Home Drug Guide Azilsartan Medoxomil

Drug Guide

Generic Name

Azilsartan Medoxomil

Brand Names Edarbi

Classification

Therapeutic: Antihypertensive

Pharmacological: Angiotensin II receptor blocker (ARB)

FDA Approved Indications

Hypertension

Mechanism of Action

Azilsartan Medoxomil is converted to azilsartan, which selectively blocks the angiotensin II type 1 (AT1) receptors. This inhibition prevents vasoconstriction and aldosterone-mediated volume expansion, leading to decreased blood pressure.

Dosage and Administration

Adult: Typically 40 mg once daily, can be adjusted up to 80 mg based on response.

Pediatric: Not indicated for pediatric use.

Geriatric: No specific dosage adjustment is generally required, but caution in renal impairment and concomitant medications.

Renal Impairment: Use with caution; may require dose adjustment based on renal function.

Hepatic Impairment: Use with caution; no specific dosage adjustments established.

Pharmacokinetics

Absorption: Rapidly absorbed; bioavailability approximately 60%.

Distribution: Almost completely bound to plasma proteins.

Metabolism: Prodrug converted to active metabolite in the gastrointestinal tract.

Excretion: Primarily fecal, minor renal excretion.

Half Life: About 11 hours.

Contraindications

Hypersensitivity to azilsartan or other ARBs.
Pregnancy - teratogenic effects.

Precautions

Use cautiously in patients with bilateral renal artery stenosis, volume or sodium depletion, hepatic impairment, or concomitant use with potassium-sparing diuretics.

Adverse Reactions - Common

Dizziness (Common)
Fatigue (Common)
Syncope (Uncommon)

Adverse Reactions - Serious

Angioedema (Rare)
Hypotension (Rare)
Elevated serum potassium (Uncommon)
Renal impairment (Uncommon)

Drug-Drug Interactions

Increased hyperkalemia risk with potassium supplements or potassium-sparing diuretics.
Enhances effect when combined with other antihypertensives.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function (serum creatinine, BUN), and serum potassium before and during therapy.

Diagnoses:

Risk for decreased cardiac output related to hypotension.
Risk for electrolyte imbalance.

Implementation: Administer orally, preferably at the same time each day. Educate patient on orthostatic hypotension precautions.

Evaluation: Assess for reduction in blood pressure, monitor for adverse effects, and adjust dose as needed.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of dizziness, swelling, or difficulty breathing.
Avoid potassium-rich foods and supplements unless instructed.

Special Considerations

Black Box Warnings:

Pregnancy: can cause injury and death to the fetus; discontinue immediately if pregnancy is detected.

Genetic Factors: None specifically associated.

Lab Test Interference: May affect serum potassium and renal function tests.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, tachycardia, or bradycardia.

Treatment: Supportive care, monitor blood pressure, and provide vasopressors or IV fluids as needed; dialysis if severe renal failure.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.