Olmesartan Medoxomil
Indications
Olmesartan Medoxomil is used for:
Hypertension, Diabetic nephropathy,
Adult Dose
Oral
Hypertension
Adult: Initial: 10-20 mg once daily may then be increased up to max 40 mg once daily if needed.
Elderly: No dosage adjustment needed.
Hepatic impairment: Moderate: Initial: 10 mg once daily may increase up to max 20 mg once daily.
Child Dose
Oral
Hypertension
Child: 6-16 yr <35 kg: 10 mg once daily; dosage range: 10-20 mg/day
>35 kg: 20 mg once daily. Doses may be doubled once if necessary after 2 wk. dosage range: 20-40 mg/day
Renal Dose
Renal impairment: Mild to moderate (CrCl: 20-60 mL/min): Max: 20 mg once daily.
Administration
Contra Indications
Pregnancy (2nd and 3rd trimesters); biliary obstruction.
Precautions
Drugs that act on renin-angiotensin system can cause fetal injury and death when used in 2nd and 3rd trimesters of pregnancy. Olmesartan medoxomil should be discontinued as soon as possible once pregnancy is detected. Symptomatic hypotension may occur in patients who are volume- and/or salt-depleted. May be associated with oliguria, progressive azotaemia, and acute renal failure (rare). Patients with bilateral or unilateral renal artery stenosis may have increased risk of severe hypotension and renal insufficiency. Caution in renal impairment; monitor serum creatinine and potassium levels periodically. Avoid use in severe renal impairment (CrCl< 20 mL/min) and severe hepatic impairment. Caution in patients with aortic or mitral valve stenosis, obstructive hypertrophic cardiomyopathy. Patients with primary aldosteronism may not respond to angiotensin receptor antagonist. Not recommended in lactation.
Lactation: No human data; use with caution
Pregnancy-Lactation
Pregnancy category: 1st trimester, C; 2nd and 3rd trimesters, D
Interactions
Increased risk of hyperkalaemia w/ ACE inhibitors, K-sparing diuretics, K salts or K supplements and drugs that may increase serum K (e.g. ciclosporin, eplerenone). May potentiate BP lowering effects w/ other antihypertensives. May decrease glomerular filtration w/ NSAIDs which can cause acute renal failure. May increase serum concentrations and toxicity of lithium.
Adverse Effects
Side effects of Olmesartan Medoxomil :
1-10%
Dizziness,Headache,Fatigue,Diarrhea,Hyperglycemia,Hypertriglyceridemia,Back pain,Bronchitis,Inflicted injury,Flulike symptoms,Pharyngitis,Rhinitis,Sinusitis,Upper respiratory tract infection (URTI)
Frequency Not Defined (selected)
Anaphylactic reaction,Angioedema,Facial edema,Rhabdomyolysis,Hyperkalemia,Tachycardia,Hypercholesterolemia,Gastroenteritis,Hyperlipidemia
Potentially Fatal: Acute renal failure.
Mechanism of Action
Olmesartan is a selective and competitive angiotensin II Type 1 (AT1) receptor antagonist that blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II. As a result, olmesartan relaxes blood vessels, hence lowering BP and increases blood supply and oxygen to the heart.