From the Guidelines
Besicar is not a recognized medication name, but it is likely referring to Benicar (olmesartan), an angiotensin II receptor blocker (ARB) used to treat high blood pressure. The medication works by blocking angiotensin II receptors, causing blood vessels to relax and widen, which lowers blood pressure 1. The typical starting dose is 20 mg once daily, which can be increased to a maximum of 40 mg daily if needed, as indicated in the 2020 ACC/AHA clinical performance and quality measures for adults with heart failure 1. Benicar can be taken with or without food and is usually prescribed as part of a comprehensive treatment plan that includes diet, exercise, and other lifestyle modifications. Some key points to consider when prescribing Benicar include:
- Starting with a low dose and titrating upward to minimize side effects
- Monitoring for potential side effects such as dizziness, headache, and rare but severe intestinal problems
- Avoiding use in pregnant or breastfeeding women, as it can harm the developing fetus or baby
- Being cautious when prescribing to patients with low systemic blood pressure, renal insufficiency, or elevated serum potassium
- Considering alternative medications, such as ACE inhibitors or ARNI, for patients with heart failure with reduced ejection fraction (HFrEF), as recommended in the 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure 1. It's essential to consult with a healthcare provider before starting or stopping any medication, including Benicar, to ensure the best possible outcome for the patient's specific condition and needs.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Besicar (Olmesartan) Efficacy
- The efficacy of besicar (olmesartan) in combination with other antihypertensive agents has been demonstrated in several studies 2, 3, 4, 5.
- A study published in 2009 found that the combination of olmesartan medoxomil and amlodipine besylate reduced sitting systolic and diastolic blood pressure by 29/19 mmHg from baseline (p < 0.001) and resulted in 54% of patients achieving blood pressure goals 2.
- Another study published in 2023 found that single-pill combinations of olmesartan with amlodipine and/or hydrochlorothiazide improved blood pressure control in hypertensive patients, including those with diabetes, chronic kidney disease, or obesity 3.
Blood Pressure Lowering Effects
- The blood pressure lowering effects of olmesartan have been compared to other angiotensin II receptor antagonists, with olmesartan showing superior efficacy 6.
- A study published in 2007 found that olmesartan had a greater blood pressure lowering effect than candesartan, irbesartan, and valsartan 6.
- The combination of olmesartan with amlodipine has been shown to provide additional blood pressure lowering effects, with more patients achieving blood pressure goals 5.
Special Populations
- The efficacy and tolerability of olmesartan plus amlodipine have been demonstrated in special populations, including the elderly, diabetic patients, and patients with chronic kidney disease or obesity 3, 5.
- A study published in 2012 found that the efficacy and tolerability of olmesartan plus amlodipine were not affected by age, gender, hypertension severity, diabetes status, race, or body mass index 5.