ARB Interactions: Avoid The Salt Substitutes

Angiotensin II Receptor Blockers (ARBs) are a class of drugs commonly used to treat high blood pressure, heart failure, and kidney disease, especially in patients who cannot tolerate ACE inhibitors. Here is a list of ARB medications available in the United States:

  • Losartan (Brand name: Cozaar)
  • Valsartan (Brand name: Diovan)
  • Irbesartan (Brand name: Avapro)
  • Candesartan (Brand name: Atacand)
  • Olmesartan (Brand name: Benicar)
  • Telmisartan (Brand name: Micardis)
  • Eprosartan (Brand name: Teveten)
  • Azilsartan (Brand name: Edarbi)

ARBs work by blocking the action of angiotensin II, a hormone that causes blood vessels to constrict. By preventing this constriction, ARBs help lower blood pressure and make it easier for the heart to pump blood. As with any medication, ARBs can have side effects and may interact with other drugs, so their use should be managed by a healthcare provider. The choice of a specific ARB depends on individual health conditions and treatment goals.

Drug-Nutrient Interactions:

ARB Drug-Nutrient Interactions:

ARBs include medications such as losartan, valsartan, irbesartan, telmisartan, candesartan, eprosartan, olmesartan, and azilsartan. Angiotensin II Receptor Blockers (ARBs) are used for managing high blood pressure and heart failure, can interact with certain nutrients and dietary supplements. Here are some drug-nutrient or supplement interactions involved with ARBs:

  • Potassium and Potassium SupplementsARB medications can reduce potassium clearance by the kidneys.  This can cause excessive potassium to build up in the blood and can lead to irregular heartbeat when very high levels of potassium are consumed. Don’t use potassium supplements (or electrolyte drinks) without your physician’s approval.  
    • DO NOT USE POTASSIUM-BASED SALT SUBSTITUTES: Many salt substitutes are high in potassium. Since ARBs can raise potassium levels, using these substitutes might further increase the risk of high potassium blood levels. [PMID: 31498767]
  • Vitamin D Supplements: In some cases, vitamin D can increase the blood pressure-lowering effects of ARBs. This interaction isn’t always harmful but should be monitored.
  • St. John’s Wort: This supplement can reduce the effectiveness of many medications, potentially including ARBs, by affecting how the body breaks down the drugs.

Other Interactions to Know

  • Anti-Inflammatory Drugs (NSAIDs): NSAIDs can reduce the effectiveness of ARBs and increase the risk of kidney problems. This includes over-the-counter medications like ibuprofen and naproxen.
  • Alcohol: While not a nutrient or supplement, alcohol can augment the blood pressure-lowering effects of ARBs, potentially leading to hypotension (low blood pressure).
  • Antacids: Some antacids, especially those containing aluminum or magnesium, can affect the absorption of ARBs when taken simultaneously.

About the Author

Stephanie Figon, MS, RDN, LD

Founder of NutriScape.NET. As a dietitian since 1992, Steph Figon has had experiences in consulting, 15 years in clinical, and has operated a private practice nutrition counseling office for since 2011. Connect on Linkedin

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