The medicine Olmesartan Medoxomil is an antihypertensive medication, the main substance of which is a group of angiotensin II receptor blockers.
The drug has increased selectivity for angiotensin II type 1 (AT1), with which the main effects of angiotensin II are realized. When these receptors are blocked, the drug prevents and suppresses the vasoconstrictive effect of the hormone, contributes to a secondary increase in plasma renin activity due to the elimination of the negative feedback when it is released and a direct decrease in aldosterone production.
With the development of arterial hypertension, this pharmacological drug causes a dose-dependent, prolonged decrease in blood pressure.
There is no information regarding the development of hypotension after taking the initial dosage of Olmesartan Medoxomil, as well as tachyphylaxis with prolonged therapy and withdrawal syndrome.
When using the drug once a day, an effective and gentle decrease in pressure is achieved within 24 hours. The maximum antihypertensive effect is achieved approximately 8 weeks after the start of treatment, although many patients notice a significant antihypertensive effect after 2 weeks of therapy.
Pharmacokinetic data
The medication Olmesartan Medoxomil is a prodrug that is rapidly converted to olmesartan (a pharmacologically active metabolite) under the influence of esterases in the intestinal mucosa and in the blood of the portal vein during absorption from the digestive tract. In plasma or in biological secretions, the undecayed basic substance and the unchanged side chain of the medoxomil category are not determined. The elimination period of the drug averages two hours after oral administration and increases almost linearly with an increase in dosage to 80 mg. Concomitant food intake does not affect the bioavailability of the main active element of this drug. This is confirmed by the instruction to "Olmesartan medoxomil."
Binding to plasma proteins is 98.9%, but the potential for a clinically significant shift of this value in the interaction of the main substance with other drugs with an increased degree of protein binding is reduced. This is confirmed by the lack of a clinically significant interaction between warfarin and olmesartan. The medicinal product is excreted in urine (approximately 41%) and bile (approximately 62%), the half-life is 10-14 hours. No accumulation of the main substance was noted.
Indications for appointment
The drug "Olmesartan Medoxomil" is intended exclusively for the treatment of essential arterial hypertension. Before taking, you should read the instructions for the drug.
Many people wonder if the safety studies of Olmesartan Medoxomil were conducted. About it further.
Dosage regimen and method of application
The medication must be taken orally, daily. The initial dosage is 10 mg / day. In case of insufficient effectiveness of the drug, it can be increased to the most optimal - 20 mg / day. If necessary, the dosage is increased to a maximum level of 40 mg.
For elderly patients, dose adjustment is not required. If it is necessary to increase the daily dose to a maximum level (40 mg / day), this event should be carried out under the constant control of blood pressure.
For patients who have impaired renal function in a moderate or mild degree, the maximum maximum daily dose is not more than 20 mg.
Side effects
What else does the instructions for use with Olmesartan Medoxomil tell us?
Despite the high effectiveness and popularity of this pharmacological agent, it has many side effects. They do not allow him to appoint a certain category of patients. The following side effects may develop:
- From the cardiovascular system: angina pectoris, arterial hypotension.
- From the hemopoietic system: thrombocytopenia.
- From the central nervous system: dizziness, vertigo, cephalalgia, asthenic syndrome (drowsiness, increased fatigue, general malaise).
- From the respiratory system: bronchitis, rhinitis, pharyngitis, cough.
- From the digestive system: diarrhea, gastroenteritis, dyspepsia, abdominal pain, vomiting, nausea, increased liver enzyme functionality.
- Dermatological phenomena: skin itching, rashes, angioedema, swelling of the face, allergic dermatitis, urticaria.
- From the musculoskeletal system: arthritis, back pain, bone pain, muscle cramps, myalgia, increased activity of CPK.
- From the urinary system: infection of the urinary tract, hematuria.
- Metabolic disorders: hyperuricemia, hypertriglyceridemia, hyperkalemia, increased levels of urea and creatinine in the blood serum, peripheral edema.
- Other adverse reactions: pain in the chest area, flu-like symptoms.
Contraindications for use
Olmesartan Medoxomil studies on safety have shown that in case of adverse reactions or in the presence of contraindications, the drug should not be used in any case, since there is a high probability of developing serious complications and overdose.
This medication is contraindicated in the following cases:
- bile duct obstruction;
- period of pregnancy, breastfeeding;
- age less than 18 years;
- sensitivity to the main active substance.
So it is said in the instructions for use to "Olmesartan medoxomil." Analogues of the drug will be considered below.
Use for impaired renal function
Given the lack of sufficient clinical experience, the use of this drug in patients with severe renal failure is not recommended.
With caution, it is necessary to apply this medicine to patients with kidney pathologies, with renal artery stenosis, since there is a high probability of developing acute azotemia, hypotension, oliguria, and renal failure. In the treatment of high blood pressure in people with impaired renal function, it is recommended to periodically check the level of creatinine and potassium in the blood serum.
Special recommendations
Given the lack of sufficient medical experience, it is not recommended to use this medication in patients with severe renal failure, as well as in patients with impaired liver function.
With caution, the drug should be used to treat patients with mitral and aortic valve stenosis or with hypertrophic obstructive cardiomyopathy.
In cases of previous intensive treatment with diuretics, maintaining a salt-free diet, with vomiting or diarrhea after taking the initial dosage, arterial hypotension may occur due to a decrease in bcc. Therefore, it is necessary to eliminate the risk of developing hypovolemia before starting treatment with this pharmacological drug.
The drug Olmesartan Medoxomil is used with caution in people with heart failure, renal pathologies, and arterial stenosis of both or one kidney, since there is a risk of developing acute azotemia, hypotension, oliguria, and renal failure.
In the treatment of patients with impaired renal function, periodic monitoring of the concentration of creatinine and potassium in the blood should be carried out. It is not recommended to take medication in patients with primary hyperaldosteronism.
It should also be borne in mind that an excessive decrease in pressure in patients with cerebral arteriosclerosis or coronary artery disease can lead to a heart attack or ischemic stroke.
Drug interaction
With the combined use of the pharmacological drug "Olmesartan medoxomil" with other antihypertensive drugs, an increase in the hypotensive effect is possible.
With the simultaneous administration of this drug with NSAIDs, a decrease in the hypotensive effect and an increase in the risk of acute renal failure are possible.
After treatment with antacids (aluminum, magnesium hydroxide), a decrease in the bioavailability of the main active substance may be noted.
With the simultaneous administration of the Olmesartan Medoxomil medication and lithium preparations, the toxicity of the latter significantly increases. This combination is not recommended.
The likelihood of developing hyperkalemia may increase with the simultaneous use of drugs with potassium-sparing diuretics, medicines containing potassium or with other drugs that can cause an increase in the concentration of this element in the blood. For example, with heparin (this combination is not recommended).
"Olmesartan Medoxomil" or "Candesartan" - which is better?
The drug “Candesartan” is a hypotensive drug of domestic production, an analogue of the medication described by us. It is designed to fight high blood pressure. This medication is able to create strong long-term bonds with AT receptors. It does not inhibit the processes of ACE, does not affect the functionality of other hormones, in addition to angiotensin II. The drug also does not block ion channels.
To say exactly which of these medications to use for treatment is preferable is impossible with absolute accuracy. They practically do not differ in therapeutic effect and are prescribed by medical specialists with the same frequency. The only difference between these medicines is their cost, which is quite substantial. So, “Olmesartan Medoxomil” costs about 700 rubles, “Candesartan” - about 250 rubles.
Analogs
The list of the main analogues of Olmesartan Medoxomil includes such drugs as:
- Amplodipine;
- "Reserpine";
- "Indapamide";
- Ramipril
- Candersartan
- "Lercanidipine";
- Aliskiren;
- "Clopamide";
- Losartan
- "Methyldopa";
- "Fimasartan";
- Enalapril;
- Telmisartan
- Gauanfacin;
- Nitrendipine
- Verapamil;
- Hinapril.
Reviews
Despite the high cost of this pharmacological agent, it is very popular among hypertensive patients. Patients who have been prescribed this medication are pleased with its effectiveness and safety. They say that the medicine practically does not cause adverse reactions in the body, is easily tolerated, lowers blood pressure quickly and gently. However, they do not experience headaches, which are a frequent companion of a sharp decrease in pressure. In addition, patients note a rare occurrence of allergic reactions to the drug, which are also observed when taking many other drugs.
There are also negative reviews about this medication, but there are very few of them. At the same time, patients are dissatisfied with the price of the medication and claim that they are well treated with the analogues of Olmesartan Medoxomil. They no less well cope with their main task, but are much cheaper.
We have reviewed the instructions and analogues for the drug Olmesartan Medoxomil.