The antihypertensive drugs such as olmesartan medoxomil and alisartan belong to the same class, and the basic antihypertensive mechanism is the same. As angiotensin ⅱ receptor antagonists, they all play a role by blocking the adverse effects of angiotensin ⅱ, such as inhibiting vasoconstriction caused by angiotensin ⅱ, inhibiting the synthesis and secretion of aldosterone, reducing water and sodium retention, reducing sodium reabsorption by heart and kidney, inhibiting the proliferation of ventricular and vascular smooth muscle cells, and reversing ventricular hypertrophy and arteriosclerosis. So as to lower blood pressure and protect the cardiovascular system.
Olmesartan medoxomil is a prodrug (it has no activity), which plays the role of olmesartan through gastrointestinal absorption and hydrolysis. Olmesartan is excreted by the liver and kidney. Basically, about half of olmesartan is excreted by the liver and the other half by the kidney. The instructions point out that for the elderly and patients with moderate to obvious liver and kidney damage (creatinine clearance rate is less than 40), there is no need to adjust the dose when taking this product, which is more suitable for friends with liver and renal insufficiency. There is no liver drug enzyme metabolism, and there is little interaction with other drugs.
Clinical trials show that olmesartan can reduce both hypertension and blood pressure, and the lowest antihypertensive drug effect can also be reduced by 10/6mmHg, which generally takes effect within 1 week, and achieves obvious antihypertensive effect two weeks later, and can maintain the antihypertensive effect after one year of treatment, without drug resistance, blood pressure does not rebound after drug withdrawal, and age and gender do not affect its antihypertensive effect. Olmesartan can be taken with or without food. Olmesartan can be combined with diuretics, and hydrochlorothiazide can increase the antihypertensive effect. Can also be used in combination with other antihypertensive drugs.
Alisartan ester is also a prodrug, which is metabolized by esterase in the liver to produce the active metabolite losartan potassium 5- carboxylate (5-EXP3 14). The active metabolite of losartan potassium after liver metabolism is the same as losartan potassium 5- carboxylate. Losartan potassium 5- carboxylate can block angiotensin Ⅱ synthesized from any other source or by any way, resist a series of adverse effects of angiotensin Ⅱ, and play a role in lowering blood pressure and protecting cardiovascular system. Compared with losartan, alisartan has a simpler metabolic pathway and does not produce many components unrelated to the antihypertensive effect of losartan potassium metabolism.
For patients with mild to moderate hypertension, in a large-scale clinical comparative study of taking 240mg of alisartan tablets and 50mg of losartan potassium tablets once a day, it was found that the antihypertensive effect of alisartan was significantly better than that of losartan. Alisartan can not only lower hypertension, but also lower hypotension, and can stably lower 24-hour blood pressure. The Gu Feng ratio of blood pressure is 60%-70%, with little fluctuation.
After taking alisartan for 64 weeks, the antihypertensive effect continued and there was no obvious drug resistance. Long-term medication has no obvious effect on blood sugar and blood lipid. After taking 12 weeks, uric acid decreased by about 24, indicating that it has the same uric acid reducing effect as losartan. Alisartan ester is well absorbed orally, but food will affect absorption, so it should not be taken with food at the same time. It is better to take it on an empty stomach. About half of them are mainly metabolized by the liver and excreted with feces.
Therefore, it can be seen that friends with hypertension and hepatic and renal insufficiency can choose olmesartan, and friends with hyperuricemia and poor antihypertensive effect of losartan can choose alisartan, which can have better antihypertensive effect and reduce uric acid.
Both drugs are well tolerated, and the adverse reactions are mild and short-lived, and most of them can be relieved by themselves. /kloc-more than 0/%of the adverse reactions are dizziness, which means that basically 100 people may have dizziness after taking the medicine, which can be relieved after symptomatic treatment or can be relieved by themselves. Therefore, friends with hypertension should comprehensively consider various factors and prices when choosing sartan antihypertensive drugs. Sometimes it is unnecessary to blindly use new drugs, but sometimes it is a better choice.