If a patient develops these symptoms during treatment with olmesartan, and in the absence of other apparent etiologies, olmesartan treatment should be immediately discontinued and should not be restarted. If diarrhoea does not improve during the week after the discontinuation, further specialist e.
As with all other angiotensin II antagonists, the blood pressure lowering effect of Olmesartan medoxomil is somewhat less in black patients than in non-black patients, possibly because of a higher prevalence of low-renin status in the black hypertensive population.
Angiotensin II antagonists should not be initiated during pregnancy. Unless continued angiotensin II antagonists therapy is considered essential, patients planning pregnancy should be changed to alternative anti-hypertensive treatments which have an established safety profile for use in pregnancy. When pregnancy is diagnosed, treatment with angiotensin II antagonists should be stopped immediately, and, if appropriate, alternative therapy should be started see sections 4.
As with any antihypertensive agent, excessive blood pressure decrease in patients with ischaemic heart disease or ischaemic cerebrovascular disease could result in a myocardial infarction or stroke.
This medicinal product contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp-lactase deficiency or glucose-galactose malabsorption should not take this medicinal product.
The blood pressure lowering effect of olmesartan medoxomil can be increased by concomitant use of other antihypertensive medications.
ACE-inhibitors, angiotensin II receptor blockers or aliskiren: Clinical trial data has shown that dual blockade of the renin-angiotensin-aldosterone-system RAAS through the combined use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is associated with a higher frequency of adverse events such as hypotension, hyperkalaemia and decreased renal function including acute renal failure compared to the use of a single RAAS-acting agent see sections 4.
Potassium supplements and potassium sparing diuretics: Based on experience with the use of other drugs that affect the renin-angiotensin system, concomitant use of potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium or other drugs that may increase serum potassium levels e.
Such concomitant use is therefore not recommended. Monitoring of renal function at the beginning of treatment should be recommended as well as regular hydration of the patient.
Additionally, concomitant treatment can reduce the antihypertensive effect of angiotensin II receptor antagonists, leading to their partial loss of efficacy.
Bile acid sequestering agent colesevelam: Administration of olmesartan medoxomil at least 4 hours prior to colesevelam hydrochloride decreased the drug interaction effect. Administering olmesartan medoxomil at least 4 hours before the colesevelam hydrochloride dose should be considered see section 5. Fecal incontinence is common in middle age and also may occur due to chronic constipation, diarrhea, or chronic diseases such as multiple sclerosis or diabetes.
Whether this is a direct effect of hormone withdrawal on motility or an immune-related mechanism needs to be determined. Some theorize that lower estrogen levels decrease bowel motility through changes in neurotransmitters. As women age, their abdominal muscles weaken, and there's more abdominal bulge after eating. Abdominal bloating also is a symptom of ovarian cancer, so if the symptoms don't improve by eating smaller meals and increasing exercise, then further investigation by a gynecologist or primary care physician should be initiated.
Reducing meal size and intake of high-fat foods, and modifying caffeine and alcohol consumption can reduce GERD symptoms. The new and emerging low-FODMAP diet, an eating pattern reduced in commonly malabsorbed short-chain carbohydrates, can decrease gas and bloating related to functional gut disorders.
In addition, minimizing excess weight gain and the stress it places on aging joints potentially can lead to reduced use of NSAIDs. Dietitians can suggest alternative ways to reduce stress to clients and patients such as walking, meditation, or a warm bath rather than relying on alcohol as a means to alleviate tension.
Reducing alcohol consumption may lower the risk of diverticulitis and GERD. RDs can encourage clients to maintain adequate fluid and fiber intake to hasten colonic transit, and choose fiber with the most evidence basis to relieve constipation, such as psyllium fiber, rather than rapidly fermentable fibers, such as chicory root or inulin, if gas and bloating are troubling symptoms. Fiber and functional gastrointestinal disorders. Ageing and the gut.
During the early stages of chronic pancreatitis, changes in your pancreas are difficult to see in blood tests. However, they may be used to determine the amount of pancreatic enzymes in your blood. Blood tests may also be used to check blood cell counts along with kidney and liver function.
Your doctor might ask you for a stool sample to test for levels of fat. Imaging tests are the most reliable way for your doctor to make a diagnosis. Your doctor might request that the following studies be done on your abdomen to look for signs of inflammation: During an endoscopic ultrasound, your doctor inserts a long, flexible tube into your mouth and down through the stomach and small intestine.
Colesevelam Hydrochloride Concurrent administration of bile acid sequestering agent colesevelam hydrochloride reduces the systemic exposure and peak plasma concentration of olmesartan. Administration of olmesartan at least 4 hours prior to colesevelam hydrochloride decreased the drug interaction effect. Lithium Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration of lithium with angiotensin II receptor antagonists, including BENICAR.
Monitor serum lithium levels during concomitant use. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia , anuria, hypotension , renal failure, and death. When pregnancy is detected, discontinue Benicar as soon as possible [see Use in specific Populations].
Drugs that act directly on the reninangiotensin aldosterone system RAAS can have effects on the development of immature kidneys [see Use in Specific Populations]. Initiate treatment under close medical supervision.
A transient hypotensive response is not a contraindication to further treatment, which usually can be continued without difficulty once the blood pressure has stabilized. Impaired Renal Function As a consequence of inhibiting the renin- angiotensin - aldosterone system, changes in renal function may be anticipated in susceptible individuals treated with Benicar.
In patients whose renal function may depend upon the activity of the renin angiotensin - aldosterone system e. In studies of ACE inhibitors in patients with unilateral or bilateral renal artery stenosis , increases in serum creatinine or blood urea nitrogen BUN have been reported. There has been no long-term use of Benicar in patients with unilateral or bilateral renal artery stenosis , but similar results may be expected. Sprue-like Enteropathy Severe, chronic diarrhea with substantial weight loss has been reported in patients taking olmesartan months to years after drug initiation.
Intestinal biopsies of patients often demonstrated villous atrophy. If a patient develops these symptoms during treatment with olmesartan, exclude other etiologies. Consider discontinuation of Benicar in cases where no other etiology is identified. Drugs that inhibit the RAS can cause hyperkalemia.
Monitor serum electrolytes periodically. Nonclinical Toxicology Carcinogenesis, Mutagenesis, Impairment Of Fertility Olmesartan medoxomil was not carcinogenic when administered by dietary administration to rats for up to 2 years.
Both olmesartan medoxomil and olmesartan tested negative in the in vitro Syrian hamster embryo cell transformation assay and showed no evidence of genetic toxicity in the Ames bacterial mutagenicity test. However, both were shown to induce chromosomal aberrations in cultured cells in vitro Chinese hamster lung and tested positive for thymidine kinase mutations in the in vitro mouse lymphoma assay.
Get regular physical activity Getting regular physical activity will make you feel better and reduce your risk of developing serious or chronic illnesses. Aerobic activities that condition your heart and lungs, such as swimming, walking or cycling, are best. Start slowly and build up to doing at least 30 minutes of moderate exercise most days. If you are taking medication, have a history of serious illness, have symptoms such as chest discomfort when you exercise, or have not exercised for a while, check with your doctor before starting a programme.
Lifting heavy weights causes increases in blood pressure and isn't recommended. Give up smoking You should also give up smoking. Your doctor will be able to suggest the best quitting strategy for you to follow.
Treatment with medicines Some people will need to take medicines, in addition to lifestyle measures, to control their blood pressure. The decision to treat high blood pressure with medicines is not based on your blood pressure alone, but on your overall level of cardiovascular risk.
Types of high blood pressure medicines There are several main types of high blood pressure medicines — also known as antihypertensive medicines. The one you are prescribed will depend on: Response to medicines varies among individuals and your doctor may need to try different types and dosages before finding the best one for you.
Blood pressure can sometimes be adequately controlled by one medicine, but often a combination of 2 or 3 medicines is required. Here are some of the types of medicines currently available in Australia.
ACE inhibitors are also used in heart failure and are useful for preserving kidney function in people with diabetes and kidney disease. Examples of ACE inhibitors are:
Severe enterocolitis associated with antiepileptic-induced drug reaction with eosinophilia and systemic symptoms. Examples of beta-blockers include atenolol e. Diverticular fistulization is gastrointestinal with nicorandil usage. Major Due to the thrombocytopenic effects of mitoxantrone, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants, NSAIDs, platelet inhibitors, including aspirin, strontium chloride, and olmesartan agents. Drugs that inhibit the RAS can cause hyperkalemia. Renal Insufficiency In patients with renal insufficiency, serum concentrations of olmesartan were elevated compared to subjects with normal renal function. Patients receiving concurrent NSAIDs should be monitored closely for symptoms of active or occult gastrointestinal bleeding. Pediatric Hypertension The antihypertensive effects of Benicar in the pediatric population were evaluated in a randomized, double-blind study involving hypertensive disorders aged 6 to 16 years. Indoor air quality problems or molds could be another possibility. Nonclinical Toxicology Carcinogenesis, Mutagenesis, Impairment Of Fertility Olmesartan medoxomil was not carcinogenic when administered by dietary administration to rats for up to 2 years. Cases of acute renal failure, olmesartan gastrointestinal disorders, some requiring hospitalization and renal replacement therapy, have been reported after high-dose or multiple NSAIDs were initiated in patients who appeared stable on tenofovir. After oral administration of therapeutic doses, amlodipine is well absorbed with peak blood levels gastrointestinal hours post dose. Potential neonatal adverse effects include skull hypoplasiaanuria, hypotensionrenal failure, and death. The blood pressure lowering effect of Benicar, with and without hydrochlorothiazide, was maintained in patients treated for up to 1 year. Minor Concurrent use of nephrotoxic disorders, such as NSAIDs, with olmesartan should be done cautiously to avoid additive nephrotoxicity, olmesartan gastrointestinal disorders.
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