Olmesartan

DEA Class; Rx

Common Brand Names; Benicar

• ARBs

Angiotensin II antagonist; used once daily for HTN; does not inhibit ACE and accumulate bradykinin; less likely to cause cough or angioedema than ACE inhibitors; not metabolized by the liver; lacks interactions with cytochrome P-450 inhibitors or inducers.

Indicated for the treatment of hypertension.

Hypersensitivity

Do not coadminister with aliskiren in patients with diabetes mellitus or with renal impairment (ie, GFR <60 mL/min/1.73 m²)

• Dizziness
• Headache
• Fatigue
• Diarrhea
• Hyperglycemia
• Hypertriglyceridemia
• Back pain
• Bronchitis
• Inflicted injury
• Flulike symptoms
• Pharyngitis
• Rhinitis
• Sinusitis
• Upper respiratory tract infection (URTI)
• Anaphylactic reaction
• Angioedema
• Facial edema
• Rhabdomyolysis
• Hyperkalemia
• Tachycardia
• Hypercholesterolemia
• Gastroenteritis
• Hyperlipidemia

Use caution in congestive heart failure (CHF), surgery or anesthesia, volume depletion (consider lower dosage)

Angioedema reported; may occur at any time during treatment, especially after first dose; risk increases in patients with idiopathic or hereditary angioedema or experiencing angioedema following ACE-inhibitor therapy; prolonged monitoring of air pathways may be necessary as reactions are associated with airway obstruction; not for administration to patients with prior history of angioedema following therapy with ARBs; discontinue therapy immediately if angioedema occurs; intramuscular administration of epinephrine may be necessary to manage angioedema

Coadministration with mTOR inhibitors (eg, temsirolimus) may increase risk for angioedema

Risk of hypotension, especially in patients with volume or salt depletion secondary to salt restriction or prolonged diuretic treatment; initiate treatment in such patients under close medical supervision and consider starting at a lower dose

Risk of hyperkalemia; monitor serum electrolytes periodically; use with caution, if at all and monitor potassium closely in patients with risk factors, including diabetes mellitus, renal dysfunction, potassium supplements and/or potassium containing salts

Use with caution in patients with unstented unilateral/bilateral renal artery stenosis; avoid therapy when unstented bilateral renal artery stenosis is present due to elevated risk of deterioration in renal function unless possible benefits outweigh risks

Renal impairment reported; may occur in patients with low renal blood flow (eg, heart failure, renal artery stenosis), whose glomerular filtration rate is dependent on efferent arteriolar vasoconstriction by angiotensin II, which may result in acute renal failure, oliguria, and progressive azotemia; discontinue therapy only in patients with progressive and/or significant deterioration in renal function

Use caution in patients with pre-existing renal insufficiency

Can cause fetal harm when administered to a pregnant woman; use of drugs that act on renin-angiotensin system during second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death

There is no information regarding presence of drug in human milk, effects on breastfed infant