Olmesartan


Concise Prescribing Info
Indications/Uses
HTN.
Dosage/Direction for Use
Adult : PO Initial: 10-20 mg once daily, may be increased to max 40 mg once daily if needed.
Dosage Details
Oral
Hypertension
Adult: Initial: 10-20 mg once daily may then be increased up to max 40 mg once daily if needed.
Child: 6-16 yr <35 kg: 10 mg once daily; ≥35 kg: 20 mg once daily. Doses may be doubled once if necessary after 2 wk.
Elderly: No dosage adjustment necessary.
Renal Impairment
CrCl Dosage
20-60 Max: 20 mg once daily.
Hepatic Impairment
Moderate: Initial: 10 mg once daily may increase up to max 20 mg once daily.
Contraindications
Biliary obstruction. Pregnancy.
Special Precautions
Patients w/ aortic or mitral valve stenosis, renal artery stenosis; at risk for hypotension (e.g. patients w/ volume or salt depletion); history of angioedema; at risk for hyperkalaemia (e.g. patients w/ DM). Severe renal and hepatic impairment. Lactation.
Adverse Reactions
May cause sprue-like enteropathy (Symptoms: Severe, chronic diarrhoea w/ substantial wt loss). Dizziness, headache, abdominal pain, dyspepsia, diarrhoea, gastroenteritis, nausea, bronchitis, pharyngitis, rhinitis, arthritis, back pain, skeletal pain, fatigue, flu-like symptoms, angioedema, peripheral oedema, haematuria, UTI, hyperkalaemia, hypertriglyceridemia, hyperuricaemia, hyperglycaemia, elevated liver enzymes.
MonitoringParameters
Monitor BP, serum creatinine and K levels periodically.
Overdosage
Symptoms: Hypotension and tachycardia. Management: Symptomatic and supportive treatment.
Drug 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.
Action
Description: 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.
Pharmacokinetics:
Absorption: Bioavailability: Approx 26%. Time to peak plasma concentration: Approx 1-2 hr.
Distribution: Volume of distribution: 17 L. Plasma protein binding: ≤99%.
Metabolism: Olmesartan medoxomil undergoes ester hydrolysis in the GI tract to active form olmesartan.
Excretion: Via faeces (50-65%) and urine (35-50%) both as olmesartan. Terminal half-life: Approx 10-15 hr.
Storage
Store between 20-25°C.
References
Anon. Olmesartan. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 18/11/2013.

Buckingham R (ed). Olmesartan Medoxomil. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/11/2013.

Joint Formulary Committee. Olmesartan medoxomil. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/11/2013.

McEvoy GK, Snow EK, Miller J et al (eds). Olmesartan medoxomil. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 18/11/2013.

Olmesartan Medoxomil: Drug Safety Communication - Label Changes To Include Intestinal Problems (Sprue-Like Enteropathy). U.S. FDA. https://www.fda.gov/. Accessed 18/11/2013.

Disclaimer: This information is independently developed by MIMS based on Olmesartan from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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