Azilsartan belongs to a family of medicines known as angiotensin II receptor blockers. It is used alone or with other medications to lower mild-to-moderate high blood pressure.

Angiotensin II is a chemical that the body releases to cause the constriction of blood vessels. Azilsartan blocks the action of angiotensin II, resulting in the relaxation of the blood vessels. This relaxation causes the blood pressure to decrease. Azilsartan can be used alone or in combination with thiazide diuretics (water pills; e.g., hydrochlorothiazide) or calcium channel blockers (e.g., diltiazem, nifedipine, verapamil).

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended starting dose for adults is 40 mg taken orally once daily by mouth.  The dose may be increased to a maximum of 80 mg once daily if necessary to control your blood pressure.

Azilsartan may be taken with food or on an empty stomach.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, in the original container. Protect it from light and moisture, and keep it out of the reach of children.

40 mg
Each white to nearly white round tablet debossed "ASL" on one side and "40" on the other contains 42.68 mg of azilsartan medoxomil potassium, which is equivalent to 40 mg of azilsartan medoxomil. Nonmedicinal ingredients: mannitol, fumaric acid, sodium hydroxide, hydroxypropyl cellulose, croscarmellose sodium, microcrystalline cellulose, and magnesium stearate.

80 mg
Each white to nearly white round tablet debossed "ASL" on one side and "80" on the other contains 85.36 mg of azilsartan medoxomil potassium, which is equivalent to 80 mg of azilsartan medoxomil. Nonmedicinal ingredients: mannitol, fumaric acid, sodium hydroxide, hydroxypropyl cellulose, croscarmellose sodium, microcrystalline cellulose, and magnesium stearate.

Do not take azilsartan if you:

• are allergic to azilsartan or any ingredients of the medication
• are taking aliskiren and have diabetes or moderately to severely decreased kidney function
• are or may be pregnant
• are breast-feeding

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal discomfort
• back pain
• constipation
• decreased sexual ability
• diarrhea
• dizziness
• dry mouth
• fatigue
• headache
• heartburn
• hives
• increased frequency of colds or flu-like symptoms (e.g., sore throat, nasal congestion, irritated nose and throat)
• increased sweating
• increased urination
• itchy skin
• joint pain
• muscle pain or spasms
• nausea
• rash
• spinning sensation
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• anxiety
• cough
• irregular, rapid, or pounding heartbeat
• lightheadedness or dizziness when rising from a sitting or lying position
• signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of bleeding (e.g., nosebleeds, blood in urine, coughing blood, bleeding gums, unusual bruising or bleeding)
• signs of kidney problems (e.g., decreased urination, nausea, vomiting, swelling of the feet and ankles)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of muscle damage (e.g., muscle pain, tenderness or weakness, or brown or discoloured urine)
• swelling of the ankles, feet or hands
• symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea)
• symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., swelling of face or throat, hives, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: People who have had an allergic reaction to other ARBs are advised not to take azilsartan. Before you take azilsartan, inform your doctor about any previous adverse reactions you have had to medications. Contact your doctor at once if you experience signs of an allergic reaction such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Kidney problems: Azilsartan may affect the function of the kidneys, especially for those people who already have kidney problems. Taking diuretics (water pills) such as aliskiren or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ASA (Aspirin) may further increase the risk of kidney problems. If you have reduced kidney function, kidney disease, or renal artery stenosis (narrowing of blood vessels in the kidneys), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

Low blood pressure: Occasionally, a larger-than-expected decrease in blood pressure occurs after taking azilsartan. In some cases, this happens after the first dose. It is more likely to occur if you take diuretics (water pills) such as aliskiren, have a reduced salt intake, are on dialysis, or are experiencing diarrhea or vomiting. Blood pressure should be monitored more often in these situations. If you have low blood pressure, are just starting this medication or are increasing the dose, move slowly from a reclining to an upright position to reduce the risk of dizziness.

Pregnancy: Azilsartan should not be taken by pregnant women as it can cause harm to an unborn child. If you are planning to become pregnant, discuss alternative medications for blood pressure control with your doctor. If you become pregnant while taking this medication, stop taking it and tell your doctor at once.

Breast-feeding: It is not known if azilsartan passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children.

Seniors: Seniors may be at increased risk of experiencing low blood pressure from this medication.

There may be an interaction between azilsartan and any of the following:

• aliskiren
• alpha blockers (e.g., alfuzosin, tamsulosin)
• amiodarone
• amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
• angiotensin converting enzyme inhibitors (ACEIs; e.g., captopril, lisinopril, ramipril)
• anti-psychotics (e.g., aripiprazole, asenapine, cariprazine, chlorpromazine, clozapine, olanzapine, quetiapine, risperidone)
• apomorphine
• barbiturates (e.g., butalbital, phenobarbital)
• beta-adrenergic blockers (e.g., atenolol, sotalol)
• brimonidine
• bromocriptine
• celecoxib
• diazoxide
• diuretics (water pills; e.g., amiloride, furosemide, triamterene)
• drospirenone
• duloxetine
• eplerenone
• flunarizine
• heparin
• levodopa
• lithium
• low molecular weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
• methylphenidate
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• morphine
• nabilone
• nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
• obinutuzumab
• other angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
• pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
• potassium supplements
• pramipexole
• ranolazine
• riociguat
• ropinirole
• rotigotine
• sacubitril
• sodium phosphates
• tacrolimus
• tizanidine
• tolvaptan
• tretinoin
• tricyclic antidepressants (e.g., clomipramine, imipramine)
• trimethoprim

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.