藥劑部參考美國 Johns Hopkins 大學研究團隊所建立的 NxP (Nephrotoxic Potential) 專家共識分級清單，本品具「顯著以上腎毒性風險」，被認定具中度至高度腎損傷潛勢，特別是同時合併其他腎毒性藥物、脫水、高齡或既有腎功能異常的患者族群，應更加注意。

【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議 CKD >stage3 之老年人長期使用。 ★LASA藥品：OLM01 【D2】Olmetec 藍字 20mg 錠劑 (形似) 點擊看LASA藥品外觀比較圖

高血壓 (ARB) Hypertension
#仿單變更2021

Angiotensin II Receptor Blocker
Olmesartan medoxomil (prodrug) is rapidly and completely converted to olmesartan after oral doses. By blocking the effects of angiotensin II, olmesartan decreases systemic vascular resistance without a marked change in heart rate.

Absorption
1. Absolute bioavailability: approximately 26%.
2. Time to peak: 1 ~ 2 hours.
3. Food does not affect the bioavailability of olmesartan.
Distribution
Protein binding: 99%.
Metobolism
Olmesartan does not undergo further metabolism by the liver.
Excretion
1. 35-50% of the administered dose is eliminated in urine, and the remainder is eliminated in the feces via biliary excretion.
2. Elimination half-life (terminal): 13 hrs

1. Hypersensitive to olmesartan or any component of this product
2. Bilateral renal artery stenosis
3. Pregnancy

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

Due to the potential for serious adverse reactions in the breastfeeding infant, the manufacturer recommends a decision be made whether to discontinue breastfeeding or to discontinue the drug, considering the importance of treatment to the mother.

Dizziness, headache, hyperglycemia and hypertriglyceridemia, back pain, CPK increased, influenza-like symptoms, hyperkalemia (In high risk patients, including renal dysfunction, diabetes mellitus, concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium containing salts, should monitor potassium closely

Adults:
Initial 20 mg orally once daily; after 2 weeks of therapy, the dose may be increased to 40 mg. Doses above 40 mg do not appear to have greater effect.
Elder:
Refer to adult. Twice-daily dosing offers no advantage over the same total dose given once daily.

Adolescents >16 years:
Initial 20 mg once daily; if initial response is inadequate, may be increased to 40 mg once daily after 2 weeks
Children and Adolescents 6 to 16 years:
1. 20 to <35 kg: 10 mg once daily; if initial response inadequate after 2 weeks, dose may be increased; maximum: 20 mg/day
2. 35 kg: 20 mg once daily; if initial response inadequate after 2 weeks, dose may be increased; maximum: 40 mg/day
Children 1 to 5 years and >5 kg:
Limited data available
Children under 1 year:
Not recommended.

1. CrCl >40 mL/minute: No dosage adjustment necessary.
2. CrCl <40 mL/minute: No initial dosage adjustment necessary. AUC is increased 3-fold in patients with CrCl <20 mL/minute and a maximum dose of 20 mg/day has been recommended for these patients.

1. Mild impairment: No dosage adjustment necessary.
2. Moderate to severe: No initial dosage adjustment necessary. Total drug exposure increased ~60% in moderate impairment.