| OLMESARTAN MEDOXOMIL
Classifications: angiotensin ii receptor antagonist, antihypertensive; Therapeutic: antihypertensive, angiotensin ii receptor antagonist
Pregnancy Category: C first trimester; D second and third trimester
5 mg, 20 mg, 40 mg tablets
Angiotensin II receptor (type AT1) antagonist acts as a potent vasodilator and primary vasoactive hormone of the renin-angiotensin-aldosterone system. Selectively
blocks the binding of angiotensin II to the AT1 receptors found in many tissues (e.g., vascular smooth muscle, adrenal glands). Antihypertensive effect results from blocking
the vasoconstricting and aldosterone-secreting effects of angiotensin II.
Antihypertensive effect is due to its potent vasodilation effect.
Treatment of hypertension.
Hypersensitivity to pimecrolimus or components in the cream; Netherton's syndrome; application to active cutaneous viral
infection; pregnancy (category C first trimester, and category D in second and third trimester); lactation, children.
Renal artery stenosis; heart failure; severe renal impairment; hypovolemia.
Route & Dosage
Adult: PO 20 mg q.d., may increase to 40 mg q.d. Start with 510 mg q.d. if volume depleted.
- Determine if patient is volume depleted (e.g., patients treated with diuretics) prior to first administration of drug. If
volume depletion is suspected, a lower starting dose is recommended.
- Store at 20°25° C (68°77° F).
Adverse Effects (≥1%)Body as a Whole:
Back pain, flu-like symptoms
Hypotension (especially if dehydrated). GI: Diarrhea
Increased CPK, hyperglycemia, hypertriglyceridemia. Respiratory: Bronchitis
, pharyngitis, rhinitis, sinusitis
, upper respiratory infection
May increase hypotensive effect of other antihypertensives
; may cause hyperkalemia with potassium-sparing diuretics
, potassium supplements
; increase risk of lithium toxicity
. Herbal: Ephedra, ma-huang
may antagonize antihypertensive effects.
Rapidly absorbed, 26% reaches systemic circulation. Peak:
12 h. Distribution:
99% protein bound. Metabolism:
Not metabolized by CYP 450 system. Elimination:
50% in urine, 50% in feces. Half-Life:
Assessment & Drug Effects
- Monitor closely any volume-depleted patient following initial drug doses. If serious hypotension occurs, place patient in
supine position and notify physician immediately.
- Monitor BP and HR at drug trough (prior to a scheduled dose). Report hypotension or bradycardia.
- Monitor drug effectiveness, especially in African Americans, when olmesartan is used as monotherapy.
- Lab tests: Monitor baseline and periodic renal functions; monitor CBC, electrolytes, and liver function with long-term therapy.
Patient & Family Education
- Discontinue drug and notify physician if you experience swelling of the face, tongue, or throat, or if you believe you are
- Notify physician of symptoms of hypotension (e.g., dizziness, fainting).