Olmesartan
BENICAR
What it isAngiotensin II receptor blocker; hypertension.
Why this oneStrong pressure lowering is its appeal, but unlike several ARBs it lacks a separate heart-failure or kidney-disease indication.
What limits itSprue-like enteropathy with chronic diarrhea and weight loss is the distinctive risk, sometimes appearing years in. Hyperkalemia as for the class.
FDA-approved for
- hypertension (2002)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 20 mg QD | 20-40 mg QD | 40 mg QD |
| Hypertension | Children ≥6 yr, 20 to <35 kg | 10 mg QD | 10-20 mg QD | 20 mg QD |
| Hypertension | Children ≥6 yr, ≥35 kg | 20 mg QD | 20-40 mg QD | 40 mg QD |
Titration May increase after 2 weeks if further BP reduction needed
Renal Undefined
Hepatic Undefined
Doses above 40 mg have no greater effect; twice-daily offers no advantage over same total daily dose
Instructions
- When pregnancy is detected, discontinue as soon as possible
- Consider lower starting dose in volume/salt-depleted patients
Contraindications
- Do not co-administer aliskiren in patients with diabetes
Cautions
- Fetal toxicity
- Hypotension in volume- or salt-depleted patients
- Worsening renal function in renal impairment
- Sprue-like enteropathy
- Not recommended in children <1 year
Adverse reactions
- Dizziness (3%)
Pregnancy Can cause fetal harm; discontinue as soon as pregnancy is detected
Lactation No human data; decide whether to discontinue nursing or the drug
⚠ BOXED WARNING
- Fetal toxicity; discontinue as soon as pregnancy is detected
Principal riskHyperkalemia; sprue-like enteropathy
Cost, est. cash$5–$150/month
Generic entry2016
Classes and tags
Clinical profile
Legacy pregnancy categoryD
Defining liabilityHyperkalemia, kidney injury, fetal toxicity and increased lithium exposure.
Mechanism of action: Olmesartan ballicule
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