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Cardiovascular medications

Dental Considerations for Patients Taking ARB (e.g. losartan/valsartan)

Routine care — note drug considerations (ARB)

Record of ARB. The points below cover relevant oral side-effects and drug interactions so prescribing and treatment remain safe and non-conflicting.

Emergency vs routine management

If EMERGENCY — what to do

  • • Treat normally; avoid NSAIDs where possible.Ref: British National Formulary (BNF) — Prescribing in renal impairment, hepatic impairment & drug interactions (current edition)

If ROUTINE — what to do

  • • Routine care; watch for lichenoid reactions.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023

Clinical precautions

  • • Avoid NSAIDs where possible; prefer paracetamol.
  • • Possible lichenoid oral reactions.
  • • Avoid prescribing drugs that interact; verify any new prescription against the patient's full medication list.

At a glance by procedure

Initial assessment before lab results or timing details are entered.

ProcedureInitial assessment
Examination / radiographsROUTINE

Routine care — note drug considerations (ARB)

Supragingival scaling / polishROUTINE

Routine care — note drug considerations (ARB)

Deep scaling / subgingival RSD (subgingival calculus)ROUTINE

Routine care — note drug considerations (ARB)

Root canal treatmentROUTINE

Routine care — note drug considerations (ARB)

Simple extraction (1–3 teeth)ROUTINE

Routine care — note drug considerations (ARB)

Surgical / bony extractionROUTINE

Routine care — note drug considerations (ARB)

Implant placementROUTINE

Routine care — note drug considerations (ARB)

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Combine all conditions, medications, lab results and the planned procedure — with anaesthetic dose calculation, lab requests and a referral letter PDF.

References

  1. Drug considerations in dentistry (oral side-effects & interactions)
  2. British National Formulary (BNF) — Prescribing in renal impairment, hepatic impairment & drug interactions (current edition)
  3. Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023

Related guides

This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.