Eprosartan

How it works

It selectively blocks the angiotensin-II type 1 receptor, causing vasodilatation and reducing aldosterone-mediated sodium and water retention to lower blood pressure.

Prescribing in practice

• It is contraindicated in pregnancy because drugs acting on the renin-angiotensin system can cause foetal harm; discontinue if pregnancy is planned or confirmed.
• It can cause hyperkalaemia and deterioration in renal function, particularly with concomitant potassium-raising drugs or in renovascular disease.
• Do not combine routinely with ACE inhibitors or aliskiren because of the increased risk of hypotension, hyperkalaemia and renal impairment.

Monitoring

Monitor blood pressure, renal function and serum potassium, especially after initiation or dose change.

Counselling the patient

• Tell your clinician straight away if you become pregnant or plan to.
• Report marked dizziness, which may indicate low blood pressure.
• Avoid potassium-containing salt substitutes unless advised.

Evidence & guidelines

Angiotensin-II receptor antagonists are an established first-line option for hypertension in NICE guidance, particularly where ACE inhibitors are not tolerated.