Dosing and uses of Teveten (eprosartan)
Adult dosage forms and strengths
tablet
- 400mg
- 600mg
Hypertension
Initial: 600 mg PO qDay, in patients without intravascular volume depletion
Maintenance: 400-800 mg/day PO qDay OR divided q12hr PO (twice daily may improve effect)
See also combo with hydrochlorothiazide (Teveten HCT)
Generally adjust qMonth; more aggressively in high-risk patients
Renal Impairment
Dose adjustment not necessary; carefully monitor patient; not to exceed 600 mg/day
Hepatic Impairment
Dose adjustment not necessary; carefully monitor patient; not to exceed 600 mg/day
Additional Information
Similar dosing has been used in diabetic nephropathy, and CHF
Pediatric dosage forms and strengths
Safety and efficacy not established
Geriatric dosage forms and strengths
Hypertension
Initial: 600 mg PO qDay, in patients without intravascular volume depletion
Maintenance: 400-800 mg/day PO qDay OR divided q12hr PO (twice daily may improve effect)
See also combo with hydrochlorothiazide (Teveten HCT)
Generally adjust qMonth; more aggressively in high-risk patients
Teveten (eprosartan) adverse (side) effects
1-10%
Upper respiratory infection (8%)
Cough (4%)
Abdominal pain (2%)
Fatigue (2%)
Frequency not defined
Facial edema
Dizziness
Headache
Neutropenia
Back pain
Myalgia
Warnings
Black box warnings
Discontinue as soon as possible when pregnancy is detected; affects renin-angiotensin system causing oligohydramnios, which may result in fetal injury and/or death
Contraindications
Hypersensitivity
Pregnancy (2nd/3rd trimesters): significant risk of fetal/neonatal morbidity and mortality
Bilateral renal artery stenosis
Do not coadminister with aliskiren in patients with diabetes
Cautions
Angioedema, hypovolemia, hyperkalemia, surgery, and anesthesia
Discontinue STAT if pregnant: potential risk of congenital malformations (see Contraindications and Black box warnings)
Risk of hypotension, especially if hypovolemic/hyponatremic, or on concomitant diuretics or dialysis
Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy
Risk of anaphylactoid reactions and/or angioedema
Increased risk of renal dysfunction with CHF
Renal/hepatic impairment
Pregnancy and lactation
Pregnancy category: C (1st trimester); D (2nd & 3rd trimesters). During the second and third trimesters of pregnancy, these drugs have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
Lactation: excretion in milk unknown/not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Teveten (eprosartan)
Mechanism of action
Angiotensin II blocker; displaces angiotensin II from AT1 receptor and may lower blood pressure by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water absorption, and hypertrophic responses
May induce more complete inhibition of renin-angiotensin system compared with ACE inhibitors; does not affect response to bradykinin
Inhibits the pressor effects of an angiotensin II infusion in a dose-related manner
Pharmacokinetics
Half-Life: 5-9 hr
Onset: 4 hr
Peak Plasma Time: 4 hr
Bioavailability: 13%, food & age increases absorption
Protein Bound: 98%
Vd: 3.8 L
Metabolism: Partially conjugated with glucuronic acid in liver
Metabolites: Acyl glucuronide metabolite (inactive)
Excretion: Feces (90%), urine (7%)
Clearance
- Total Body: 48.5 L/hr
- Renal: 39-45 mL/min
