ADVERSE DRUG REACTIONS OF ANGIOTENSIN RECEPTOR BLOCKERS (ARBS): A COMPREHENSIVE REVIEW WITH PHARMACOVIGILANCE PERSPECTIVES

Raj R. Pawar*, Pranit Y. Nimse, Vivek A. Waghere, Avinash A. Gunjal

ABSTRACT

Background: Angiotensin receptor blockers (ARBs) are widely prescribed for hypertension, heart failure, and diabetic nephropathy. Although generally well tolerated, ARBs are associated with adverse drug reactions (ADRs) that may affect patient safety and treatment adherence. Objective: This review summarizes the therapeutic use of ARBs, profiles reported ADRs, and discusses pharmacovigilance perspectives for safer clinical practice. Methods: Data were compiled from published literature, drug information sources, and pharmacovigilance databases including WHO-VigiBase and the Pharmacovigilance Programme of India (PvPI). Reported ADRs were classified by organ system and compared across individual ARBs, with demographic susceptibility trends also assessed. Results: Frequently reported ADRs include hyperkalemia, renal impairment, hypotension, dizziness, and gastrointestinal disturbances, with rare events such as angioedema. Olmesartan is distinctly linked with sprue-like enteropathy, while telmisartan demonstrates relatively fewer ADRs. Elderly patients and those with comorbidities such as diabetes or chronic kidney disease appear more susceptible. Literature also highlights persistent underreporting of ADRs, particularly in low- and middle-income countries. Conclusion: ARBs remain an effective and generally safe therapeutic class. However, integrating pharmacovigilance insights and improving ADR reporting practices are essential to minimize risks, ensure patient safety, and optimize therapeutic outcomes.

Keywords: Angiotensin Receptor Blockers, Adverse Drug Reactions, Pharmacovigilance, Safety, Hypertension.