Olmesartan Medoxomil

A to Z Drug Facts

  Action Blocks vasoconstrictor effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT₁ receptor in vascular smooth muscle.

  Indications Treatment of hypertension.

  Contraindications Standard considerations.

  Route/Dosage

Adults: PO Start with 20 mg once daily; after 2 wk, dosage may be increased to 40 mg/day if further reduction in BP is needed.

  Interactions None well documented.

  Lab Test Interferences

Lithium

Plasma concentrations may be increased by olmesartan, resulting in an increase in the pharmacologic and adverse effects of lithium.

  Adverse Reactions

CARDIOVASCULAR: Tachycardia. CNS: Dizziness; fatigue; vertigo; insomnia. DERMATOLOGIC: Rash. GI: Abdominal pain; dyspepsia; gastroenteritis; nausea. GU: UTI. METABOLIC: Hypercholesterolemia; hyperlipemia; hyperuricemia. OTHER: Chest pain; pain; peripheral edema; arthritis; myalgia; skeletal pain.

  Precautions

Pregnancy: Category C (first trimester); category D (second and third trimester). Can cause injury or death to the fetus if used during second or third trimester. Lactation: Undetermined. CHILDREN: Safety and efficacy not established. Renal function impairment: In patients whose renal function may depend on activity of the renin-angiotensin-converting enzyme system (eg, patients with severe CHF), treatment with olmesartan may be associated with oliguria and progressive azotemia, rarely resulting in acute renal failure or death.

  Administration/Storage

• Give prescribed dose once daily, with or without food.
• Administer with food if GI upset occurs.
• Store tablets at controlled room temperature (68° to 77°F).

  Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note history of impaired renal function, severe CHF, renal artery stenosis, volume depletion or dehydration, or allergy to olmesartan or other angiotensin II receptor antagonists.
• Ensure that serum electrolytes are monitored periodically.
• Monitor and record BP and pulse. Should hypotension result, withhold medication and notify health care provider.
• Take safety precautions if orthostatic hypotension occurs.
• Monitor for signs of hypersensitivity, including angioedema involving swelling of the face, lips, eyelids, and tongue. Discontinue medication and contact health care provider immediately if noted.

  Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to take once daily as prescribed, without regard to meals, but to take with food if GI upset occurs.
• Advise patient to take each dose at about the same time each day.
• Inform patient that the drug controls, but not does cure, hypertension and to continue taking the drug as prescribed, even when BP is not elevated.
• Caution patient not to change the dose or stop taking unless advised by health care provider.
• Instruct patient to continue taking other BP medications as prescribed by health care provider.
• Instruct patient in BP and pulse measurement skills.
• Advise patient to monitor and record BP and pulse at home and to inform health care provider should abnormal measurements be noted. Advise patient to take record of BP and pulse to each follow-up visit.
• Instruct patient to lie or sit down if experiencing dizziness or lightheadedness when standing.
• Caution patient that inadequate fluid intake, excessive perspiration, diarrhea, or vomiting can lead to an excessive fall in BP resulting in lightheadedness or fainting.
• Emphasize to hypertensive patient the importance of the following other modalities on BP: weight control, regular exercise, smoking cessation, moderate intake of alcohol and salt.
• Instruct women to notify health care provider if pregnant, plan on becoming pregnant, or breastfeeding.
• Instruct patient to stop taking drug and immediately report any of the following symptoms to health care provider: fainting; swelling of the face, lips, eyelids, or tongue.
• Caution patient to not take any prescription or OTC medications, salt substitutes, or dietary supplements unless advised by health care provider.
• Advise patient that follow-up visits and lab tests may be required to monitor therapy and to keep appointments.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts