Generic Name and Formulations:
Olmesartan medoxomil 5mg, 20mg, 40mg; tabs.
Individualize. ≥16yrs: Monotherapy, not volume-depleted: initially 20mg once daily; may increase to max 40mg once daily after 2 weeks. Volume-depleted (eg, concomitant diuretic): consider lower initial dose.
Individualize. <1yr: do not give. <6yrs: not recommended. 6–16yrs: (20kg to <35kg): initially 10mg once daily; may increase to max 20mg once daily after 2 weeks; (≥35kg): initially 20mg once daily; may increase to max 40mg once daily after 2 weeks. Tablets may be prepared as an oral suspension if unable to swallow: see literature.
Angiotensin II receptor blocker.
Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Correct salt/volume depletion before beginning therapy, or monitor closely. Renal impairment: monitor for worsening renal function. Severe CHF. Renal artery stenosis. Possibly less effective in black patients. Elderly. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers: not recommended.
May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume-depleted). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Take 4hrs before colesevelam HCl dose.
Dizziness, possible sprue-like enteropathy, rhabdomyolysis (rare).
Tabs 5mg—30; 20mg, 40mg—30, 90