Olmesartan enteropathy

Last updated on: 29.10.2020

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ARB-associated intestinal malabsorption

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After taking olmesartan, an AT1 receptor inhibitor, side effects such as respiratory infection, dizziness, headaches, elevated blood potassium levels, low blood pressure and reduced kidney function can often occur. Nevertheless, compared to other antihypertensive drugs, olmesartan is considered to have few side effects. Under olmesartan, celiac enteropathy can occur.

A prurigo-like clinical picture has been described on the skin together with the gastroenteritic symptoms (Hammoudi N et al.2016).

Clinical picture
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Enteropathy similar to coeliac disease with chronic diarrhoea and pronounced weight loss.

Duodenal villous atrophy with varying degrees of inflammation (intraepithelial lymphocytic infiltrates, subepithelial collagen depots) can be detected endoscopically.

After discontinuation of olmesartan the clinical symptoms decrease. The histological changes are also reversible (Shenbagaraj L et al. 2018).

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In fact, the so-called Olmesartan enteropathy does not only refer to olmesartan. Out of 73 published cases, 59 cases were olmesartan-associated, another 14 case reports were published for telmisartan (4), valsartan (3), losartan (2), candesartan (1) and eprosartan (1) (Wenzel RR et al. 2019). Based on the available cohort studies, ARB-associated intestinal malabsorption occurs in 9.8 to 14 cases per 100,000 patients treated with ARB. Although the majority of case reports with olmesartan have been published, no clear difference within ARBs can be excluded in the cohort studies (Wenzel RR et al. 2019).

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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.

Incoming links (2)

Olmesartan; Valsartan;

Last updated on: 29.10.2020