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Overview

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This medicine contains an important and useful components, as it consists of
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Name

Olmesartan Medoxomil

Precaution

Before starting **Olmesartan Medoxomil**, patients should consult their healthcare provider, particularly if they have any of the following conditions: - **Renal Impairment**: - **Olmesartan** is primarily excreted through the kidneys, and in patients with **renal impairment**, there may be a need for dose adjustments or close monitoring of kidney function. Severe renal dysfunction can increase the risk of **hyperkalemia** (high potassium levels) and other adverse effects. - **Hepatic Impairment**: - Patients with liver disease may experience a prolonged effect of **Olmesartan Medoxomil**. Although no significant dose adjustments are typically required for mild to moderate liver impairment, individuals with **severe liver disease** should not use **Olmesartan** due to an increased risk of side effects. - **Dehydration or Electrolyte Imbalances**: - **Olmesartan** may cause **hypotension (low blood pressure)**, particularly in patients who are dehydrated or have an electrolyte imbalance (such as low sodium or high potassium). Such patients should be monitored carefully when initiating treatment. - **Pregnancy**: - **Olmesartan** is contraindicated in **pregnancy** due to the potential for fetal harm, particularly during the second and third trimesters. It can cause **renal failure**, **hypotension**, and **skull ossification defects** in the fetus. Women who are pregnant or planning to become pregnant should avoid this medication and consult their healthcare provider for an alternative treatment. - **Breastfeeding**: - **Olmesartan** is excreted into breast milk, and because of the potential for harm to a nursing infant, its use is generally not recommended while breastfeeding. Consult a healthcare provider before using this medication during lactation. - **Angioedema**: - **Olmesartan** can cause **angioedema**, a condition involving swelling of the deeper layers of the skin, particularly around the eyes, lips, and throat. Patients with a history of **angioedema** related to **ACE inhibitors** should be carefully monitored when using **Olmesartan**.

Indication

**Olmesartan Medoxomil** is primarily used to treat **hypertension (high blood pressure)**. By lowering blood pressure, it helps prevent complications such as: - **Stroke** - **Heart attack** - **Kidney damage** In addition to treating hypertension, **Olmesartan** is sometimes prescribed to help reduce the risk of **cardiovascular disease** in individuals with risk factors like diabetes or a history of heart disease. - **Chronic Kidney Disease (CKD)**: - In patients with **chronic kidney disease** or **diabetic nephropathy**, **Olmesartan** can help protect kidney function by reducing the progression of kidney damage associated with high blood pressure and diabetes.

Contra indication

**Olmesartan Medoxomil** should not be used in the following situations: - **Pregnancy**: - As mentioned, **Olmesartan** is contraindicated during pregnancy due to its potential to cause harm to the fetus, including renal failure, oligohydramnios (low amniotic fluid), and skeletal malformations. - **Severe Renal Impairment**: - It is contraindicated in patients with **severe renal impairment** or **bilateral renal artery stenosis** due to the increased risk of worsening kidney function and potential acute renal failure. - **Hypersensitivity**: - Patients with a known **hypersensitivity** or **allergy** to **Olmesartan** or any of its components should avoid using this medication. Symptoms of an allergic reaction can include rash, itching, swelling, or difficulty breathing. - **Concurrent Use with Aliskiren**: - **Olmesartan** should not be used in combination with **Aliskiren** in patients with **diabetes** or **renal impairment** due to an increased risk of adverse kidney effects and **hyperkalemia**.

Side Effect

Common and serious side effects of **Olmesartan Medoxomil** include: - **Common Side Effects**: - **Dizziness** or **lightheadedness**: Especially when standing up quickly, due to **low blood pressure**. - **Headache**: A common effect as the body adjusts to blood pressure changes. - **Fatigue**: Some individuals may feel tired or weak while on this medication. - **Back pain**: Muscle or back pain is occasionally reported. - **Serious Side Effects**: - **Hyperkalemia**: High potassium levels, which can cause **heart arrhythmias** and muscle weakness. Symptoms include irregular heartbeats, muscle fatigue, and numbness. - **Hypotension (Low Blood Pressure)**: Severe hypotension can occur, especially after the first dose, or if the patient is dehydrated or on other antihypertensives. - **Acute Kidney Injury**: In patients with pre-existing kidney conditions, **Olmesartan** may worsen kidney function. Symptoms of kidney injury include reduced urine output, swelling, and fatigue. - **Angioedema**: Swelling of the deeper layers of the skin, especially in the face, lips, throat, and tongue. This can cause difficulty breathing and is a medical emergency. - **Rash or Itching**: Can occur due to an allergic reaction to the medication. - **Elevated Liver Enzymes**: Indicating liver damage or dysfunction. Patients should contact their healthcare provider immediately if they experience any of these serious side effects, particularly **angioedema** or **signs of kidney damage**.

Pregnancy Category ID

3

Mode of Action

**Olmesartan Medoxomil** is an **angiotensin II receptor blocker (ARB)**, which works by selectively blocking the action of **angiotensin II**, a hormone that causes blood vessels to constrict. By blocking the effects of **angiotensin II**, **Olmesartan** helps to: - **Dilate blood vessels**, reducing blood pressure. - **Decrease aldosterone secretion**, which leads to a reduction in sodium and water retention, further aiding in blood pressure reduction. - **Improve kidney function** in patients with conditions like diabetic nephropathy or chronic kidney disease. Unlike **ACE inhibitors**, which block the formation of **angiotensin II**, **Olmesartan** directly blocks the receptors it binds to, thereby avoiding the **coughing** side effect often associated with ACE inhibitors.

Interaction

**Olmesartan Medoxomil** can interact with a variety of medications, leading to enhanced side effects or reduced efficacy: - **Other Antihypertensive Drugs**: - **Olmesartan** can increase the blood pressure-lowering effect of other antihypertensive medications such as **ACE inhibitors**, **diuretics**, and **calcium channel blockers**. This may lead to an increased risk of hypotension (low blood pressure), especially during the initial phases of treatment. - **Diuretics**: - The combination of **Olmesartan** and **diuretics** (especially potassium-sparing diuretics like **spironolactone** or **amiloride**) can increase the risk of **hyperkalemia** (high potassium levels). Patients should be monitored for signs of elevated potassium, including muscle weakness, fatigue, and abnormal heart rhythms. - **Lithium**: - **Olmesartan** can reduce the renal clearance of **lithium**, leading to an increased risk of **lithium toxicity**. Monitoring of lithium levels is essential if both drugs are used together. - **NSAIDs**: - **Nonsteroidal anti-inflammatory drugs (NSAIDs)** like **ibuprofen** or **naproxen** can reduce the antihypertensive effects of **Olmesartan** and may worsen kidney function. Caution is needed when combining these drugs, particularly in patients with kidney disease. - **Potassium Supplements**: - The use of **potassium supplements** or potassium-sparing diuretics in combination with **Olmesartan** can increase the risk of **hyperkalemia**, so potassium levels should be closely monitored.

Pregnancy Category Note

Pregnancy category: 1st trimester, C; 2nd and 3rd trimesters, D

Adult Dose

The usual starting dose of **Olmesartan Medoxomil** for **adults** with **hypertension** is **20 mg** once daily, taken with or without food. If the target blood pressure is not achieved after 2 weeks, the dose may be increased to **40 mg** daily. The maximum recommended dose is **40 mg** daily. For patients with **renal impairment**, the dose should be adjusted based on kidney function, and they should be monitored for side effects closely.

Child Dose

**Olmesartan** is not typically used in pediatric patients under 18 years of age for hypertension treatment due to insufficient data on safety and efficacy in this population. However, for children aged **6 years and older** with **hypertension**, the usual starting dose is **10 mg** once daily. The dose may be increased based on blood pressure response, but should not exceed **20 mg** per day. Always consult a healthcare provider before starting **Olmesartan Medoxomil**, as they can provide personalized guidance based on individual health conditions.

Renal Dose

In patients with **mild to moderate renal impairment (creatinine clearance >30 mL/min)**, no dosage adjustment of **Olmesartan** is necessary. However, in patients with **severe renal impairment** or **end-stage renal disease (creatinine clearance <30 mL/min)**, the medication should be used with caution, and monitoring of kidney function is essential.

Administration

Information not available