Angiotensin Receptor Blockers – Olmesartan

Generic Name

olmesartan, including in combination with hydrochlorothiazide
Form 20 mg, 40 mg, 20 mg/12.5 mg, 40 mg/12.5 mg, 40 mg/25 mg
Form tablet

Criteria

Approval Period

1. Person identified as experiencing intractable cough or angioedema on an Angiotensin Converting Enzyme Inhibitor (ACE-I).

AND

2. Failure on optimal doses of, or intolerance to, ALL reference drugs: candesartan, losartan, telmisartan AND valsartan.

Indefinite

Practitioner Exemptions

  • No practitioner exemptions.

Special Notes

  • Individuals requiring a diuretic combination product must satisfy the same criteria.

Special Authority Request Form(s)