Olmesartan Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Initial dose: 20 mg orally once a day.
Maintenance dose: May increase to 40 mg/day if further blood pressure reduction is necessary after 2 weeks. Diuretics or other antihypertensive agents may be added.

Usual Pediatric Dose for Hypertension

6 to 16 years of age:

20 to less than 35 kg (44 to 77 pounds): Initial: 10 mg orally once daily; Maximum: if the initial response is inadequate after 2 weeks, dose may be increased to a maximum of 20 mg/day.

Greater than or equal to 35 kg (greater than or equal to 77 pounds): 20 mg orally once daily; Maximum: if the initial response is inadequate after 2 weeks, dose may be increased to a maximum of 40 mg/day.

Renal Dose Adjustments

No initial dosage adjustment is recommended for patients with moderate to marked hepatic dysfunction.

Liver Dose Adjustments

Initial dose adjustments are not recommended for patients with moderate to marked hepatic dysfunction.

Dose Adjustments

Lower initial doses may be required for patients with intravascular volume depletion. Close medical supervision is recommended.

There are no additional benefits from doses greater than 40 mg/day or from twice-daily dosing.

Precautions

When pregnancy is detected, discontinue olmesartan as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus.

Safety and effectiveness have not been established in pediatric patients less than 6 years of age. Children less than 1 year of age must not receive olmesartan for hypertension. Drugs that act directly on the renin-angiotensin aldosterone system (RAAS) can have effects on the development of immature kidneys.

Dialysis

Data not available

Other Comments

Concurrent administration of colesevelam reduces the systemic exposure and peak plasma concentration of olmesartan. Olmesartan should be administered at least 4 hours before colesevelam.

Compared with Caucasian patients, Black patients have a reduced blood pressure response to monotherapy with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers; however, the reduced response is largely eliminated if combination therapy that includes an adequate dose of a diuretic is instituted.

For pediatric patients who cannot swallow tablets, the same dose can be given using an extemporaneous suspension: (for 200 mL of a 2 mg/mL suspension): Add 50 mL of purified water to an amber polyethylene terephthalate (PET) bottle containing twenty olmesartan 20 mg tablets and allow to stand for a minimum of 5 minutes. Shake the container for at least 1 minute and allow the suspension to stand for at least 1
minute. Repeat 1-minute shaking and 1-minute standing for four additional times. Add 100 mL of Ora-Sweet (R) and 50 mL of Ora-Plus(R) to the suspension and shake well for at least 1 minute. The suspension should be refrigerated at 2-8°C (36-46°F) and can be stored for up to 4 weeks. Shake the suspension well before each use and return promptly to the refrigerator.

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