ARB and uricosuric effect

Q: Which of the following angiotensin II receptor blocker (ARB) has a direct uricosuric effect? (select one)

A) Losartan 

B) Candesartan 

C) Valsartan 

D) Irbesartan 

E) Olmesartan 

Answer: A

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) decrease the serum uric acid level. The mechanism of action is by revering the stimulatory effect of angiotensin II on proximal sodium and urate reabsorption. Moreover, out of all, losartan is found to have a direct uricosuric effect.

It may be of interest to clinicians that a combination of losartan or any ACE inhibitor with a thiazide diuretic has shown a better blood control effect and minimizes the side effects such as hypokalemia and/or hyperlipidemia.

#pharmacology

References:

1. Weinberger MH. Influence of an angiotensin converting-enzyme inhibitor on diuretic-induced metabolic effects in hypertension. Hypertension 1983; 5:III132.

2. Soffer BA, Wright JT Jr, Pratt JH, et al. Effects of losartan on a background of hydrochlorothiazide in patients with hypertension. Hypertension 1995; 26:112.

3. Manolis AJ, Grossman E, Jelakovic B, et al. Effects of losartan and candesartan monotherapy and losartan/hydrochlorothiazide combination therapy in patients with mild to moderate hypertension. Losartan Trial Investigators. Clin Ther 2000; 22:1186.

4. Shahinfar S, Simpson RL, Carides AD, et al. Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia. Kidney Int 1999; 56:1879.