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Olmesartan medoxomil/amlodipine/hydrochlorothiazide S

Drug induced enteropathy: 2 case reports

In a case series, 2 women [including one 61-year-old woman; not all ages stated] were described, who developed enteropathy
during treatment with olmesartan medoxomil/amlodipine or olmesartan medoxomil/hydrochlorothiazide for arterial hypertension
[routes, dosages and duration of the treatments to reaction onsets not stated].
Case 1: A woman, who had arterial hypertension, had been receiving olmesartan medoxomil/amlodipine [amlodipine/
olmesartan] 20/5mg once daily from the past 10 years. She never drunk non-drinking water. She had no history of alcohol intake,
allergies, animal contact or recent foreign travel. In 2018, she presented to emergency department multiple times. At two incidents,
she was admitted to ICU, where she developed severe metabolic acidaemia, hypokalaemia and hypoalbuminaemia. Diagnosis of
olmesartan medoxomil-induced enteropathy was considered. She was treated with renal replacement therapy. Olmesartan
medoxomil/amlodipine was discontinued. After three years of follow up, diarrhoea did not occur again. At the age of 70 years, she
presented with abdominal pain, anorexia, weight loss of 10% and watery stool (6–10 stools a day) without blood. Results for
laboratory examination were normal.
Case 2: A 61-year-old woman, who had arterial hypertension, had been receiving olmesartan medoxomil/hydrochlorothiazide
[olmesartan/hydrochlorothiazide] 20/25mg since the past 2 years. She had no history of allergies as well as no epidemiological risk.
She presented with watery diarrhoea (6 stools a day) without blood. She was hospitalised for acute kidney injury KDIGO 1 along
with weight loss. She reported similar events that had occurred over the course of one year. Colon biopsy revealed presence of
histological findings compatible with olmesartan medoxomil-induced enteropathy. Olmesartan medoxomil/hydrochlorothiazide
was suspended. After 3 months of follow up, diarrhoea did not occur again.
Moura de Azevedo S, et al. Olmesartan-induced enteropathy. Medicina Clinica Practica 6: No. 1, Jan-Mar 2023. Available from: URL: https://www.journals.elsevier.com/
medicina-clinica-practica 803728073

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