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Olmesartan medoxomil-induced angioedema
1Department of Clinical and Administrative Services, College of Pharmacy and Health Sciences, Mercer University, Atlanta, GA 30341, USA. Nykamp_D@Mercer.edu
The Annals of Pharmacotherapy
|March 8, 2007
Summary
This case report details a patient who developed angioedema after starting olmesartan medoxomil, an angiotensin receptor blocker. This highlights a rare but serious side effect of ARBs, even in patients not previously on ACE inhibitors.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Adverse Drug Reactions
Background:
- Angiotensin receptor blockers (ARBs) are often prescribed as alternatives to angiotensin-converting enzyme (ACE) inhibitors for hypertension.
- ARBs are generally considered safer regarding angioedema risk compared to ACE inhibitors.
- The mechanism of angioedema with ARBs is not fully understood but may involve bradykinin pathways.
Observation:
- A 61-year-old patient, treatment-naïve to ACE inhibitors, developed angioedema.
- Symptoms included facial, neck, and lip swelling within 10 days of initiating olmesartan medoxomil.
- Discontinuation of olmesartan medoxomil led to symptom resolution within 10 days.
Findings:
- The Naranjo probability scale indicated a probable link between olmesartan medoxomil and the angioedema.
- This is the first reported case of angioedema specifically induced by olmesartan medoxomil.
- The event suggests potential alternative mechanisms for ARB-induced angioedema, possibly involving AT2 receptor stimulation and increased bradykinin.
Implications:
- Clinicians should be aware of the potential for olmesartan medoxomil to cause angioedema, even in ACE inhibitor-naïve patients.
- This case underscores the importance of considering ARBs in the differential diagnosis of angioedema.
- Further research may be needed to elucidate the precise mechanisms of ARB-induced angioedema.
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