Azilsartan use in specific populations: Difference between revisions

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#REDIRECT [[Azilsartan kamedoxomil#Use in Specific Populations]]
{{Azilsartan}}
{{CMG}}; {{AE}} {{SS}}
 
==Use In Specific Populations==
 
===Pregnancy===
 
'''Pregnancy Category D'''
 
Use of drugs that affect the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung [[hypoplasia]] and skeletal deformations. Potential neonatal adverse effects include skull [[hypoplasia]], [[anuria]], [[hypotension]], [[renal failure]], and death. When pregnancy is detected, discontinue Edarbi as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to [[antihypertensive ]]use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other [[antihypertensive ]]agents. Appropriate management of maternal [[hypertension ]]during pregnancy is important to optimize outcomes for both mother and fetus.
 
In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. Perform serial ultrasound examinations to assess the intra-amniotic environment. If oligohydramnios is observed, discontinue Edarbi, unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Closely observe infants with histories of in utero exposure to Edarbi for [[hypotension]], oliguria, and [[hyperkalemia]] [see Use in Specific Populations (8.4)].
 
===Nursing Mothers===
 
It is not known if azilsartan is excreted in human milk, but azilsartan is excreted at low concentrations in the milk of lactating rats. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
 
===Pediatric Use===
 
Neonates with a history of in utero exposure to Edarbi
 
If oliguria or [[hypotension]] occurs, support blood pressure and renal function. Exchange transfusions or dialysis may be required.
 
Safety and effectiveness in pediatric patients under 18 years of age have not been established.
 
===Geriatric Use===
 
No dose adjustment with Edarbi is necessary in elderly patients. Of the total patients in clinical studies with Edarbi, 26% were elderly (65 years of age and older); 5% were 75 years of age and older. Abnormally high serum creatinine values were more likely to be reported for patients age 75 or older. No other differences in safety or effectiveness were observed between elderly patients and younger patients, but greater sensitivity of some older individuals cannot be ruled out [see Clinical Pharmacology (12.3)].
 
===Renal Impairment===
 
Dose adjustment is not required in patients with mild-to-severe renal impairment or end-stage renal disease. Patients with moderate to severe renal impairment are more likely to report abnormally high serum creatinine values.
 
===Hepatic Impairment===
 
No dose adjustment is necessary for subjects with mild or moderate [[hepatic impairment]]. Edarbi has not been studied in patients with severe [[hepatic impairment]] [seeClinical Pharmacology (12.3)].<ref name="dailymed.nlm.nih.gov">{{Cite web  | last =  | first =  | title = EDARBI (AZILSARTAN KAMEDOXOMIL) TABLET [TAKEDA PHARMACEUTICALS AMERICA, INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=75b16bfc-38c1-4133-bd7d-13258d54edec | publisher =  | date =  | accessdate = 19 February 2014 }}</ref>
 
==References==
{{Reflist}}
 
[[Category:Angiotensin II receptor antagonists]]
[[Category:Benzimidazoles]]
[[Category:Carbamates]]
[[Category:Ethers]]
[[Category:Cardiovascular Drugs]]
[[Category:Drugs]]

Latest revision as of 03:09, 22 July 2014