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Indications
Olmesartan Medoxomil is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.
Pharmacology
Angiotensin II, formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor, the major active hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates the secretion of aldosterone by the adrenal cortex. Olmesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT receptor found in many tissues (eg, vascular smooth muscle, adrenal gland). . Penetration studies indicate that olmesartan is a reversible and competitive inhibitor of the AT1 receptor. Olmesartan does not inhibit ACE (kinase I, the enzyme that converts angiotensin I to angiotensin II and breaks down bradykinin).
Dosage & Administration
Dosage must be individualized. The usual recommended starting dose of Olmesartan is 20 mg once daily when used as monotherapy in patients who are not volume-contracted. For patients requiring further reduction in blood pressure after 2 weeks of therapy, the dose of Olmesartan may be increased to 40 mg. Doses above 40 mg do not appear to have a greater effect. Twice-daily dosing offers no advantage over the same total dose given once daily.
No initial dosage adjustment is recommended for elderly patients, for patients with moderate to marked renal impairment (creatinine clearance <40 ml/min) or with moderate to marked hepatic dysfunction. For patients with possible depletion of intravascular volume (e.g. patients treated with diuretics, particularly those with impaired renal function), Olmesartan should be initiated under close medical supervision and consideration should be given to the use of a lower starting dose. Olmesartan may be administered with or without food.
Interaction
With medicine: No significant drug interactions were reported in which Olmesartan was co-administered.
With food & others: Food does not affect the bioavailability of Olmesartan.
Contraindications
Olmesartan is contraindicated in patients who are hypersensitive to any component of this product.
Side Effects
Common: The most common adverse events include back pain, bronchitis, increased creatine phosphokinase, diarrhea, headache, hematuria, hyperglycemia, hypertriglyceridemia, flu-like symptoms, pharyngitis, inflammation nose and sinusitis.
Rare: Chest pain, peripheral edema, arthritis.
Pregnancy & Lactation
Pregnancy: When pregnancy is discovered, discontinue this product as soon as possible. When used during pregnancy in the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus.
Lactation: It is not known whether olmesartan is excreted in human milk, but olmesartan is secreted at low concentrations in the milk of lactating rats. Because of the potential for adverse effects in the nursing infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Precautions & Warnings
Due to the inhibition of the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible individuals treated with olmesartan medoxomil. In patients where renal function may be dependent on the activity of the renin-angiotensin-aldosterone system - eg. In patients with severe congestive heart failure, treatment with ACE inhibitors and angiotensin receptor antagonists has been associated with oliguria and/or progressive uremia and (rarely) leading to acute renal failure and/or death. death. Similar results can be expected in patients treated with olmesartan medoxomil.
Storage Conditions
Store in a cool & dry place below 30ºC, and protect from light & moisture. Keep out of the reach of children.
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