page143
necessary increased after several weeks to 100 mg
once daily;
ELDERLY
over 75 years initially 25 mg daily
. Chronic heart failure, 12.5 mg once daily, increased at
weekly intervals to 50 mg once daily if tolerated
Losartan Potassium
(Non-proprietary)
Tablets
, losartan potassium 12.5 mg, net price 28-tab
pack = £7.70;
25 mg, 28-tab pack = £2.64; 50 mg, 28-
tab pack = £2.38;
100 mg,
28-tab pack = £2.84
Cozaar
c
(MSD) T A
Tablets
,
f/c,
losartan potassium 12.5 mg (blue),
net
price 28-tab pack = £8.09; 25 mg (white), net price 28-
tab pack = £16.18; 50 mg (white, scored), 28-tab pack
= £12.80;
100 mg (white),
28-tab pack = £16.18
Oral suspension
,
losartan potassium 12.5 mg/5 mL
when reconstituted with solvent provided,
net price
200-mL (berry-citrus flavour) = £53.68
With diuretic
Note
For hypertension not adequately controlled with losartan
alone.
For prescribing information on thiazides, see section
2.2.1
Cozaar-Comp
c
(MSD) A
Tablets 50/12.5
,
yellow,
f/c,
losartan potassium
50 mg,
hydrochlorothiazide 12.5 mg,
net price 28-tab
pack = £12.80
Tablets 100/12.5
,
white,
f/c,
losartan potassium
100 mg, hydrochlorothiazide 12.5 mg, net price 28-tab
pack = £16.18
Tablets 100/25
,
yellow,
f/c,
losartan potassium
100 mg,
hydrochlorothiazide 25 mg,
net price 28-tab
pack = £16.18
OLMESARTAN MEDOXOMIL
Indications
hypertension (see also notes above)
Cautions
see notes above
Contra-indications
biliary obstruction
Hepatic impairment
dose should not exceed 20 mg
daily in moderate impairment; manufacturer advises
avoid in severe impairment—no information available
Renal impairment
max.
20 mg daily if eGFR 20–
60 mL/minute/1.73 m
2
;
avoid if eGFR less than
20 mL/minute/1.73 m
2
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above;
also gastro-intestinal
disturbances;
chest pain,
peripheral oedema, hyper-
triglyceridaemia; fatigue;
influenza-like symptoms,
cough, pharyngitis,
rhinitis;
urinary-tract infection;
haematuria, hyperuricaemia; arthritis,
musculo-
skeletal pain;
less commonly
angina,
vertigo,
rash;
very rarely
headache,
thrombocytopenia,
myalgia,
pruritus, urticaria
Dose
. Initially 10 mg once daily;
if necessary increased to
20 mg once daily; max.
40 mg daily
Olmetec
c
(Daiichi Sankyo) A
Tablets
,
f/c,
olmesartan medoxomil 10 mg,
net price
28-tab pack = £10.95;
20 mg,
28-tab pack = £12.95;
40 mg,
28-tab pack = £17.50
With calcium-channel blocker
Note
For hypertension in patients stabilised on the individual
components in the same proportions.
For prescribing infor-
mation on amlodipine, see section 2.6.2
Sevikar
c
(Daiichi Sankyo) T A
Tablets 20/5
,
white,
f/c,
olmesartan medoxomil
20 mg, amlodipine (as besilate) 5 mg, net price 28-tab
pack = £16.95
Tablets 40/5
,
ivory,
f/c,
olmesartan medoxomil
40 mg, amlodipine (as besilate) 5 mg, net price 28-tab
pack = £16.95
Tablets 40/10
,
brownish-red, f/c,
olmesartan
medoxomil 40 mg, amlodipine (as besilate) 10 mg, net
price 28-tab pack = £16.95
With diuretic
Note
For hypertension not adequately controlled with olme-
sartan alone. For prescribing information on thiazides,
see
section 2.2.1
Olmetec Plus
c
(Daiichi Sankyo) T A
Tablets
,
f/c,
olmesartan medoxomil 20 mg,
hydro-
chlorothiazide 12.5 mg (red-yellow), net price 28-tab
pack = £12.95;
olmesartan medoxomil 20 mg,
hydro-
chlorothiazide 25 mg (pink),
28-tab pack = £12.95;
olmesartan medoxomil 40 mg,
hydrochlorothiazide
12.5 mg (red-yellow), 28-tab pack = £17.50
TELMISARTAN
Indications
hypertension (see also notes above);
pre-
vention of cardiovascular events in patients with
established atherosclerotic cardiovascular disease,
or
type 2 diabetes mellitus with target-organ damage
Cautions
see notes above
Hepatic impairment
20–40 mg once daily in mild or
moderate impairment; avoid in severe impairment or
biliary obstruction
Renal impairment
manufacturer advises initial dose
of 20 mg once daily in severe impairment
Pregnancy
see notes above
Breast-feeding
see notes above
Side-effects
see notes above;
also gastro-intestinal
disturbances;
chest pain;
influenza-like symptoms
including pharyngitis and sinusitis; urinary-tract
infection;
arthralgia,
myalgia,
back pain, leg cramps;
eczema;
less commonly
dry mouth,
flatulence,
anxiety,
vertigo,
tendinitis-like symptoms,
abnormal
vision,
increased sweating;
rarely
bradycardia,
tachycardia, dyspnoea,
insomnia,
depression,
blood
disorders, increase in uric acid, eosinophilia, rash, and
pruritus;
syncope and asthenia also reported
Dose
. Hypertension,
usually 40 mg once daily (but 20 mg
may be sufficient), increased if necessary after at least
4 weeks,
to max.
80 mg once daily
. Prevention of cardiovascular events, 80 mg once daily
Micardis
c
(Boehringer Ingelheim) T A
Tablets
,
telmisartan 20 mg,
net price 28-tab pack =
£8.00;
40 mg,
28-tab pack = £12.50;
80 mg,
28-tab
pack = £17.00
BNF 61
2.5.5 Drugs affecting the renin-angiotensin system
123
2
Cardiovascular system