EPROSARTAN MESYLATE

EPROSARTAN MESYLATE (e-pro-sar'tan) Teveten Classifications: angiotensin ii receptor antagonist, antihypertensive; Therapeutic: antihypertensive, angiotensin ii receptor antagonist Prototype: Losartan potassium Pregnancy Category: C first trimester; D second and third trimester

Availability

400 mg, 600 mg tablets

Action

Selectively blocks the binding of angiotensin II to the AT₁ receptors found in many tissues. This blocks the vasoconstricting and aldosterone-secreting effects of angiotensin II, thus resulting in an antihypertensive effect.

Therapeutic Effect

It decreases both the systolic and diastolic BP.

Uses

Treatment of hypertension.

Contraindications

Hypersensitivity to eprosartan, losartan, or other angiotensin II receptor antagonists; pregnancy (category C first trimester, and category D second and third trimesters), lactation; children <18 y.

Cautious Use

Angioedema, aortic or mitral value stenosis, coronary artery disease, cardiomyopathy, hypotension, CHF; biliary obstruction; older adults; severe hepatic dysfunction, renal artery stenosis, renal disease, renal impairment.

Route & Dosage

Hypertension Adult: PO 600 mg q.d. or 400 mg q.d. to b.i.d. (max: 800 mg/d)

Administration

Oral

• Correct volume depletion prior to therapy to prevent hypotension.
• Store at 15°–30° C (59°–86° F); protect from moisture and direct light.

Adverse Effects (≥1%)

Body as a Whole: Viral infection, fatigue, arthralgia. CNS: Depression. GI: Abdominal pain, hypertriglyceridemia. Respiratory: Upper respiratory infection, rhinitis, pharyngitis, cough.

Pharmacokinetics

Absorption: Only 13% of oral dose reaches systemic circulation. Peak: 1–2 h. Metabolism: Minimal metabolism. Elimination: 61% in feces and 37% in urine. Half-Life: 5–9 h.

Nursing Implications

Assessment & Drug Effects

• Monitor BP periodically; do trough readings just before scheduled dose when possible.
• Monitor for S&S of angioedema (may occur within 30 min or as long as 30 d after initial dose).
• Lab tests: Monitor liver function, BUN & creatinine, serum potassium, CBC with differential periodically.

Patient & Family Education

• Inform physician immediately of pregnancy.
• Report episodes of dizziness especially associated with position changes.
• Report swelling of lips, tongue, face, or feeling of obstruction in neck immediately.

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Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug