Esatec 20/Esatec 40 Dosage/Direction for Use

Oral: In order to assist compliance, it is recommended that Olmesartan medoxomil tablets be taken at about the same time each day, with or without food, for example at breakfast time. The tablet should be swallowed with a sufficient amount of fluid (e.g. one glass of water). The tablet should not be chewed.
Posology: Adults: The recommended starting dose of Olmesartan medoxomil is 10 mg once daily. In patients whose blood pressure is not adequately controlled at this dose, the dose of Olmesartan medoxomil may be increased to 20 mg once daily as the optimal dose. If additional blood pressure reduction is required, Olmesartan medoxomil dose may be increased to a maximum of 40 mg daily or Hydrochlorothiazide therapy may be added, "Consider other sources for 10 mg dosing."
The antihypertensive effect of Olmesartan medoxomil is substantially present within 2 weeks of initiating therapy and is maximal by about 8 weeks after initiating therapy. This should be borne in mind when considering changing the dose regimen for any patient.
Elderly (65 years or over): No adjustment of dosage is generally required in elderly people. If up-titration to the maximum dose of 40 mg daily is required, blood pressure should be closely monitored.
Renal impairment: The maximum dose in patients with mild to moderate renal impairment (creatinine clearance of 20-60 mL/min) is 20 mg Olmesartan medoxomil once daily, owing to limited experience of higher dosages in this patient group. The use of Olmesartan medoxomil in patients with severe renal impairment (creatinine clearance <20 mL/min) is not recommended, since there is only limited experience in this patient group.
Hepatic impairment: No adjustment of dosage recommendations is required for patients with mild hepatic impairment. In patients with moderate hepatic impairment, an initial dose of 10 mg Olmesartan medoxomil once daily is recommended and the maximum dose should not exceed 20 mg once daily. Close monitoring of blood pressure and renal function is advised in hepatically-impaired patients who are already receiving diuretics and/or other antihypertensive agents. There is no experience of Olmesartan medoxomil in patients with severe hepatic impairment, therefore use is not recommended in this patient group. Olmesartan medoxomil should not be used in patients with biliary obstruction. "Consider other sources for 10 mg dosing."
Pediatric population: The safety and efficacy of Olmesartan medaxomil in children and adolescents below 18 years has not been established.