg tab. Replacement therapy: may be substituted for the titrated components. Severe renal impairment: titrate slowly. ≥75yrs, or hepatic impairment: not for initial use (initially use amlodipine alone, or add amlodipine 2.5mg to telmisartan; titrate slowly). Children: Not established.
amlodipine besylate/ valsartan	Exforge	5mg/ 160mg, 5mg/ 320mg, 10mg/ 160mg, 10mg/ 320mg	tabs	Adults: Take once daily. Initial therapy and not volume depleted: Initially 5/160mg; may increase after 1−2wks up to max 10/320mg. Add‑on therapy: may be used if not controlled on monotherapy; if inadequate response after 3−4wks, may titrate up to max 10/320mg. Replacement therapy: may be substituted for the titrated components. Maximum effects within 2wks after dose change. Elderly, hepatic impairment: initial therapy not recommended. Children: Not established.
NOTES
Key: + = scored tabs. Not an inclusive list of medications, official indications, and/or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 2/2024)

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