Dosage must be individualized. The usual recommended starting dose of olmesartan medoxomil is 20 mg once daily when used as monotherapy in patients who are not volume-contracted.
For patients requiring further reduction in blood pressure after 2 weeks of therapy, the dose of olmesartan medoxomil may be increased to 40 mg.
Doses above 40 mg do not appear to have greater effect. Twice-daily dosing offers no advantage over the same total dose given once daily.
No initial dosage adjustment is recommended for elderly patients, for patients with moderate to marked renal impairment (creatinine clearance <40 mL/min) or with moderate to marked hepatic dysfunction (see PHARMACOLOGY: Pharmacokinetics: Pharmacokinetics in Special Populations under Actions). For patients with possible depletion of intravascular volume (e.g., patients treated with diuretics, particularly those with impaired renal function), olmesartan medoxomil should be initiated under close medical supervision and consideration should be given to use of a lower starting dose (see Volume- or Salt-depleted Patients with Activated Renin-Angiotensin System under WARNINGS).
Olmesartan medoxomil may be administered with or without food.
If blood pressure is not controlled by olmesartan medoxomil alone, a diuretic may be added. Olmesartan medoxomil may be administered with other antihypertensive agents.