III. Contraindications

IV. Mechanism

V. Dosing: Adults

  1. Hypertension
    1. Start 20 mg orally daily
    2. Maximum 40 mg/day

VI. Dosing: Children (age 6 to 16 years)

  1. Hypertension
    1. Weight 20 to 35 kg (and age >=6 years old)
      1. Start 10 mg orally daily
      2. Maximum 20 mg orally daily
    2. Weight >=35 kg (and age 6 to 16 years old)
      1. Use adult dosing (see above)

VII. Medications: Combinations

  1. Amlodipine and Olmesartan (Azor)
  2. Hydrochlorothiazide and olemesartan (Benicar HCT)

VIII. Adverse Effects

  1. See Angiotensin Receptor Blocker
  2. Sprue-like Enteropathy
    1. Appears specific to Olmesartan (not ARB class effect)
    2. Presents with progressive, severe Chronic Diarrhea, weight loss and sprue-like intestinal changes
    3. May be a delayed Hypersensitivity Reaction (typically months to years after starting Olmesartan)
    4. Rubio-Tapia (2012) Mayo Clin Proc 87(8):732-8 [PubMed]

IX. Safety

  1. See Angiotensin Receptor Blocker
  2. Pregnancy Category X
  3. Unknown Safety in Lactation

XI. References

  1. (2018) Presc Lett, Resource #340901, Angiotensin Receptor Blocker (ARB) Antihypertensive Dose Comparison
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

olmesartan (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
OLMESARTAN MEDOXOMIL 20 MG TAB Generic $0.08 each
OLMESARTAN MEDOXOMIL 40 MG TAB Generic $0.13 each
OLMESARTAN MEDOXOMIL 5 MG TAB Generic $0.06 each
OLMESARTAN-HYDROCHLOROTHIAZIDE 20-12.5 MG TAB Generic $0.20 each
OLMESARTAN-HYDROCHLOROTHIAZIDE 40-12.5 MG TAB Generic $0.26 each
OLMESARTAN-HYDROCHLOROTHIAZIDE 40-25 MG TAB Generic $0.26 each
benicar (on 3/22/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
BENICAR 20 MG TABLET Generic $0.09 each
BENICAR 40 MG TABLET Generic $0.13 each
BENICAR HCT 20-12.5 MG TABLET Generic $0.19 each
BENICAR HCT 40-12.5 MG TABLET Generic $0.25 each
BENICAR HCT 40-25 MG TABLET Generic $0.27 each

Ontology: olmesartan (C1098320)

Definition (NCI) A synthetic imidazole derivative and angiotensin II receptor antagonist with antihypertensive activity. Olmesartan selectively binds to the angiotensin type 1 (AT1) receptor subtype in vascular smooth muscle and adrenal gland, thereby competing with angiotensin II for binding to the AT1 receptor. This prevents angiotensin II-induced vasoconstriction and interferes with angiotensin II-mediated aldosterone secretion, thereby decreasing aldosterone production and preventing aldosterone-stimulated sodium retention and potassium excretion.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C437965
SnomedCT 385540001, 412259001
English olmesartan [Chemical/Ingredient], omesartan, OLMESARTAN, Olmesartan (product), Olmesartan, Olmesartan (substance), olmesartan, 4-(hydroxy-1-methylethyl)-2-propyl-1-((2'-(1H-tetrazol-5-yl)-1,1'-biphenyl-4-yl)methyl)-1H-imidazole-5-carboxylic acid
Spanish olmesartán (producto), olmesartán, olmesartán (sustancia)

Ontology: Benicar (C1122245)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C097933
English benicar, Forest Brand of Olmesartan Medoxomil, Olmetec, Sankyo Brand of Olmesartan Medoxomil, Benicar