Olmesartan

Structural formula
General
Non-proprietary name	Olmesartan
other names	5- (1-Hydroxy-1-isopropyl) -2-propyl-3- [2 ′ - (1 H -tetrazol-5-yl) biphenyl-4-ylmethyl] -3 H -imidazole-4-carboxylic acid ( IUPAC )
Molecular formula	C 24 H 26 N 6 O 3
Brief description	monoclinic crystals (from ethanol )
External identifiers / databases
EC number	646-413-5
ECHA InfoCard	100.174.243
PubChem	158781
ChemSpider	139674
DrugBank	DB00275
Wikidata	Q421156
Drug information
ATC code	C09 CA08 ; C09 DA08 ;
Drug class	Antihypertensive drug
Mechanism of action	AT 1 antagonist
properties
Molar mass	446.50 g mol −1
Physical state	firmly
Melting point	180–182 ° C (decomposition)
solubility	practically insoluble in water, slightly soluble in methanol
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS labeling of hazardous substances	no GHS pictograms
	no GHS pictograms
H and P phrases	H: no H-phrases
	P: no P-phrases
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Olmesartan is a drug from the group of selective AT1 antagonists ("sartans") and is used to treat high blood pressure. Olmesartan is used medicinally in the form of its absorption ester, olmesartan medoxomil.

effect

The compound used as a progdrug olmesartan medoxomil

Olmesartan medoxomil is a prodrug that is metabolized to the pharmacologically active olmesartan during absorption in the gastrointestinal tract . A maximum effect is reached after about 8 weeks of regular use, while already after 2 weeks a large part of the blood pressure reduction is achieved. By simply lowering blood pressure, olmesartan has positive effects on kidney function as a further therapeutic component and a protective effect on the blood vessels because it has anti-arteriosclerotic properties.

application areas

Olmesartan has been on the market in Germany for the treatment of high blood pressure since 2002 . Due to its strong reduction in blood pressure and the long-lasting effect, it offers a reliable and constant regulation of blood pressure when taken once a day.

The antihypertensive effect of olmesartan can be increased by concomitant use of other antihypertensive drugs . For this purpose, olmesartan is often combined with the diuretic hydrochlorothiazide (HCT).

Contraindications and restrictions on use

Olmesartan must not be used during the last two trimesters of pregnancy or when there is biliary obstruction . In the first trimester of pregnancy as well as during breastfeeding, the intake is not recommended, as there are insufficient data on safety.

Side effects

Olmesartan is characterized by very good subjective and objective tolerability. The occurrence of adverse side effects and the side effect profile in numerous clinical studies were comparable to that of placebo . Side effects mentioned are orthostatic hypotension , headache, diarrhea, infections of the upper respiratory tract, increased or decreased pulse, and dry, unproductive cough.

The FDA advises that olmesartan can cause diarrhea similar to celiac disease , which may also be associated with greater weight loss. The connection between the antihypertensive drug and the alleged celiac disease was not initially clear.

Trade names

Monopreparations

Mencord (A), Olmetec (D, A, CH), Votum (D, CH), Belsar, numerous generics

Combination preparations

in combination with hydrochlorothiazide : Mencord Plus (A), Olmetec Plus (D, A, CH), Votum Plus (D, CH), Belsar Plus, numerous generics
in combination with amlodipine : Amelior (A), Sevikar (D, A, CH), Vascord (CH), Vocado (D)
in combination with amlodipine and hydrochlorothiazide : Amelior HCT (A), Sevikar HCT (D, A, CH), Vocado HCT (D)

Individual evidence

^ ^A ^b ^c The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 14th Edition (Merck & Co., Inc.), Whitehouse Station, NJ, USA, 2006; ISBN 978-0-911910-00-1 .
↑ Registration dossier on 4- (2-hydroxypropan-2-yl) -2-propyl-1 - {[2 '- (1H-tetrazol-5-yl) biphenyl-4-yl] methyl} -1H-imidazole-5- carboxylic acid ( GHS section ) from the European Chemicals Agency (ECHA), accessed on July 10, 2020.
↑ J. Moser: Olmesartan: Comprehensive vascular protection through targeted angiotensin II blockade (PDF; 2.0 MB). Journal for Hypertension - Austrian Journal of Hypertension 2008; 12 (3), 34-37.
↑ FDA Drug Safety Communication: FDA approves label changes to include intestinal problems (sprue-like enteropathy) linked to blood pressure medicine olmesartan medoxomil .

[MERCK_Index-1] A ^b ^c The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 14th Edition (Merck & Co., Inc.), Whitehouse Station, NJ, USA, 2006; ISBN 978-0-911910-00-1 .

[2] Registration dossier on 4- (2-hydroxypropan-2-yl) -2-propyl-1 - {[2 '- (1H-tetrazol-5-yl) biphenyl-4-yl] methyl} -1H-imidazole-5- carboxylic acid ( GHS section ) from the European Chemicals Agency (ECHA), accessed on July 10, 2020.

[3] J. Moser: Olmesartan: Comprehensive vascular protection through targeted angiotensin II blockade (PDF; 2.0 MB). Journal for Hypertension - Austrian Journal of Hypertension 2008; 12 (3), 34-37.

[4] FDA Drug Safety Communication: FDA approves label changes to include intestinal problems (sprue-like enteropathy) linked to blood pressure medicine olmesartan medoxomil .