Olmesartan

Olmesartan is a drug used as an antihypertensive agent in essential arterial hypertension. In addition, it is approved for the treatment of patients with heart failure and impaired left ventricular systolic function in addition to ACE inhibitors or in patients with ACE inhibitor intolerance. Olmesartan is a member of the group of AT1 receptor antagonists. The action of olmesartan is based on non-competitive inhibition of the AT1 receptor.

The absorption ester olmesartanmedoxomil is used pharmaceutically. This prodrug is only converted into the actual active form olmesartan in the body when it passes through the mucous membrane of the small intestine. The blood pressure-lowering effect of olmesartan can be enhanced by the simultaneous use of other antihypertensives. For this purpose olmesartan is often combined with the diuretic hydrochlorothiazide (HCT).

After taking olmesartan, side effects such as respiratory infection, dizziness, headaches, elevated potassium levels in the blood, low blood pressure and restriction of kidney function can often occur. Nevertheless, compared to other antihypertensive drugs, olmesartan is considered to have few side effects.

Under olmesartan (but also under other AT1-receptor blockers), diarrhoea similar to celiac disease can occur, which may be accompanied by greater weight loss(olmesartan enteropathy).

Other rare side effects are:

• Drug-induced anti-Ro positive subacute cutaneous lupus erythematosus, Raynaud's phenomenon, palmo-plantar psoriasis, cases of photic sensitivity, achromatic malignant melanoma (Tchernev G et al. 2019), porphyria cutanea tarda (Mas-Vidal A et al. 2010)

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1. Hammoudi N et al(2016) Olmesartan-induced enteropathy associated with cutaneous lesions. Clin Case Rep 4:379-382
2. Mas-Vidal A et al (2010) Porphyria cutanea tarda induced by olmesartan. J Eur Acad Dermatol Venereol 24:977-978.
3. Ozaki C et al (2018) Case of photosensitivity after the administration of olmesartan medoxomil. J Dermatol 45:e277-e278.
4. Shenbagaraj L et al (2018) Olmesartan-associated severe gastritis and enteropathy. BMJ Case Rep 11:e226133.
5. Tchernev G et al (2019) Olmesartan/valsartan induced giant achromatic cutaneous melanoma: "modified" one-step surgical approach with favourable outcome. J Biol Regul Homeost Agents 33:1775-1777.
6. Wenzel RR et al (2019) Association of sprue-like enteropathy and angiotensin receptor-1 antagonists. Vienna Klin Weekly Report 131:493-501.