Olmesartan medoxomil
[CAS# 144689-63-4]

Identification

• Classification: API >> Circulatory system medication >> Antihypertensive drug
• Name: Olmesartan medoxomil
• Synonyms: Olmetec; CS-866; 4-(1-Hydroxy-1-methylethyl)-2-propyl-1-[[2'-(1H-tetazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1H-imidazole-5-carboxylic acid (5-Methyl-2-oxo-1,3-dioxol-4-yl)methyl ester
• Molecular Formula: C₂₉H₃₀N₆O₆
• Molecular Weight: 558.59
• CAS Registry Number: 144689-63-4
• EC Number: 604-433-1
• SMILES: CCCC1=NC(=C(N1CC2=CC=C(C=C2)C3=CC=CC=C3C4=NNN=N4)C(=O)OCC5=C(OC(=O)O5)C)C(C)(C)O

Properties

• Density: 1.4±0.1 g/cm³, Calc.^*
• Melting point: 180 °C
• Decomposition: 180 °C
• Index of Refraction: 1.661, Calc.^*
• Boiling Point: 804.2±75.0 °C (760 mmHg), Calc.^*
• Flash Point: 440.2±37.1 °C, Calc.^*

^* Calculated using Advanced Chemistry Development (ACD/Labs) Software.

Safety Data

• Hazard Symbols: GHS07;GHS08 Danger
• Risk Statements: H302-H312-H319-H332-H360
• Safety Statements: P203-P261-P264-P264+P265-P270-P271-P280-P301+P317-P302+P352-P304+P340-P305+P351+P338-P317-P318-P321-P330-P337+P317-P362+P364-P405-P501

Hazard Classification

Hazard	Class	Category Code	Hazard Statement
Acute toxicity	Acute Tox.	4	H302
Acute toxicity	Acute Tox.	4	H312
Acute toxicity	Acute Tox.	4	H332
Eye irritation	Eye Irrit.	2	H319
Reproductive toxicity	Repr.	1A	H360
Reproductive toxicity	Repr.	2	H361
Specific target organ toxicity - repeated exposure	STOT RE	2	H373
Reproductive toxicity	Repr.	1B	H360
Skin irritation	Skin Irrit.	2	H315
Specific target organ toxicity - single exposure	STOT SE	2	H335
Specific target organ toxicity - single exposure	STOT SE	3	H335

Discovery and Applications

Olmesartan medoxomil is an antihypertensive drug used primarily in the treatment of high blood pressure (hypertension). It is a prodrug that is converted in the body to its active form, olmesartan, which is an angiotensin II receptor blocker (ARB). The compound works by blocking the action of angiotensin II, a peptide hormone that constricts blood vessels and increases blood pressure. By inhibiting the binding of angiotensin II to its receptor, olmesartan medoxomil causes blood vessels to relax and dilate, thus lowering blood pressure. This mechanism of action has made it an important therapeutic option for the management of hypertension.

Olmesartan medoxomil was discovered in the 1990s and was developed by the pharmaceutical company Daiichi Sankyo. It was first approved by the U.S. Food and Drug Administration (FDA) in 2002 for the treatment of hypertension in adults. Since its approval, olmesartan medoxomil has become one of the most widely used ARBs for the management of high blood pressure due to its efficacy and relatively favorable side-effect profile.

The drug is typically administered orally in tablet form, with the recommended starting dose of 20 mg once daily. Depending on the patient’s response to treatment, the dose may be increased to a maximum of 40 mg per day. Olmesartan medoxomil can be used alone or in combination with other antihypertensive agents, such as diuretics, to achieve better blood pressure control. Clinical studies have shown that olmesartan is effective in lowering both systolic and diastolic blood pressure, and it is particularly useful in patients with primary hypertension. Additionally, the drug is associated with a lower incidence of certain adverse effects compared to other antihypertensive medications, such as angiotensin-converting enzyme (ACE) inhibitors.

Beyond its use in hypertension, olmesartan medoxomil has also been explored for its potential benefits in other conditions related to cardiovascular health. Some studies have suggested that it may offer protective effects in patients with chronic kidney disease, as it has been shown to reduce proteinuria (excessive protein in the urine), a common marker of kidney damage. Additionally, olmesartan medoxomil has been investigated for its potential in preventing strokes and improving outcomes in patients with heart failure. However, more research is needed to fully understand its efficacy in these areas.

Despite its efficacy, olmesartan medoxomil is not without side effects. Some patients may experience dizziness, headaches, or gastrointestinal disturbances, such as diarrhea. In rare cases, olmesartan has been associated with more severe side effects, including hyperkalemia (high potassium levels), renal dysfunction, and angioedema (swelling of deeper layers of the skin). As with all ARBs, olmesartan medoxomil should be used with caution in patients with a history of renal impairment or those taking other medications that can increase potassium levels.

In conclusion, olmesartan medoxomil has proven to be a highly effective and well-tolerated medication for the treatment of hypertension. Its ability to block the effects of angiotensin II and lower blood pressure has made it a valuable tool in managing this common condition. While it is primarily used for hypertension, ongoing research continues to explore its potential benefits in other cardiovascular-related conditions.

References

2010-10-26. Coronary vascular dysfunction promoted by oxidative‐nitrative stress in SHRSP.Z‐Leprfa/IzmDmcr rats with metabolic syndrome
DOI: 10.1111/j.1440-1681.2010.05432.x

2010-10. A sensitive short-term evaluation of antifibrotic effects using newly established type I collagen reporter transgenic rats
DOI: 10.1152/ajprenal.00141.2009

2009-01. Regulation of coronary vascular tone via redox modulation in the α1-adrenergic-angiotensin-endothelin axis of the myocardium
DOI: 10.1152/ajpheart.00480.2008