Risk of Angioedema with Olmesartan

Overview of Angioedema Risk with ARBs

• The American College of Cardiology and American Heart Association acknowledge that ARBs can cause angioedema, though they are generally considered safer alternatives for patients who experienced angioedema with ACE inhibitors 1, 2

Comparative Risk Among Antihypertensives

• ACE inhibitors have a higher incidence of angioedema compared to ARBs, with a higher risk noted in black patients 3
• The American College of Cardiology recommends that patients with a history of angioedema with an ACE inhibitor can receive an ARB beginning 6 weeks after ACE inhibitor is discontinued 1, 4

Management Recommendations

• The American College of Cardiology recommends not using olmesartan in patients with a history of angioedema with any ARB, and considering alternative antihypertensive classes such as calcium channel blockers, thiazide diuretics, or beta-blockers for patients who develop angioedema while taking olmesartan 1, 2
• If a patient has experienced angioedema with an ACE inhibitor but requires RAAS blockade, an ARB like olmesartan may be considered after a 6-week washout period, but with careful monitoring 1, 4