FDA issues warning on blood pressure drug, olmesartan medoxomil

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Food and Drug Administration (FDA) regulators have issued a warning on the blood pressure drug known generically as olmesartan medoxomil. The drug can cause intestinal problems known as spruelike enteropathy, which has side effects including severe, chronic diarrhea and substantial weight loss, sometimes requiring hospitalization.

The FDA said the intestinal problems can develop months to years after starting the drug. The drug is in a class known as angiotensin II receptor blockers, or ARBs.

The change resulted from research published in the July 2012 edition of Mayo Clinic Proceedings by a team of researchers at Mayo Clinic. A copy of the news release about the study can be found here.

"We are still seeing new cases where the doctor was not aware of the problem," says study author Joseph Murray, M.D., a Mayo Clinic gastroenterologist. "The FDA has done the right thing, and their warning will bring this to the notice of doctors."

Dr. Murray has the following advice for patients and physicians.

For patients on olmesartan:

* If you feel well and have no unexplained weight loss, diarrhea or signs of malabsorption, then olmesartan is a good drug for blood pressure. These side effects are quite rare. However, if you get these symptoms, even if you have been on the drug for years, then talk with your doctor about alternatives.

* If you have been diagnosed with celiac disease while on olmesartan, you need to be re- evaluated to check the diagnosis.

For doctors:

* As advised for patients, physicians need to be aware of this problem. The side effects can happen even years after the drug is started and seem to be tolerated quite well.

* Consider avoiding the use of olmesartan in patients with a history of chronic diarrhea illness or celiac disease.

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