Formulary
Azilsartan medoxomil: Indications, Dosing, Side Effects and Interactions
Azilsartan medoxomil clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Azilsartan medoxomil: Indications, Dosing, Side Effects and Interactions
Azilsartan medoxomil clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Hypertension**
- **Adult** (By Mouth): 75 years and over Initially 20-40 mg once daily, increased if necessary to 80 mg once daily.
**Hypertension with intravascular volume depletion**
- **Adult** (By Mouth): Initially 20-40 mg once daily, increased if necessary to 80 mg once daily.
Cautions
II receptor antagonists Aortic or mitral valve stenosis; elderly (lower initial doses may be appropriate); hypertrophic cardiomyopathy; patients of black African or African-Caribbean origin; patients with a history of angioedema; patients with primary aldosteronism (may not benefit from an angiotensin-II receptor antagonist); renal artery stenosis Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: with hyperkalaemia with persistent postural hypotension i.e. recurrent drop in systolic blood pressure 20 mmHg (risk of syncope and falls) Cautions For azilsartan medoxomil Heart failure
Contraindications
II receptor antagonists The combination of an angiotensin-II receptor antagonist with aliskiren is contra-indicated in patients with an eGFR less than 60 mL/minute/1.73 m 2 ; the combination of an angiotensin-II receptor antagonist with aliskiren is contra-indicated in patients with diabetes mellitus
Side effects
II receptor antagonists Common or very common Abdominal pain; asthenia; back pain; cough; diarrhoea; dizziness; headache; hyperkalaemia; hypotension; nausea; postural hypotension (more common in patients with intravascular volume depletion, e.g. those taking high-dose diuretics); renal impairment; vertigo; vomiting Uncommon Angioedema; myalgia; skin reactions; thrombocytopenia Rare or very rare Arthralgia; hepatic function abnormal Side-effects For azilsartan medoxomil Uncommon Hyperuricaemia; muscle spasms; peripheral oedema
Pregnancy
Important safety information For all angiotensin II receptor antagonists MHRA/CHM advice: ACE inhibitors and angiotensin II receptor antagonists: not for use in pregnancy (December 2014) See Conception and contraception and Pregnancy . MHRA/CHM advice: ACE inhibitors and angiotensin II receptor antagonists: recommendations on how to use for breastfeeding (December 2014) See Breast feeding .
Breast feeding
II receptor antagonists Information on the use of angiotensin-II receptor antagonists in breast-feeding is limited. They are not recommended in breast-feeding. Alternative treatment options, with better established safety profile during breast-feeding, are preferable M (recommendation also supported by specialist sources).
Hepatic impairment
II receptor antagonists In general, manufacturers advise caution in mild to moderate impairment (limited information available); avoid in severe impairment (no information available). Hepatic impairment For azilsartan medoxomil Dose adjustments Manufacturer advises consider initial dose of 20 mg in mild to moderate impairment. Monitoring Manufacturer advises monitor closely in mild to moderate hepatic impairment (limited information available).
Renal impairment
II receptor antagonists Dose adjustments In general, manufacturers advise start with low dose and adjust according to response. Renal impairment For azilsartan medoxomil Manufacturer advises caution in severe impairment-no information available.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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