eprosartan mesilate: clinical use

Prescribing considerations

• Assess volume or sodium depletion and correct it before initiation.
• Use particular caution with severe heart failure, renal impairment, dialysis, valve stenosis, hypertrophic cardiomyopathy or mild-to-moderate hepatic impairment.
• Limited evidence is available after recent kidney transplantation; eprosartan is not recommended for primary hyperaldosteronism.
• The selected product is not recommended for children or adolescents because safety and efficacy data are lacking.

Contraindications and cautions

• Hypersensitivity to eprosartan or an excipient.
• Second or third trimester of pregnancy.
• Severe hepatic impairment.
• Haemodynamically significant bilateral renovascular disease or severe stenosis affecting a solitary functioning kidney.
• Concomitant aliskiren in diabetes or renal impairment with GFR below 60 mL/min/1.73 m².

Monitoring

• Check blood pressure, renal function, sodium and potassium before treatment.
• Reassess renal function and electrolytes after initiation or clinically significant treatment changes, and periodically thereafter.
• Increase surveillance in renal impairment, older people, volume depletion or when interacting medicines are added.
• Reassess treatment if renal function deteriorates, potassium rises materially or symptomatic hypotension develops.

Clinical pharmacology

Eprosartan is an orally active, selective AT1-receptor antagonist. It has high plasma protein binding, does not inhibit the principal human CYP enzymes in vitro, and is eliminated through biliary and renal routes.

Formulation and product differences

• The selected product is a white, capsule-shaped film-coated tablet marked “5046”. It contains lactose and is supplied in blister packaging.

Tablet

Route: Oral

Strengths: 300 mg, 400 mg, 600 mg