Should I stop taking Olmarstatin (medication) before my ablation surgery?

Perioperative Management of Olmesartan for Aquablation Surgery

Olmesartan should be discontinued at least 24 hours before your aquablation surgery to reduce the risk of intraoperative hypotension.

Understanding Olmesartan and Surgical Risk

• Olmesartan (Olmarstatin) is an angiotensin II receptor antagonist (AIIA) used for treating hypertension 1
• Studies show that patients who continue AIIA medications on the day of surgery experience more severe hypotensive episodes during anesthesia induction compared to those who discontinue the medication 2
• These hypotensive episodes often require vasoconstrictor treatment and can complicate surgical management 2

Specific Recommendations for Olmesartan Discontinuation

• Discontinue olmesartan at least 24 hours before your scheduled aquablation procedure 2
• This timing allows for reduction of the drug's effect while minimizing the period without blood pressure control 2
• Olmesartan has an elimination half-life of 10-15 hours, so discontinuing 24 hours before surgery allows for significant clearance of the active metabolite 1

Perioperative Management Algorithm

1. 24-48 hours before surgery:

   • Take your last dose of olmesartan 2
   • Continue monitoring your blood pressure at home if possible 3

2. Day of surgery:

   • Do not take olmesartan on the morning of surgery 2
   • Inform your anesthesiologist about your regular olmesartan use 3

3. Post-procedure:

   • Resume olmesartan 24-48 hours after surgery once adequate hemostasis is established and you're able to take oral medications 3
   • Follow your surgeon's specific instructions regarding timing of medication resumption 3

Special Considerations

• If you have severe uncontrolled hypertension, your physician may recommend an alternative antihypertensive medication during the perioperative period 3
• The decision to discontinue olmesartan should balance the risks of perioperative hypotension against the need for blood pressure control 3
• Patients with coronary stents may require special consideration of their complete medication regimen 4

Common Pitfalls to Avoid

• Failing to inform all members of your healthcare team about your olmesartan use 3
• Stopping olmesartan too far in advance of surgery (more than 48 hours), which could lead to rebound hypertension 3
• Resuming olmesartan too soon after surgery before hemostasis is adequate 3

Monitoring Recommendations

• Your blood pressure should be closely monitored during the perioperative period 2
• Report any significant changes in blood pressure (either high or low) to your healthcare provider 3
• Follow up with your primary care physician after surgery to ensure your blood pressure remains well-controlled 3