Indication

Olmesartan is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.


Dosage & Administration

Adult Hypertension:
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 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), initiate Olmesartan under close medical supervision and give consideration to use of a lower starting dose. Olmesartan may be administered with or without food. Olmesartan may be administered with other antihypertensive agents.
Child: 6 to 16 yr: 20-35 kg: 10 mg once daily, may increase to maximum of 20 mg once daily. >35 kg: 20 mg once daily, may increase to maximum of 40 mg once daily.
Elderly: May consider lower starting dose of 5-10 mg daily.


Precautions

Pregnancy Category (US FDA): Category D: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening

 

situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Symptomatic hypotension may occur in patients who are volume- and/orsalt-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.


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