Angiotensin II receptor blockers for HFrEF

All patients with HFrEF should be treated with a renin-angiotensin system inhibitor. Angiotensin II receptor blockers (ARBs) should only be used if a patient is unable to tolerate sacubitril+valsartan or an ACEI; see also Overview of renin-angiotensin system inhibitors.

Start ARB therapy for HFrEF with a low dose and uptitrate to the highest tolerated dose within the recommended range. Aim to achieve the target dose within 2 to 3 months. Use1:

1candesartan 4 mg orally, daily, increasing to maximum 32 mg daily candesartan candesartan candesartan

OR

1eprosartan 400 mg orally, daily, increasing to maximum 600 mg daily eprosartan eprosartan eprosartan

OR

1irbesartan 75 mg orally, daily, increasing to maximum 300 mg daily irbesartan irbesartan irbesartan

OR

1losartan 25 mg orally, daily, increasing to maximum 100 mg daily losartan losartan losartan

OR

1olmesartan 10 mg orally, daily, increasing to maximum 40 mg daily olmesartan olmesartan olmesartan

OR

1telmisartan 40 mg orally, daily, increasing to maximum 80 mg daily telmisartan telmisartan telmisartan

OR

1valsartan 40 mg orally, twice daily, increasing to maximum 160 mg twice daily. valsartan valsartan valsartan

1 Candesartan and valsartan are the only angiotensin II receptor blockers approved by the Australian Therapeutic Goods Administration (TGA) for treatment of heart failure. See the TGA website for current information.Return