What is the difference between Olmesartan and Telmisartan in the sartan class of drugs?

A friend who suffers from high blood pressure left a message to Huazi. He has been using Olmesartan. What are the characteristics of this drug? I heard that Telmisartan has a strong antihypertensive effect. How effective is Olmesartan and what is the difference between it and Telmisartan?

Huazi said that Olmesartan is a later-coming sartan drug. Compared with previously launched sartans, Olmesartan has a slightly stronger antihypertensive effect and slightly less impact on the liver and kidneys. However, it may cause adverse reactions such as sprue and diarrhea, so care should be taken when using the drug.

1. Different sartans have different antihypertensive effects

Sartan drugs are divided into several "sartans". Although they have the same pharmacological mechanism and can prevent angiotensin 2 from binding to the corresponding receptors (AT1 receptors) on blood vessels, their binding sites, metabolic pathways, blood drug concentration half-life, etc. are different, so their actual effects are not exactly the same.

Before Olmesartan was launched, telmisartan was the strongest in terms of blood pressure reduction, followed by irbesartan, candesartan, valsartan and losartan. However, after Olmesartan was launched, people found that its blood pressure reduction strength was slightly greater than that of telmisartan, and it has become the strongest blood pressure reduction sartan.

2. Blood drug concentration half-life and drug efficacy persistence

After drug absorption, the time it takes for the blood concentration to drop by half is called the blood drug concentration half-life. The longer the half-life, the longer the drug effect lasts . Among sartan drugs, telmisartan has the longest blood drug concentration half-life, which can reach more than 20 hours.

The blood concentration half-life of Olmesartan is 13 hours, but it binds tightly to the AT1 receptor and can maintain its efficacy for 24 hours if taken once a day.

For people with normal blood pressure fluctuations, blood pressure rises during the day and drops at night, taking Olmesartan every morning can achieve the greatest antihypertensive effect. For people with irregular blood pressure fluctuations, who may experience nocturnal hypertension or early morning hypertension, it is more appropriate to use Telmisartan to maintain a stable blood concentration for a long enough time.

3. Effects of metabolic pathways on liver and kidney

Telmisartan is mainly metabolized by the liver and excreted by the bile duct. It should be used with caution by patients with abnormal liver function and should not be used by patients with severe liver dysfunction or bile duct obstruction. Olmesartan is excreted in a balanced manner through both the liver and kidney channels . Patients with mild or moderate liver and kidney dysfunction do not need to adjust the dosage when taking the drug. It is suitable for elderly hypertensive patients with decreased liver and kidney function.

Telmisartan will increase the blood concentration of digoxin, an anti-heart failure drug. If used together, the blood concentration of digoxin needs to be monitored. Olmesartan, on the other hand, does not undergo hepatic drug-enzyme metabolism and has less impact on other drugs . For elderly people with more underlying diseases and complex medication regimens, taking Olmesartan will result in fewer drug interactions.

4. Specific adverse reactions of Olmesartan

All sartan drugs have similar adverse reactions, such as orthostatic hypotension , which may lead to syncope; in the early stages of medication, it may cause an increase in blood creatinine , and it is not suitable for patients with renal artery stenosis; it may also cause hyperkalemia , and blood potassium levels should be checked regularly during medication.

However, Olmesartan has a unique adverse reaction, which is sprue . If patients who take Olmesartan for a long time develop chronic diarrhea accompanied by weight loss, and the diarrhea symptoms improve significantly after stopping the drug, it may be an adverse reaction of the drug. You need to seek medical attention and intervene in time.

In summary, Olmesartan and Telmisartan are both sartan drugs with strong antihypertensive effects. Olmesartan is slightly stronger than Telmisartan; the half-life of Telmisartan's blood concentration is longer than Olmesartan; the two also have different metabolic pathways. Doctors need to choose to use it according to the actual situation of different patients. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi. Welcome to follow me and share more health knowledge.