From the Research
Baxdrostat is typically initiated at a dose of 0.5 mg once daily, with potential dose adjustments based on blood pressure response, as evidenced by the Phase 2 Trial of Baxdrostat for Treatment-Resistant Hypertension 1. The dose may be increased to 1 mg once daily after 4 weeks if needed, and further increased to 2 mg once daily if blood pressure targets are not achieved. The medication should be taken at approximately the same time each day, with or without food. Patients should be monitored for hypotension, especially when starting therapy or increasing doses. Baxdrostat works by inhibiting aldosterone synthase (CYP11B2), reducing aldosterone production and thereby lowering blood pressure through decreased sodium retention and water reabsorption. This mechanism makes it particularly useful for treatment-resistant hypertension. Some key points to consider when prescribing baxdrostat include:
- Maintaining consistent sodium intake while taking this medication, as dramatic changes in salt consumption may affect its efficacy, as discussed in the context of its pharmacodynamics 2.
- Regular monitoring of electrolytes, particularly potassium levels, is important during treatment as aldosterone suppression can lead to hyperkalemia in some patients.
- The pharmacokinetics of baxdrostat are not significantly affected by renal impairment, suggesting that dose adjustment due to pharmacokinetic differences in patients with kidney disease is unnecessary 3.
- Baxdrostat does not significantly affect the pharmacokinetics of metformin, indicating that diabetic patients with hypertension receiving both metformin and baxdrostat are unlikely to require dose adjustment 4.