Olmesartan – an Angiotensin Receptor Blocker
Comprehensive guide to olmesartan (Olmetec): uses, dosage, side effects, and precautions for managing high blood pressure effectively.
Olmesartan is used to treat high blood pressure (hypertension). It helps lower your blood pressure, as well as reduce your risk of having a stroke or heart attack in the future.
About olmesartan
Olmesartan belongs to a group of medicines called angiotensin-II receptor antagonists (AIIRAs), also known as angiotensin receptor blockers (ARBs). These medicines are used to lower high blood pressure. Angiotensin II is a substance in the body that causes blood vessels to narrow (constrict). Olmesartan blocks the action of angiotensin II and so relaxes the blood vessels. This brings the blood pressure down.
High blood pressure often has no symptoms. You may have been diagnosed with high blood pressure after visiting your doctor for another condition, or if a blood pressure check was done for any reason. Sometimes high blood pressure has no cause but can be associated with kidney disease, lifestyle factors such as being overweight, lack of exercise, smoking or a poor diet, or a family history of high blood pressure.
Everyone who is diagnosed with high blood pressure is advised to make some changes to their lifestyle. These are in addition to taking the tablets as prescribed. You should:
- eat a healthy diet, which includes eating lots of fruit and vegetables, and whole grains. You are likely to be advised to cut down your salt intake.
- not smoke;
- lose weight if you are overweight;
- take regular exercise (for example, 30-45 minutes of brisk walking at least most days of the week);
- cut down on alcohol to not more than 2-3 units a day.
Olmesartan is available as tablets (usually branded as Olmetec®). There is also a preparation that combines olmesartan with another blood pressure-lowering medicine called amlodipine. This is called Sevikar®.
Before taking olmesartan
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking olmesartan it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding. This is because olmesartan is contraindicated during pregnancy, particularly in the second and third trimesters, as it can cause fetal injury including anuria, oligohydramnios, renal failure, and death.
- If you have gallbladder problems.
- If you have a problem with your kidneys, particularly if it is a blockage of the artery which supplies blood to your kidneys (a condition called renal artery stenosis). Olmesartan is contraindicated in severe renal impairment (creatinine clearance <30 mL/min).
- If you have any problems with your heart valves or heart muscle (such as aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy).
- If you have a problem with the way your liver works. Use is not recommended in severe hepatic impairment (Child-Pugh score 10-15).
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines. In particular, tell your doctor if you are taking painkillers such as ibuprofen or indometacin, potassium supplements, diuretics, lithium, or medicines for diabetes.
- If you have ever had an allergic reaction to a medicine, or if you have had any other type of allergic reaction.
Primary aldosteronism: Patients with primary aldosteronism generally will not respond well to olmesartan and other ARBs.
How to take olmesartan
Before taking olmesartan tablets read any leaflet or information that comes with your tablets carefully. If you are not sure about anything ask your doctor or pharmacist.
Olmesartan tablets
Take olmesartan exactly as your doctor tells you to. It is usual to take one tablet each day. There are several different strengths of tablet available (10 mg, 20 mg and 40 mg). When you first start treatment your doctor may gradually increase the strength of the tablets to suit your condition.
Swallow the tablet with a drink of water. You can take olmesartan tablets with or without food. Try to take your doses at the same time of day each day.
Olmesartan with amlodipine tablets
If you have been prescribed the combination tablets (Sevikar®), take one tablet each day, as directed by your doctor. Again, swallow the tablet with a drink of water. You can take the tablets with or without food.
Dosage in special populations:
- Renal impairment: In patients with mild to moderate renal impairment (creatinine clearance 20-60 mL/min), the maximum dose is 20 mg once daily.
- Hepatic impairment: No initial dose adjustment needed for mild to moderate; not recommended in severe.
- Pediatric use: Approved for hypertension in children aged 6 years and older; dosing based on weight and response.
Getting the most from your treatment
Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Olmesartan will not cure your high blood pressure but it will work throughout the day to help keep it under control.
- Your doctor may ask you to have a blood test from time to time. This is to check the levels of potassium in your blood and how well your kidneys are working.
- If you buy any medicines, check with a pharmacist that they are suitable to take with olmesartan. This is because some anti-inflammatory painkillers (such as aspirin and ibuprofen) can interfere with the way it works, and also may increase the risk of side-effects.
- It is very important that you follow any dietary and lifestyle advice that you have been given by your doctor, such as eating a healthy diet, not smoking, and taking regular exercise.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking olmesartan. This is because your blood pressure may drop too low if you are given some anaesthetics.
- Unless you experience an adverse effect, treatment with olmesartan is usually long-term. It’s possible that your doctor may advise that you skip a few doses if you have a tummy bug or some other acute illness, but otherwise, please continue to take the tablets regularly.
- Treatment should be discontinued immediately if pregnancy is detected.
Side-effects
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with olmesartan.
| Common side-effects (these affect fewer than 1 in 10 people) | What can I do if I experience this? |
|---|---|
| Feeling dizzy or light-headed, especially when you stand up | This is more likely to happen just after you take a tablet. If it becomes troublesome, lie down until the feeling passes. Stand up slowly and one step at a time. Do not drive or use tools or machines if you are affected |
| Headache | Rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a suitable painkiller |
| Diarrhoea | Drink plenty of water to replace lost fluids |
| Cough and flu-like symptoms, aches and pains, urine infections, feeling tired | If any of these become troublesome, discuss them with your doctor |
| Changes to the results of some blood tests | You will have blood tests from time to time to check for these |
Important: a few people have developed problems with their liver whilst taking this medicine. Although your doctor will check for this, you should speak with your doctor as soon as possible if you have any unexplained sickness (nausea or vomiting), yellowing of skin or eyes (jaundice), loss of weight, or feel extremely tired.
Other side-effects: Serious side effects are rare but include angioedema (swelling of face, lips, tongue), hyperkalemia, acute kidney injury, and sprue-like enteropathy (severe diarrhea).
Frequently Asked Questions (FAQs)
Q: Can I take olmesartan if I am pregnant?
A: No, olmesartan is contraindicated in pregnancy due to risk of fetal harm. Use effective contraception and discontinue if pregnancy occurs.
Q: What if I miss a dose of olmesartan?
A: Take it as soon as you remember unless it’s near the next dose. Do not double up. Continue with your regular schedule.
Q: Does olmesartan cause weight gain?
A: Weight gain is not a common side effect. Report any unexplained weight changes to your doctor.
Q: Is olmesartan safe for kidneys?
A: Use cautiously in renal impairment; contraindicated if severe. Regular monitoring of kidney function is required.
Q: Can I drink alcohol while on olmesartan?
A: Limit alcohol as it can lower blood pressure further and increase dizziness. Moderate consumption is advised.
References
- Olmesartan – an angiotensin receptor blocker – Patient.info — Patient.info. 2023. https://patient.info/medicine/olmesartan-an-angiotensin-receptor-blocker-olmetec
- AusPAR Olmesartan medoxomil Product Information — Therapeutic Goods Administration (TGA). 2013-02-26. https://www.tga.gov.au/sites/default/files/auspar-olmesartan-medoxomil-130226-pi.pdf
- Olmetec Product Label — Pfizer. Accessed 2023. https://labeling.pfizer.com/ShowLabeling.aspx?id=13984
- Olmesartan – StatPearls — NCBI Bookshelf, NIH. 2023-10-24. https://www.ncbi.nlm.nih.gov/books/NBK544367/
- Olmetec Product Monograph — Organon Canada. 2021-05. https://www.organon.com/canada-en/wp-content/uploads/sites/5/2021/05/OLMETEC-CI_E.pdf
- Olmesartan MedlinePlus — NIH MedlinePlus. Accessed 2023. https://medlineplus.gov/druginfo/meds/a603006.html
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