Overview
Azilsartan is an angiotensin II receptor blocker (ARB) used for the treatment of hypertension. It selectively blocks the binding of angiotensin II to the AT1 receptor, leading to vasodilation, reduced aldosterone secretion, and decreased blood pressure. Azilsartan medoxomil is a prodrug that is hydrolyzed to the active metabolite azilsartan in the gastrointestinal tract.
Mechanism of Action
Azilsartan is a selective and competitive antagonist of angiotensin II type 1 (AT1) receptors. By blocking the binding of angiotensin II to AT1 receptors, it inhibits vasoconstriction, aldosterone release, sodium and water retention, and sympathetic nervous system activation, resulting in decreased blood pressure.
Indications
- Treatment of hypertension in adults
- May be used alone or in combination with other antihypertensive agents
Dosage
Initial dose: 40 mg once daily. May be increased to 80 mg once daily if blood pressure is not controlled. Can be taken with or without food. Dose adjustment may be needed in patients with renal impairment.
Contraindications
- Hypersensitivity to azilsartan or any component of the formulation
- Pregnancy (second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes
Side Effects
- Common: Diarrhea, dizziness, fatigue, headache
- Less common: Hypotension, hyperkalemia, renal impairment
- Rare: Angioedema, rash, increased serum creatinine
Interactions
- NSAIDs: May reduce antihypertensive effect and increase risk of renal impairment
- Potassium supplements/potassium-sparing diuretics: Increased risk of hyperkalemia
- Lithium: Increased lithium levels
- ACE inhibitors: Increased risk of hyperkalemia, hypotension, and renal impairment