Olsi Uses

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What is Olsi?

Olsi is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

Olsi is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes the blood vessels to tighten. As a result, Olsi relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Olsi is available only with your doctor's prescription.

Olsi indications

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Olsi is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. There are no controlled trials demonstrating risk reduction with Olsi.

Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).

Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.

Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment a lower blood pressure goal.

Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.

It may be used alone or in combination with other antihypertensive agents.

How should I use Olsi?

Use Olsi as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Olsi.

Uses of Olsi in details

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Olsi is used to treat high blood pressure (hypertension), prevention and treatment of heart attack (Myocardial Infarction) and heart failure; when heart is unable to pump sufficient blood. It is also used in patients of diabetes with kidney failure.

Olsi description

Each film-coated tablet contains Olmesartan medoxomil 20 mg and 40 mg, respectively. It also contains the following excipients: Titanium dioxide and ferric oxide yellow (40 mg only).

Olsi medoxomil, a prodrug, is hydrolyzed to Olsi during absorption from the gastrointestinal tract. Olsi is a selective AT1 subtype angiotensin II receptor antagonist. Olsi medoxomil is described chemically as 2,3-dihydroxy-2-butenyl 4-(1 hydroxy-1-methylethyl)-2-propyl-1-[p-(o-1H-tetrazol-5-ylphenyl)benzyl]imidazole-5-Carboxylate, cyclic 2,3-carbonate. Its empirical formula is C29H30N6O6 and its molecular weight is 558.59.

Olsi dosage

Olsi Dosage

Generic name: Olsi MEDOXOMIL 5mg

Dosage form: tablet, film coated

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Adult Hypertension

Dosage must be individualized. The usual recommended starting dose of Olsi is 20 mg once daily when used as monotherapy in patients who are not volume-contracted. For patients requiring further reduction in blood pressure after 2 weeks of therapy, the dose of Olsi may be increased to 40 mg. Doses above 40 mg do not appear to have greater effect. Twice-daily dosing offers no advantage over the same total dose given once daily.

No initial dosage adjustment is recommended for elderly patients, for patients with moderate to marked renal impairment (creatinine clearance <40 mL/min) or with moderate to marked hepatic dysfunction. For patients with possible depletion of intravascular volume (e.g., patients treated with diuretics, particularly those with impaired renal function), initiate Olsi under close medical supervision and give consideration to use of a lower starting dose.

Olsi may be administered with or without food.

If blood pressure is not controlled by Olsi alone, a diuretic may be added. Olsi may be administered with other antihypertensive agents.

Pediatric Hypertension (6 to 16 years of age)

Dosage must be individualized. For children who can swallow tablets, the usual recommended starting dose of Olsi is 10 mg once daily for patients who weigh 20 to <35 kg (44 to 77 lb), or 20 mg once daily for patients who weigh ≥35 kg. For patients requiring further reduction in blood pressure after 2 weeks of therapy, the dose of Olsi may be increased to a maximum of 20 mg once daily for patients who weigh <35 kg or 40 mg once daily for patients who weigh ≥35 kg.

Children <1 year of age must not receive Olsi for hypertension.

For children who cannot swallow tablets, the same dose can be given using an extemporaneous suspension as described below. Follow the suspension preparation instructions below to administer Olsi as a suspension.

Preparation of 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 Olsi 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®* and 50 mL of Ora-Plus®* 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.

* Ora-Sweet® and Ora-Plus® are registered trademarks of Paddock Laboratories, Inc.

More about Olsi (Olsi)

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Olsi interactions

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What other drugs will affect Olsi?

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No significant drug interactions were reported in studies in which Olsi was co-administered with digoxin or warfarin in healthy volunteers.

The bioavailability of Olsi was not significantly altered by the co-administration of antacids [Al(OH)].

Olsi medoxomil is not metabolized by the cytochrome P450 system and has no effects on P450 enzymes; thus, interactions with drugs that inhibit, induce, or are metabolized by those enzymes are not expected.

Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors)

In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including Olsi medoxomil, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving Olsi medoxomil and NSAID therapy.

The antihypertensive effect of angiotensin II receptor antagonists, including Olsi medoxomil may be attenuated by NSAIDs including selective COX-2 inhibitors.

Dual Blockade Of The Renin-Angiotensin System (RAS)

Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Most patients receiving the combination of two RAS inhibitors do not obtain any additional benefit compared to monotherapy. In general, avoid combined use of RAS inhibitors. Closely monitor blood pressure, renal function and electrolytes in patients on Olsi and other agents that affect the RAS.

Do not co-administer aliskiren with Olsi in patients with diabetes. Avoid use of aliskiren with Olsi in patients with renal impairment (GFR < 60 ml/min).

Colesevelam Hydrochloride

Concurrent administration of bile acid sequestering agent colesevelam hydrochloride reduces the systemic exposure and peak plasma concentration of Olsi. Administration of Olsi at least 4 hours prior to colesevelam hydrochloride decreased the drug interaction effect. Consider administering Olsi at least 4 hours before the colesevelam hydrochloride dose.

Lithium

Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration of lithium with angiotensin II receptor antagonists, including Olsi. Monitor serum lithium levels during concomitant use.

Olsi side effects

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What are the possible side effects of Olsi?

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Clinical Trials Experience

Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.

Adult Hypertension

Olsi has been evaluated for safety in more than 3825 patients/subjects, including more than 3275 patients treated for hypertension in controlled trials. This experience included about 900 patients treated for at least 6 months and more than 525 for at least 1 year. Treatment with Olsi was well tolerated, with an incidence of adverse reactions similar to placebo. Events generally were mild, transient and had no relationship to the dose of Olsi.

The overall frequency of adverse reactions was not dose-related. Analysis of gender, age and race groups demonstrated no differences between Olsi and placebo-treated patients. The rate of withdrawals due to adverse reactions in all trials of hypertensive patients was 2.4% (i.e., 79/3278) of patients treated with Olsi and 2.7% (i.e., 32/1179) of control patients. In placebo-controlled trials, the only adverse reaction that occurred in more than 1% of patients treated with Olsi and at a higher incidence versus placebo was dizziness (3% vs. 1%).

The following adverse reactions occurred in placebo-controlled clinical trials at an incidence of more than 1% of patients treated with Olsi, but also occurred at about the same or greater incidence in patients receiving placebo: back pain, bronchitis, creatine phosphokinase increased, diarrhea, headache, hematuria, hyperglycemia, hypertriglyceridemia, influenza-like symptoms, pharyngitis, rhinitis and sinusitis.

The incidence of cough was similar in placebo (0.7%) and Olsi (0.9%) patients.

Other potentially important adverse reactions that have been reported with an incidence of greater than 0.5%, whether or not attributed to treatment, in the more than 3100 hypertensive patients treated with Olsi monotherapy in controlled or open-label trials are listed below.

Body as a Whole: chest pain, peripheral edema

Central and Peripheral Nervous System: vertigo

Gastrointestinal: abdominal pain, dyspepsia, gastroenteritis, nausea

Heart Rate and Rhythm Disorders: tachycardia

Metabolic and Nutritional Disorders: hypercholesterolemia, hyperlipemia, hyperuricemia

Musculoskeletal: arthralgia, arthritis, myalgia

Skin and Appendages: rash

Facial edema was reported in five patients receiving Olsi. Angioedema has been reported with angiotensin II antagonists.

Laboratory Test Findings: In controlled clinical trials, clinically important changes in standard laboratory parameters were rarely associated with administration of Olsi.

Hemoglobin and Hematocrit: Small decreases in hemoglobin and hematocrit (mean decreases of approximately 0.3 g/dL and 0.3 volume percent, respectively) were observed.

Liver Function Tests: Elevations of liver enzymes and/or serum bilirubin were observed infrequently. Five patients (0.1%) assigned to Olsi and one patient (0.2%) assigned to placebo in clinical trials were withdrawn because of abnormal liver chemistries (transaminases or total bilirubin). Of the five Olsi patients, three had elevated transaminases, which were attributed to alcohol use, and one had a single elevated bilirubin value, which normalized while treatment continued.

Pediatric Hypertension

No relevant differences were identified between the adverse experience profile for pediatric patients aged 1 to16 years and that previously reported for adult patients.

Post-Marketing Experience

The following adverse reactions have been reported in post-marketing experience. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body as a Whole: Asthenia, angioedema, anaphylactic reactions

Gastrointestinal: Vomiting, sprue-like enteropathy

Metabolic and Nutritional Disorders: Hyperkalemia

Musculoskeletal: Rhabdomyolysis

Urogenital System: Acute renal failure, increased blood creatinine levels

Skin and Appendages: Alopecia, pruritus, urticaria

Data from one controlled trial and an epidemiologic study have suggested that high-dose Olsi may increase cardiovascular (CV) risk in diabetic patients, but the overall data are not conclusive. The randomized, placebo-controlled, double-blind ROADMAP trial (Randomized Olsi And Diabetes MicroAlbuminuria Prevention trial, n=4447) examined the use of Olsi, 40 mg daily, vs. placebo in patients with type 2 diabetes mellitus, normoalbuminuria, and at least one additional risk factor for CV disease. The trial met its primary endpoint, delayed onset of microalbuminuria, but Olsi had no beneficial effect on decline in glomerular filtration rate (GFR). There was a finding of increased CV mortality (adjudicated sudden cardiac death, fatal myocardial infarction, fatal stroke, revascularization death) in the Olsi group compared to the placebo group (15 Olsi vs. 3 placebo, HR 4.9, 95% confidence interval [CI], 1.4, 17), but the risk of non-fatal myocardial infarction was lower with Olsi (HR 0.64, 95% CI 0.35, 1.18).

The epidemiologic study included patients 65 years and older with overall exposure of > 300,000 patient-years. In the sub-group of diabetic patients receiving high-dose Olsi (40 mg/d) for > 6 months, there appeared to be an increased risk of death (HR 2.0, 95% CI 1.1, 3.8) compared to similar patients taking other angiotensin receptor blockers. In contrast, high-dose Olsi use in non-diabetic patients appeared to be associated with a decreased risk of death (HR 0.46, 95% CI 0.24, 0.86) compared to similar patients taking other angiotensin receptor blockers. No differences were observed between the groups receiving lower doses of Olsi compared to other angiotensin blockers or those receiving therapy for < 6 months.

Overall, these data raise a concern of a possible increased CV risk associated with the use of high-dose Olsi in diabetic patients. There are, however, concerns with the credibility of the finding of increased CV risk, notably the observation in the large epidemiologic study for a survival benefit in non-diabetics of a magnitude similar to the adverse finding in diabetics.

Olsi contraindications

See also:
What is the most important information I should know about Olsi?

Stop using this medication and tell your doctor right away if you become pregnant. Olsi can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not use this medication if you are allergic to Olsi.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of Olsi.

Do not use potassium supplements or salt substitutes while you are taking Olsi, unless your doctor has told you to.

Your blood pressure will need to be checked often. Visit your doctor regularly.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Active ingredient matches for Olsi:

Olmesartan


Unit description / dosage (Manufacturer)Price, USD
OLSI 40 MG TABLET 1 strip / 10 tablets each (C M R Life Sciences)$ 1.52

List of Olsi substitutes (brand and generic names):

Olsertain Active 40mg Tablet (Dr Reddy's Laboratories Ltd)$ 0.08
Olstan 40mg Tablet (Biochem Pharmaceutical Industries)$ 0.11
Olstan H Tablet (Elder Pharmaceuticals Ltd)$ 0.29
OLTAS 20 MG TABLET 1 strip / 10 tablets each (Tas Med India Pvt Ltd)$ 0.71
OLTAS 40 MG TABLET 1 strip / 10 tablets each (Tas Med India Pvt Ltd)$ 0.98
Oltas 20mg Tablet (Tas Med India Pvt Ltd)$ 0.07
Oltas 40mg Tablet (Tas Med India Pvt Ltd)$ 0.10
20 mg x 10's (Ranbaxy Laboratories Ltd.,)$ 0.98
40 mg x 10's (Ranbaxy Laboratories Ltd.,)$ 1.75
Olvance 20 mg Tablet (Ranbaxy Laboratories Ltd.,)$ 0.10
Olvance 40 mg Tablet (Ranbaxy Laboratories Ltd.,)$ 0.17
Olvance 20mg TAB / 10 (Ranbaxy Laboratories Ltd.,)$ 0.98
Olvance 40mg TAB / 10 (Ranbaxy Laboratories Ltd.,)$ 1.75
OLVANCE 20 MG TABLET 1 strip / 10 tablets each (Ranbaxy Laboratories Ltd.,)$ 1.16
OLVANCE 40 TABLET 1 strip / 10 tablets each (Ranbaxy Laboratories Ltd.,)$ 1.96
OLVANCE H 50MG TABLET 1 strip / 10 tablets each (Ranbaxy Laboratories Ltd.,)$ 1.40
OLVANCE tab 20 mg x 10's (Ranbaxy Laboratories Ltd.,)$ 0.98
OLVANCE tab 40 mg x 10's (Ranbaxy Laboratories Ltd.,)$ 1.75
Olvance FC tab 20 mg 2 x 7's (Ranbaxy Laboratories Ltd.,)
Olvance FC tab 40 mg 2 x 7's (Ranbaxy Laboratories Ltd.,)
Olvance 20mg TAB / 10 (Ranbaxy Laboratories Ltd.,)$ 0.98
Olvance 40mg TAB / 10 (Ranbaxy Laboratories Ltd.,)$ 1.75
Olvance 20mg Tablet (Ranbaxy Laboratories Ltd.,)$ 0.12
OLVAS 20 MG TABLET 1 strip / 10 tablets each (Cadila)$ 1.01
OLVAS 40 MG TABLET 1 strip / 10 tablets each (Cadila)$ 1.74
OLVAS film-coated tab 20 mg x 10's (Cadila)$ 0.78
OLVAS film-coated tab 40 mg x 10's (Cadila)$ 1.46
Olvas 20mg Tablet (Cadila)$ 0.11
Olvas 40mg Tablet (Cadila)$ 0.17
OMEN Capsule/ Tablet / 20mg / 10 units (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.49
20 mg x 10's (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.49
Omen 20 mg Capsule (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.05
Omen 20mg CAP / 10 (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.49
OMEN 20 MG CAPSULE 1 strip / 10 capsules each (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.88
OMEN cap 20 mg x 10's (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.49
Omen 20mg CAP / 10 (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.49
Omen 20mg Capsule (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.09
Omen 20mg Tablet (Adroit Pharmaceuticals Pvt. Ltd.)$ 0.10
OMEN 20 MG TABLET 1 strip / 10 tablets each (Medley Pharmaceuticals)$ 0.88
OMEN 40 MG TABLET 1 strip / 10 tablets each (Medley Pharmaceuticals)$ 1.55
RASOTAN 40 MG TABLET 1 strip / 10 tablets each (Emcure Pharmaceuticals Ltd)$ 0.52
SOLMIREST tab 20 mg x 10's (Invision)$ 0.84

References

  1. PubChem. "Olmesartan". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  2. DrugBank. "Olmesartan". http://www.drugbank.ca/drugs/DB00275 (accessed September 17, 2018).
  3. DTP/NCI. "Olmesartan: The NCI Development Therapeutics Program (DTP) provides services and resources to the academic and private-sector research communities worldwide to facilitate the discovery and development of new cancer therapeutic agents.". https://dtp.cancer.gov/dtpstandard/s... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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