olmesartan medoxomil (redirected from Benicar)

olmesartan medoxomil,

an antihypertensive agent.

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olmesartan medoxomil

Benicar, Olmetec (UK)

Pharmacologic class: Angiotensin II type 1-receptor antagonist

Therapeutic class: Antihypertensive

Pregnancy risk category C (first trimester), D (second and third trimesters)

FDA Boxed Warning

• When used during second or third trimester of pregnancy, drug may cause fetal harm or death. Discontinue as soon as possible when pregnancy is detected.

Action

Selectively blocks binding of angiotensin II to specific tissue receptors in vascular smooth muscle and adrenal gland. This action blocks vasoconstrictive effects of renin-angiotensin system as well as aldosterone release, thereby reducing blood pressure and possibly preventing vascular remodeling related to arteriosclerosis.

Availability

Tablets: 5 mg, 20 mg, 40 mg

⊘Indications and dosages

➣ Hypertension

Adults: 20 mg P.O. once daily; may titrate to 40 mg daily after 2 weeks, if needed

Dosage adjustment

• Volume depletion

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• hepatic disease, renal dysfunction, hypovolemia, sodium depletion
• elderly patients
• pregnant patients (first trimester; not recommended in second and third trimesters)
• breastfeeding patients
• children (safety and efficacy not established).

Administration

• Give with or without food.
• Know that drug may be used alone or with other antihypertensives.

Route	Onset	Peak	Duration
P.O.	Variable	1-2 hr	Unknown

Adverse reactions

CNS: fatigue, dizziness, headache, insomnia

CV: orthostatic hypotension, chest pain, peripheral edema, syncope, tachycardia

EENT: sinusitis, rhinitis, pharyngitis

GI: nausea, diarrhea, constipation, abdominal pain, dry mouth

GU: hematuria

Hematologic: hyperglycemia

Musculoskeletal: back pain, arthritis, muscle weakness

Respiratory: upper respiratory infection symptoms, bronchitis, cough

Skin: dry skin, rash, inflammation, pruritus, alopecia, angioedema

Other: dental pain, flulike symptoms

Interactions

Drug-diagnostic tests. Triglycerides: increased level

Drug-herbs. Ephedra (ma huang): antagonism of antihypertensive effect

Patient monitoring

• Monitor vital signs and cardiovascular status. Stay alert for orthostatic hypotension, syncope, and peripheral edema.
• Check temperature and watch for signs and symptoms of flu and other infections (especially respiratory and EENT infections).
• Watch for angioedema.
• In volume-depleted patient, monitor blood pressure carefully after initial dose. Transient blood pressure drop may occur.

Patient teaching

• Tell patient to take at same time each day, with or without food.
• Advise patient to promptly report signs and symptoms of infection, particularly respiratory symptoms.
• Inform patient that when he begins therapy, inadequate fluid intake, excessive perspiration, vomiting, or diarrhea may cause blood pressure to drop. Tell him to change position slowly to avoid dizziness or fainting.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
☞ Tell female patient to notify prescriber immediately if she suspects pregnancy.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the tests and herbs mentioned above.