Azilsartan

Drug Information: Azilsartan

Azilsartan is an angiotensin II receptor blocker (ARB) medication used primarily for the treatment of hypertension. It works by selectively blocking the binding of angiotensin II to the AT1 receptor in various tissues, such as vascular smooth muscle and the adrenal gland. This action prevents the vasoconstrictive effects of angiotensin II, leading to vasodilation and a reduction in blood pressure. Unlike some ARBs, azilsartan has demonstrated superior blood pressure lowering effects in some clinical trials. It is often prescribed as part of a comprehensive hypertension management plan, which may also include lifestyle modifications such as diet and exercise.

Category

Antihypertensive

Mechanism of Action

Azilsartan, an angiotensin II receptor blocker (ARB), exerts its antihypertensive effect by selectively blocking the angiotensin II type 1 (AT1) receptor. Angiotensin II is a potent vasoconstrictor hormone that plays a crucial role in the renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure and fluid balance. By blocking the AT1 receptor, azilsartan prevents angiotensin II from binding and exerting its effects, which include vasoconstriction, aldosterone secretion (leading to sodium and water retention), and stimulation of cell growth. This blockade results in vasodilation, reduced sodium and water retention, and ultimately, a decrease in blood pressure. The AT1 receptor is the primary receptor responsible for mediating the cardiovascular effects of angiotensin II. Azilsartan’s high affinity and selective binding to this receptor contribute to its efficacy in treating hypertension. It does not inhibit angiotensin-converting enzyme (ACE), therefore avoiding the dry cough sometimes associated with ACE inhibitors. The prolonged receptor binding exhibited by Azilsartan contributes to its lasting effects on blood pressure control.

Clinical Uses

The primary clinical use of azilsartan is in the management of hypertension (high blood pressure). It is effective as monotherapy or in combination with other antihypertensive agents, such as diuretics (e.g., hydrochlorothiazide) or calcium channel blockers. By reducing blood pressure, azilsartan helps to decrease the risk of cardiovascular events, including stroke, heart attack, and kidney disease. While primarily used for hypertension, ARBs like azilsartan may also be prescribed off-label for other conditions, such as heart failure (particularly in patients who cannot tolerate ACE inhibitors), diabetic nephropathy, and proteinuria. However, its main FDA-approved indication remains the treatment of hypertension. Studies have shown that Azilsartan can be more effective at lowering blood pressure than other ARBs and ACE inhibitors in some patients.

Dosage

Adults: The typical starting dose of azilsartan is 40 mg once daily. The dose may be increased to 80 mg once daily if blood pressure remains uncontrolled after 2-4 weeks. Azilsartan should be administered orally, with or without food.

Pediatrics: The safety and efficacy of azilsartan in pediatric patients have not been established. Therefore, it is generally not recommended for use in children.

Route of Administration: Oral.

Indications

* Hypertension (high blood pressure)

Contraindications

* Hypersensitivity to azilsartan or any of the excipients.
* Pregnancy (use in pregnancy can cause fetal harm).
* Co-administration with aliskiren in patients with diabetes.

FAQ

Q: What is Azilsartan used for?

A: Azilsartan is primarily used to treat hypertension (high blood pressure).

Q: How does Azilsartan work?

A: Azilsartan blocks the effects of angiotensin II, a hormone that causes blood vessels to constrict. By blocking angiotensin II, azilsartan helps to relax blood vessels, which lowers blood pressure.

Q: What are the common side effects of Azilsartan?

A: Common side effects may include dizziness, diarrhea, and fatigue.

Q: Can I take Azilsartan if I am pregnant?

A: No, Azilsartan is contraindicated during pregnancy as it can cause harm to the developing fetus.

Q: Can I take Azilsartan with other medications?

A: It is important to inform your doctor about all the medications you are taking, including over-the-counter drugs and herbal supplements, before starting Azilsartan. Certain medications, such as NSAIDs, may interact with Azilsartan.

Q: What should I do if I miss a dose of Azilsartan?

A: If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.

Q: Does Azilsartan cause a cough like ACE inhibitors?

A: No, Azilsartan is an ARB and does not typically cause the dry cough associated with ACE inhibitors.

Q: How long does it take for Azilsartan to start working?

A: Azilsartan typically starts to lower blood pressure within a few weeks of starting treatment. However, it may take several weeks to see the full effects of the medication.