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Benicar Disease Interactions

There are 7 disease interactions with Benicar (olmesartan).

Major

AR antagonists (applies to Benicar) angioedema

Major Potential Hazard, Moderate plausibility.

The use of these agents is contraindicated in patients with a history of angioedema related to previous angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) therapy or in patients with hereditary angioedema. Patients with a history of angioedema unrelated to these agents may be at increased risk of angioedema while receiving angiotensin II receptor (AR) antagonists. Patients should be advised to immediately report any signs or symptoms suggestive of angioedema (swelling of face, extremities, eyes, lips, or tongue, or difficulty swallowing or breathing) and to stop taking the medication until otherwise directed by their physician. Emergency therapy and/or measures to prevent airway obstruction are required for angioedema involving the tongue, glottis, or larynx. Treatment with angiotensin II receptor (AR) antagonists should be discontinued permanently if angioedema develops in association with therapy.

References

  1. "Product Information. Cozaar (losartan)." Merck & Company Inc (2001):
  2. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb (2001):
  4. "Product Information. Teveten (eprosartan)." SmithKline Beecham (2001):
  5. "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals (2001):
  6. "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim (2001):
  7. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):
  8. "Product Information. Edarbi (azilsartan)." Takeda Pharmaceuticals America (2011):
View all 8 references
Major

AR antagonists (applies to Benicar) hypotension

Major Potential Hazard, High plausibility. Applicable conditions: Dehydration, hemodialysis, Hyponatremia

Angiotensin II receptor (AR) antagonists can cause symptomatic hypotension in patients with an activated renin-angiotensin system, such as volume- and/or sodium-depleted patients. Therapy with AR antagonists should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if high doses were used or if recently instituted; those on dietary salt restriction; renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with AR antagonists, and the patient should be hemodynamically stable. Ideally, patients at risk for excessive hypotension should initiate AR antagonist therapy under close medical supervision, preferably with a lower dose, and followed closely for the first 2 weeks of treatment and whenever the dosage of AR antagonist or diuretic is increased.

References

  1. McWilliams EJ, Osborne B, Waldman SA, Lewis G, Lipert S, Bjornsson TD, Tanaka WK, Bradstreet TE, Pivadori L, Goldberg MR, et al. "Biochemical effects of losartan, a nonpeptide angiotensin II receptor antagonist, on the renin-angiotensin-aldosterone system in hypertensive patients." Hypertension 25 (1995): 37-46
  2. Sweet CS, MacFadyen RJ, Doig JK, Lees KR, Reid JL "Dose-ranging study of the angiotensin type I receptor antagonist losartan (DuP753/MK954), in salt-deplete normal man." J Cardiovasc Pharmacol 21 (1993): 732-8
  3. Dunlay MC, Sweet CS, Goldberg AI "Safety and tolerability of losartan potassium, and angiotensin II receptor antagonist, compared with hydrochlorothiazide, atenolol, felodipine ER, and angiotensin-converting enzyme inhibitors for the treatment of systemic hypertension." Am J Cardiol 75 (1995): 793-5
  4. "Product Information. Cozaar (losartan)." Merck & Company Inc (2001):
  5. Bryyny RL, Pratt JH, Weber MA, et al. "Blood pressure effects of the angiotensin II receptor blocker, losartan." Arch Intern Med 155 (1995): 405-11
  6. Menard J, Macfadyen RJ, Brunner HR, Insuasty J, Mcintyre M, Meredith PA, Reid JL "Comparison of the oral angiotensin II receptor antagonist UP 269-6 or enalapril 20 mg on blood pressure and neurohormonal effects in salt-deplete man." J Cardiovasc Pharmacol 25 (1995): 994-1000
  7. Dunlay MC, Sweet CS, Goldberg AI "Safety and tolerability of losartan compared with atenolol, felodipine and angiotensin converting enzyme inhibitors." J Hypertens 13 Suppl (1995): s77-80
  8. Jensen HA, Omvik P, Tikkanen I "Comparison of the angiotensin II antagonist losartan with the angiotensin converting enzyme inhibitor enalapril in patients with essential hypertension." J Hypertens 13 (1995): 1343-51
  9. Schaefer KL, Porter JA "Angiotensin II receptor antagonists: the prototype losartan." Ann Pharmacother 30 (1996): 625-36
  10. Barr E, Weir MR, Edelman JM, Elkins M, Liss C, Vrecenak AJ "Efficacy, tolerability, and quality of life of losartan, alone or with hydrochlorothiazide, versus nifedipine GITS in patients with essential hypertension." Clin Ther 18 (1996): 411-28
  11. Brunner HR, Waeber B "Angiotensin II antagonists: a new class of antihypertensive agent." Br J Clin Pract 50 (1996): 265-8
  12. Beevers DG, Ferner RE, Gibbs CR "Angiotensin receptor antagonists - a new class of antihypertensive drug." J Clin Pharm Ther 21 (1996): 127-30
  13. Patterson H, Ellis ML "A new class of antihypertensive therapy: angiotensin II receptor antagonists." Pharmacotherapy 16 (1996): 849-60
  14. Angeli P, Fogari R, Holwerda NJ, et al. "Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: efficacy and safety compared with placebo and enalapril." J Hypertens 14 (1996): 1147-115
  15. Barr E, Oparil S, Edelman J, Elkins M, Liss C, Vrecenak A "Efficacy, tolerability, and effects on quality of life of losartan, alone or with hydrochlorothiazide, versus amlodipine, alone or with hydrochlorothiazide, in patients with essential hypertension." Clin Ther 18 (1996): 608-25
  16. Brunner HR, Burnier M, Waeber B, Nussberger J "Experience with angiotensin II antagonists in hypertensive patients." Clin Exp Pharmacol Physiol 23 ( Suppl (1996): s142-6
  17. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals (2001):
  18. Admiraal PJ, Kroodsma JM, Man In 't Veld AJ, Mulder PG, Blankestijn PJ, Boomsma F, de Ronde WA, Janssen JA, Sissmann J, van den Meiracker AH "Hemodynamic and biochemical effects of the AT1 receptor antagonist irbesartan in hypertension." Hypertension 25 (1995): 22-9
  19. MacFadyen RJ, Brouard R, McIntyre M, Meredith PA, Reid JL "Dose-ranging study of the angiotensin II receptor antagonist irbesartan (SR 47436/BMS-186295) on blood pressure and neurohormona effects in salt-deplete men." J Cardiovasc Pharmacol 28 (1996): 101-6
  20. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb (2001):
  21. "Product Information. Teveten (eprosartan)." SmithKline Beecham (2001):
  22. "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals (2001):
  23. "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim (2001):
  24. Hermansson K, Karlberg BE, Lins LE "Efficacy and safety of telmisartan, a selective AT(1) receptor antagonist, compared with enalapril in elderly patients with primary hypertension." J Hypertens 17 (1999): 293-302
  25. McClellan KJ, Markham A "Telmisartan." Drugs 56 (1998): 1039-44
  26. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):
  27. "Product Information. Edarbi (azilsartan)." Takeda Pharmaceuticals America (2011):
View all 27 references
Moderate

AR antagonists (applies to Benicar) CHF

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Congestive Heart Failure

Angiotensin II receptor (AR) antagonists can cause renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic hypotension can occur in susceptible individuals, which may compromise renal and myocardial perfusion. In patients with severe congestive heart failure (CHF), treatment with AR antagonists has been associated with oliguria and/or progressive azotemia and, rarely, renal failure, myocardial ischemia, and death. Therapy with AR antagonists should be initiated cautiously in patients with severe CHF, especially when accompanied by volume and/or sodium depletion. In patients who experience a decline in renal function, discontinuation of AR antagonist therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with AR antagonists, since therapy can usually be reinstated without difficulty after blood pressure stabilizes.

References

  1. Byyny RL, Faison EP, Nelson EB, Goldberg AI, Snavely DB, Weber MA, Pratt JH "Blood pressure effects of the angiotensin II receptor blocker, losartan." Arch Intern Med 155 (1995): 405-11
  2. Crozier I, Awan N, Young J, Cleland J, Dickstein K, Frey M, Klinger G, Ikram H, Makris L, Stephen N, et al. "Losartan in heart failure. Hemodynamic effects and tolerability. Losartan Hemodynamic Study Group." Circulation 91 (1995): 691-7
  3. DeKock M, Gottlieb SS, Kostis J, Dickstein K, Fleck E, LeJemtel T, Levine TB "Hemodynamic and neurohormonal effects of the angiotensin II antagonist losartan in patients with congestive heart failure." Circulation 88 (1993): 1602-9
  4. McWilliams EJ, Osborne B, Waldman SA, Lewis G, Lipert S, Bjornsson TD, Tanaka WK, Bradstreet TE, Pivadori L, Goldberg MR, et al. "Biochemical effects of losartan, a nonpeptide angiotensin II receptor antagonist, on the renin-angiotensin-aldosterone system in hypertensive patients." Hypertension 25 (1995): 37-46
  5. Barchowsky A, Lo MW, Bjornsson TD, Tanaka W, Bradstreet TE, Goldberg MR, McWilliams EJ Jr, McCrea J "Effects of losartan on blood pressure, plasma renin activity, and angiotensin II in volunteers." Hypertension 21 (1993): 704-13
  6. Sweet CS, MacFadyen RJ, Doig JK, Lees KR, Reid JL "Dose-ranging study of the angiotensin type I receptor antagonist losartan (DuP753/MK954), in salt-deplete normal man." J Cardiovasc Pharmacol 21 (1993): 732-8
  7. DeKock M, Kostis J, Gottlieb S, Levine B, Dickstein K, Fleck E, LeJemtel T "Hemodynamic and neurohumoral effects of the angiotensin II antagonist losartan in patients with heart failure." J Hypertens Suppl 12 (1994): s31-5
  8. Abdelrahman AM, Johnston CI, Burrell LM "Blockade of the renin-angiotensin system at different sites: effect on renin, angiotensin and aldosterone." J Hypertens 11 Suppl 3 (1993): s23-6
  9. Rajfer SI, Rush JE "Theoretical basis for the use of angiotensin II antagonists in the treatment of heart failure." J Hypertens 11 Suppl 3 (1993): s69-71
  10. "Product Information. Cozaar (losartan)." Merck & Company Inc (2001):
  11. Crozier I, Ikram H "The acute and chronic effects of losartan in heart failure." J Hypertens 13 Suppl (1995): s59-61
  12. Ahrens ER, Saine DR "Renal impairment associated with losartan." Ann Intern Med 124 (1996): 775
  13. Schaefer KL, Porter JA "Angiotensin II receptor antagonists: the prototype losartan." Ann Pharmacother 30 (1996): 625-36
  14. Brunner HR, Waeber B "Angiotensin II antagonists: a new class of antihypertensive agent." Br J Clin Pract 50 (1996): 265-8
  15. Beevers DG, Ferner RE, Gibbs CR "Angiotensin receptor antagonists - a new class of antihypertensive drug." J Clin Pharm Ther 21 (1996): 127-30
  16. Patterson H, Ellis ML "A new class of antihypertensive therapy: angiotensin II receptor antagonists." Pharmacotherapy 16 (1996): 849-60
  17. Angeli P, Fogari R, Holwerda NJ, et al. "Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: efficacy and safety compared with placebo and enalapril." J Hypertens 14 (1996): 1147-115
  18. Brunner HR, Burnier M, Waeber B, Nussberger J "Experience with angiotensin II antagonists in hypertensive patients." Clin Exp Pharmacol Physiol 23 ( Suppl (1996): s142-6
  19. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals (2001):
  20. Martinez FA, Pitt B, Segal R, et al. "Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE)." Lancet 349 (1997): 747-52
  21. Admiraal PJ, Kroodsma JM, Man In 't Veld AJ, Mulder PG, Blankestijn PJ, Boomsma F, de Ronde WA, Janssen JA, Sissmann J, van den Meiracker AH "Hemodynamic and biochemical effects of the AT1 receptor antagonist irbesartan in hypertension." Hypertension 25 (1995): 22-9
  22. MacFadyen RJ, Brouard R, McIntyre M, Meredith PA, Reid JL "Dose-ranging study of the angiotensin II receptor antagonist irbesartan (SR 47436/BMS-186295) on blood pressure and neurohormona effects in salt-deplete men." J Cardiovasc Pharmacol 28 (1996): 101-6
  23. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb (2001):
  24. "Product Information. Teveten (eprosartan)." SmithKline Beecham (2001):
  25. "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals (2001):
  26. "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim (2001):
  27. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):
  28. "Product Information. Edarbi (azilsartan)." Takeda Pharmaceuticals America (2011):
View all 28 references
Moderate

AR antagonists (applies to Benicar) hyperkalemia

Moderate Potential Hazard, Moderate plausibility.

Drugs that inhibit the renin-angiotensin, such as angiotensin II receptor antagonist system can cause hyperkalemia. Concomitant use of these agents with drugs that increase potassium levels may increase the risk of hyperkalemia. Use caution when using these agents together and monitor serum potassium periodically.

References

  1. "Product Information. Cozaar (losartan)." Merck & Company Inc (2001):
  2. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb (2001):
  4. "Product Information. Teveten (eprosartan)." SmithKline Beecham (2001):
  5. "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals (2001):
  6. "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim (2001):
  7. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):
  8. "Product Information. Edarbi (azilsartan)." Takeda Pharmaceuticals America (2011):
View all 8 references
Moderate

AR antagonists (applies to Benicar) renal artery stenosis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Artery Atherosclerosis

In patients with bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, angiotensin II receptor (AR) antagonists may reduce renal perfusion to a critically low level. Increases in serum creatinine or blood urea nitrogen have been reported with ACE inhibitors, a class of drugs that also block the renin-angiotensin-aldosterone system. Although there are no long-term data on the use of AR antagonists in patients with renal artery stenosis, a similar effect should be anticipated. Renal function should be monitored closely for the first few weeks of therapy.

References

  1. "Product Information. Cozaar (losartan)." Merck & Company Inc (2001):
  2. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb (2001):
  4. "Product Information. Teveten (eprosartan)." SmithKline Beecham (2001):
  5. "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals (2001):
  6. "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim (2001):
  7. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):
  8. "Product Information. Edarbi (azilsartan)." Takeda Pharmaceuticals America (2011):
View all 8 references
Moderate

AR antagonists (applies to Benicar) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Changes in renal function including acute renal failure can be caused by drugs that inhibit the renin-angiotensin system and by diuretics. Patients whose renal function may depend in part on the activity of the renin-angiotensin system (e.g., patients with renal artery stenosis, chronic kidney disease, severe congestive heart failure, or volume depletion) may be at particular risk of developing acute renal failure with these agents. Monitor renal function periodically in these patients. Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function with these agents.

References

  1. "Product Information. Cozaar (losartan)." Merck & Company Inc (2001):
  2. "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Avapro (irbesartan)." Bristol-Myers Squibb (2001):
  4. "Product Information. Teveten (eprosartan)." SmithKline Beecham (2001):
  5. "Product Information. Atacand (candesartan)." Astra-Zeneca Pharmaceuticals (2001):
  6. "Product Information. Micardis (telmisartan)." Boehringer-Ingelheim (2001):
  7. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):
  8. "Product Information. Edarbi (azilsartan)." Takeda Pharmaceuticals America (2011):
View all 8 references
Moderate

Olmesartan (applies to Benicar) renal/liver disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction, Biliary Obstruction

Olmesartan is eliminated unchanged in the urine and bile. After repeated dosing in patients with severe renal impairment (CrCl < 20 mL/min), the systemic exposure (AUC) was approximately tripled compared to subjects with normal renal function. In patients with moderate hepatic impairment, the AUC increased about 60% relative to that in matched controls. The manufacturer states that no initial dosage adjustment is necessary in patients with moderate to marked renal or hepatic impairment. However, patients should be monitored for undue adverse effects of the drug.

References

  1. "Product Information. Benicar (olmesartan)." Sankyo Pharma (2002):

Benicar drug interactions

There are 263 drug interactions with Benicar (olmesartan).

Benicar alcohol/food interactions

There is 1 alcohol/food interaction with Benicar (olmesartan).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.