Dosage of benicar
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Dosage of Benicar (Olmesartan Medoxomil) for Hypertension
Introduction to Benicar Dosage
Benicar, known generically as olmesartan medoxomil, is an angiotensin II receptor blocker (ARB) used to manage hypertension. The appropriate dosage of Benicar is crucial for achieving optimal blood pressure control and minimizing adverse effects.
Initial Dosage Recommendations
The recommended starting dose of Benicar for patients with hypertension is 20 mg per day. This dosage has been shown to be effective in reducing blood pressure significantly compared to other ARBs such as losartan, valsartan, and irbesartan. In a study comparing these medications, olmesartan medoxomil at 20 mg/day demonstrated superior efficacy in lowering diastolic blood pressure (DBP) and achieving target blood pressure goals.
Titration and Adjustments
For patients who do not achieve the desired blood pressure reduction with the initial 20 mg/day dose, the dosage can be increased. In the BENIFICIARY study, patients who did not reach a blood pressure of less than 120/70 mm Hg after three weeks on 20 mg/day were up-titrated to 40 mg/day. If further blood pressure control was needed, the regimen was adjusted to include hydrochlorothiazide (HCTZ), starting with 40/12.5 mg/day and potentially increasing to 40/25 mg/day.
Efficacy of Dosage Adjustments
The efficacy of these dosage adjustments was confirmed through 24-hour ambulatory blood pressure monitoring (ABPM). Patients who were titrated to higher doses of olmesartan medoxomil, with or without HCTZ, showed significant reductions in both systolic blood pressure (SBP) and DBP. Specifically, mean 24-hour ambulatory SBP and DBP decreased by 20.4 mm Hg and 11.1 mm Hg, respectively. Additionally, a substantial proportion of patients achieved target blood pressure levels, with 61.6% reaching <130/80 mm Hg, 47.1% reaching <125/75 mm Hg, and 39.0% reaching <120/80 mm Hg.
Comparative Efficacy
When compared to other ARBs, olmesartan medoxomil at the starting dose of 20 mg/day was more effective in reducing blood pressure over a 24-hour period. This was particularly evident in the last 2 and 4 hours of the dosing interval, where olmesartan medoxomil maintained larger mean decreases in blood pressure, thus providing better control during the morning surge. The goal rates for achieving critical ambulatory blood pressure values were also higher for olmesartan medoxomil compared to losartan and valsartan.
Conclusion
The dosage of Benicar (olmesartan medoxomil) for hypertension typically starts at 20 mg/day, with the potential to increase to 40 mg/day if necessary. For further blood pressure control, the addition of hydrochlorothiazide can be considered. This titration approach has been shown to be effective and well-tolerated, providing significant reductions in blood pressure and achieving target levels in a substantial proportion of patients .
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