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Olmesartan is an angiotensin II inhibitor antihypertensives that is recommended at  . Olmesartan has more than a 12,500-fold greater affinity for the AT1 receptor than for the AT2 receptor.  It's main impact for CFIDS is its impact on inflammation. Telmisartan appears to be a better choice for CFIDS than Olmesartan.

WARNING:  advocates dosages higher than the FDA maximum recommendation. Other drugs in this family have been reported as effective below their FDA maximum recommendation. There is no FDA data on the risks of long term high dosage Benicar. There are long term studies suggesting that it may trigger life threatening Addison Disease.

Benicar does not cross the blood-brain barrier. CFIDS cognitive issues may persist while physical energy increases significantly.

Inflammation Literature

  • reduction of inflammatory cytokines
  • Researchers have found that its affect on microinflammation is enhanced if given with statins
  • losartan (same family) with statins reduces inflammation in combination
    "combined therapy may reduce insulin resistance by multiple mechanisms such as lipoprotein changes and reduced oxidant stress that also contribute to NO bioavailability. "


  • BENICARHCT(Sankyo Pharma) is the trade name for Olmesartan combines with hydrochlorothiazide.
    • C22, C23, C25 on back of pill (see images)
    • without hydrochlorothiazide. C12,C14,C15 on back of pill (see images)
  • OPENVAS (Pfizer) is the trade name for Olmesartan without hydrochlorothiazide.

Same Family of Drugs

Other drugs that are angiotensin II inhibitors/blockers in the same family (note the "sartan") - often they are prescribed with Hydrochlorothiazide or includes it:

  • losartan (Cozaar) - Weight gain reported
  • valsartan
  • irbesartan (Avapro)
  • candesartan - Weight gain reported
  • telmisartan
  • eprosartan

Differences occurs between these drugs with inflammation

Many CFIDS patients report 5-10 lbs per month weight gain on this medicine. This is a common problem with Antihypertensive Medications . It has been suggested that it may be a result of:

  • reduction in basal metabolic rate,
  • reduction in the thermogenic response to meals,
  • increased insulin resistance, and
  • inhibition of lipolysis.

Irbesartan - "weight ... showed trends for improvement"

The hydrochlorothiazide may be the cause of the weight gain if BenicarHCT is being used. Hydrochlorothiazide is known to increase aldosterone production. Aldosterone is known to cause weight gain. Many CFIDS people are reported to have aldosterone deficiency hence this increase in aldosterone has this abnormal weight gain as a consequence.

  • Decreased Calcium Levels -- see CALCIUM for detail discussion
  • Adipocyte hormones adiponectin and resistin are inversely related to obesity  (less you have, the more obese).

An alternative explanation is that if not sufficient water is taken each day, the body is unable to eliminate the wastes in the urine and is forced to store the wastes in fat. [ Some people on Marshall protocol report kidney pain if they do not drink enough water]. The literature report the following recommendations for normal healthy individuals , because of increase urine production - a higher quality is suggested. (The use of bottled water makes tracking the actual amount easier).

Sex Daily Average for Healthy Suggested on Benicar
Female 2.7 liters (91 oz) 4 liters
Male 3.7 liters (125 oz) 5 liters



The following risks are reported by NIH:

  • AT2 inhibitors may cause more urine is produced by the kidneys [Regular monitoring of kidney function is advised].

  • Fetal Death if used early in pregnancy
  • Abdominal pain;  back pain;  blurred vision;  body aches or pain ;  diarrhea;  dizziness;  dry mouth;  fatigue;  flushed, dry skin;  fruit-like breath odor;  general feeling of discomfort or illness;  increased hunger;  increased thirst;  increased urination;  loss of appetite ;  muscle aches and pains;  nausea;  pain or tenderness around eyes and cheekbones ;  shivering;  sweating;  tender, swollen glands in neck;  troubled breathing;  trouble sleeping;  trouble in swallowing;  unexplained weight loss;  vomiting 
  • Acid or sour stomach;  belching;  bloating or swelling of face, arms, hands, lower legs, or feet ;  chest pain;  difficulty in moving;  feeling of constant movement of self or surroundings;  heartburn;  indigestion;  muscle pains or stiffness;  nausea;  rash;  rapid weight gain;  sensation of spinning;  skeletal pain;  sleeplessness;  stomach pain;  swelling or puffiness of face;  tingling of hands or feet;  unusual weight gain or loss 




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