Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. When pregnancy is detected, discontinue Benicar as soon as possible [see Use of Benicar in children <1 year of age is not recommended. Refill and manage your prescriptions online, anytime. For children who can swallow tablets, the usual recommended starting dose of Benicar 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. Health professionals also need to stay up to date with the latest evidence as it emerges. After repeated dosing, the AUC was approximately tripled in patients with severe renal impairment (creatinine clearance <20 mL/min).

Fetal testing may be appropriate, based on the In contrast, high-dose olmesartan 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. Benicar is indicated for the treatment of hypertension in adults and children six years of age and older, to lower blood pressure. 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.Data from one controlled trial and an epidemiologic study have suggested that high-dose olmesartan may increase cardiovascular (CV) risk in diabetic patients, but the overall data are not conclusive. assess the intra-amniotic environment. 20 mg/day PO initially; may be increased to 40 mg/day PO after 2 weeks; a diuretic may be addedVolume-depleted patients: Consider lower initial dosageAlso given in combination with hydrochlorothiazide (Benicar HCT)5-10 mg/day PO initially; may be increased to 40 mg/day PO after 2 weeks (with monitoring of blood pressure); a diuretic may be addedDiscontinue as soon as possible when pregnancy is detected; drug affects renin-angiotensin system, causing oligohydramnios, which may result in fetal injury or deathDo not coadminister with aliskiren in patients with diabetes mellitus or with renal impairment (ie, GFR <60 mL/min/1.73 m²)Use caution in congestive heart failure (CHF), surgery or anesthesia, volume depletion (consider lower dosage)Angioedema reported; may occur at any time during treatment, especially after first dose; risk increases in patients with idiopathic or hereditary angioedema or experiencing angioedema following ACE-inhibitor therapy; prolonged monitoring of air pathways may be necessary as reactions are associated with airway obstruction; not for administration to patients with prior history of angioedema following therapy with ARBs; discontinue therapy immediately if angioedema occurs; intramuscular administration of epinephrine may be necessary to manage angioedemaCoadministration with mTOR inhibitors (eg, temsirolimus) may increase risk for angioedemaRisk of hypotension, especially in patients with volume or salt depletion secondary to salt restriction or prolonged diuretic treatment; initiate treatment in such patients under close medical supervision and consider starting at a lower doseRisk of hyperkalemia; monitor serum electrolytes periodically; use with caution, if at all and monitor potassium closely in patients with risk factors, including diabetes mellitus, renal dysfunction, potassium supplements and/or potassium containing saltsUse with caution in patients with unstented unilateral/bilateral renal artery stenosis; avoid therapy when unstented bilateral renal artery stenosis is present due to elevated risk of deterioration in renal function unless possible benefits outweigh risksRenal impairment reported; may occur in patients with low renal blood flow (eg, heart failure, renal artery stenosis), whose glomerular filtration rate is dependent on efferent arteriolar vasoconstriction by angiotensin II, which may result in acute renal failure, oliguria, and progressive azotemia; discontinue therapy only in patients with progressive and/or significant deterioration in renal functionUse caution in patients with pre-existing renal insufficiencyAvoid use in patients with ascites resulting from cirrhosis or refractory ascites; monitor blood pressure and renal function closely if use cannot be avoidedIntestinal problems (ie, sprue-like enteropathy) reported; symptoms may include severe, chronic diarrhea with substantial weight loss; discontinue treatment and consider other antihypertensive therapyDual blockade of the renin-angiotensin system with angiotensin-receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, or aliskiren is associated with increased risk of hypotension, hyperkalemia, and altered renal function (including acute renal failure) in comparison with monotherapy; closely monitor blood pressureChildren <1 year of age must not receive olmesartan for hypertension; drugs that act directly on the renin-angiotensin-aldosterone system can have adverse effects on the development of immature kidneysCan cause fetal harm when administered to a pregnant woman; use of drugs that act on renin-angiotensin system during second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and deathMost epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agentsHypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage)Hypertension increases fetal risk for intrauterine growth restriction and intrauterine deathPregnant women with hypertension should be carefully monitored and managed accordinglyThere is no information regarding presence of drug in human milk, effects on breastfed infant, or on milk production; drug is secreted at low concentration in milk of lactating rats; because of potential for adverse effects on nursing infant, a decision should be made whether to discontinue nursing or discontinue drug, considering importance of drug to motherA: Generally acceptable.

Monitor serum lithium levels during concomitant use.Concurrent administration of bile acid sequestering agent colesevelam hydrochloride reduces the systemic exposure and peak plasma concentration of olmesartan.