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What is the difference between olmesartan and telmisartan in sartans?

Time:2023-02-01 22:24:11 source:psychiatricethics.com author:Anxiety disorder Read:914次
What is the difference between olmesartan and telmisartan in sartans?

A friend with high blood pressure left a message to Hua Zi. He has been using olmesartan. What are the characteristics of this drug? I heard that telmisartan has a strong antihypertensive effect. What is the effect of olmesartan and what is the difference between it and telmisartan? Hua Zi said that olmesartan is a later version of the sartan drugs. Compared with the previously listed sartans, olmesartan has a slightly stronger antihypertensive effect and a slightly smaller impact on the liver and kidneys. Adverse reactions that may cause sprue diarrhea need to be paid attention to when taking medication.

I. Different sartans have different antihypertensive effects

Sartans are divided into multiple “sartans”, although the pharmacological mechanism is the same, all of them can Prevents angiotensin 2 from binding to the corresponding receptor (AT1 receptor) on blood vessels, but the binding sites, metabolic pathways, and half-life of plasma concentrations are all different, so the actual effects are not exactly the same. Before Olmesartan was launched, telmisartan was the highest in terms of antihypertensive intensity, followed by irbesartan, followed by candesartan, followed by valsartan and losartan. However, after the listing of olmesartan, it was found that its antihypertensive intensity was slightly greater than that of telmisartan, and it has become the sartan drug with the strongest antihypertensive effect.

Second, half-life of blood concentration and durability of drug effect

After drug absorption, the time when the blood concentration decreases by half is called the half-life of blood concentration, and the longer the half-life means The longer the drug effect lasts. Among the sartans, telmisartan has the longest plasma half-life, which can reach more than 20 hours. The half-life of olmesartan in plasma concentration is 13 hours, but it binds tightly to AT1 receptors. Taking it once a day can also maintain the drug effect for 24 hours. For people with normal blood pressure fluctuations, blood pressure increases during the day and decreases at night. Taking olmesartan every morning can exert the greatest antihypertensive effect. For people with irregular blood pressure fluctuations, nighttime hypertension or morning hypertension may occur, and it is more suitable to use telmisartan to maintain a stable blood concentration for a long enough time.

III. Effects of Metabolic Pathways on Liver and Kidney

Telmisartan is mainly metabolized by the liver and excreted by the biliary tract. Those with abnormal liver function should be used with caution, as the liver function is serious Insufficiency and bile duct blockage cannot be used. However, olmesartan is excreted in a balanced manner through the dual channels of the liver and kidney. People with mild or moderate insufficiency of liver and kidney functions do not need to adjust the dose when taking the drug. It is suitable for elderly hypertensive patients with decreased liver and kidney functions. Telmisartan can increase the blood concentration of the anti-heart failure drug digoxin. If it is used in combination, the blood concentration of digoxin needs to be monitored. However, olmesartan is not metabolized by the liver drug enzyme system, and has less impact with other drugs. For the elderly with more underlying diseases and complicated drug regimens, taking olmesartan has fewer drug interactions.

IV. Special adverse reactions of olmesartan

All sartans have similar adverse reactions, such as possible Orthostatic hypotension occurs, leading to syncope; in the early stage of medication, serum creatinine may increase, which is not suitable for patients with renal artery stenosis; it may also lead to hyperkalemia, and serum potassium should be checked regularly during the medication process. However, olmesartan has a unique adverse reaction, that is, sprue. Long-term use of olmesartan, if chronic diarrhea accompanied by weight loss occurs, and the diarrhea symptoms are greatly improved after stopping the drug, it may be an adverse reaction caused by the drug. Immediate medical attention and intervention are required. To sum up, olmesartan and telmisartan are both sartan drugs with strong antihypertensive effect, olmesartan is slightly stronger than telmisartan; the plasma concentration half-life of telmisartan is longer than that of olmesartan ; The two metabolic pathways are also different. It needs to be selected by the doctor according to the actual situation of different patients. If you have any doubts about medication, please consult your doctor or pharmacist. I am pharmacist Hua Zi. Welcome to follow me and share more health knowledge.

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