olmesartan medoxomil
CLINICAL USE
Angiotensin-II receptor antagonist:Hypertension
DOSE IN NORMAL RENAL FUNCTION
10–40 mg once daily
PHARMACOKINETICS
Molecular weight :558.6 %Protein binding :99.7 %Excreted unchanged in urine : 35–50 Volume of distribution (L/kg) :0.24half-life – normal/ESRD (hrs) :10–15/36 DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50 : Dose as in normal renal function 10 to 20 : Dose as in normal renal function. Start with low doses <10 : Dose as in normal renal function Initial dose 10 mg daily and gradually increase DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD :Not dialysed. Dose as in GFR <10 mL/min HD :Not dialysed. Dose as in GFR <10 mL/minHDF/high flux :Unlikely to be dialysed. Dose as in GFR <10 mL/minCAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Anaesthetics: enhanced hypotensive effect Analgesics: antagonism of hypotensive effect and increased risk of renal impairment with NSAIDs; hyperkalaemia with ketorolac and other NSAIDsCiclosporin: increased risk of hyperkalaemia and nephrotoxicity Diuretics: enhanced hypotensive effect; hyperkalaemia with potassium-sparing diuretics Epoetin: increased risk of hyperkalaemia; antagonism of hypotensive effect Lithium: reduced excretion (possibility of enhanced lithium toxicity) Potassium salts: increased risk of hyperkalaemia Tacrolimus: increased risk of hyperkalaemia and nephrotoxicity ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Hyperkalaemia and other side effects are more common in patients with impaired renal functionRenal failure has been reported in association with angiotensin-II antagonists in patients with renal artery stenosis, post renal transplant, and in those with congestive heart failureClose monitoring of renal function during therapy is necessary in those with renal insufficiencyIn mild, moderate and severe renal failure, the AUC is increased by 62, 82 and 179% respectively
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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