Drug Guide
Eprosartan Mesylate
Classification
Therapeutic: Antihypertensive
Pharmacological: Angiotensin II receptor blocker (ARB)
FDA Approved Indications
- Hypertension
Mechanism of Action
Eprosartan selectively blocks angiotensin II type 1 (AT1) receptors, resulting in vasodilation and reduction of aldosterone-mediated volume expansion, thus lowering blood pressure.
Dosage and Administration
Adult: Initially, 600 mg once daily. Dose may be adjusted based on response up to a maximum of 800 mg once daily.
Pediatric: Not approved for use in pediatric patients.
Geriatric: Same as adult dosing, but elderly patients should be monitored closely for hypotension, especially if they are volume-depleted or on diuretics.
Renal Impairment: Adjust dose carefully; consider starting at a lower dose and monitor renal function.
Hepatic Impairment: No specific adjustment required; use with caution and monitor liver function.
Pharmacokinetics
Absorption: Absorbed orally with approximately 60-70% bioavailability.
Distribution: Widely distributed; protein bound (~98%).
Metabolism: Metabolized minimally; mostly excreted unchanged.
Excretion: Excreted primarily via the feces and urine.
Half Life: Approximately 6 hours.
Contraindications
- Pregnancy (Category D), due to risk of fetal injury or death; Concurrent use with aliskiren in patients with diabetes.
Precautions
- Use with caution in patients with bilateral renal artery stenosis, volume-depleted states, or hepatic impairment. Monitor blood pressure, renal function, and serum potassium.
Adverse Reactions - Common
- Dizziness (Common)
- Headache (Common)
- Neck soreness (Less common)
Adverse Reactions - Serious
- Hypotension (Serious (rare in normotensive patients))
- Angioedema (Rare)
- Hyperkalemia (Less common)
- Acute renal failure (Rare)
Drug-Drug Interactions
- Other antihypertensives, diuretics, potassium supplements, NSAIDs, lithium
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood pressure, renal function (BUN, serum creatinine), and serum potassium before and during therapy.
Diagnoses:
- Ineffective tissue perfusion related to hypotension.
- Risk for electrolyte imbalance.
Implementation: Administer as directed, typically once daily. Educate patient about orthostatic hypotension.
Evaluation: Assess blood pressure response and watch for signs of hypotension, hyperkalemia, or adverse effects.
Patient/Family Teaching
- Take medication as prescribed, even if feeling well.
- Report any swelling, difficulty breathing, or hypersensitivity.
- Avoid potassium-rich foods or supplements unless instructed.
- Do not discontinue abruptly.
Special Considerations
Black Box Warnings:
- Fetal toxicity: Do not use during pregnancy.
Genetic Factors: Patients may have genetic variations affecting response to ARBs.
Lab Test Interference: May increase serum potassium and serum creatinine, monitoring is recommended.
Overdose Management
Signs/Symptoms: Hypotension, dizziness, tachycardia or bradycardia.
Treatment: Supportive care, monitor vital signs, and provide fluids as necessary. No specific antidote.
Storage and Handling
Storage: Store at room temperature, away from moisture and light.
Stability: Stable for shelf life as specified by manufacturer.