Is Olmesartan-Induced Angioedema Triggered by Angiotensin Converting Enzyme Inhibition and Kinin Peptides? A Rare Case

Olmesartan medoxomil (OM) is an angiotensin II receptor blocker (ARB) and it is used for the treatment of hypertension. Among all ARB drugs, only OM shows an angiotensin converting enzyme inhibitory effect (ACEI). OM may cause angioedema by its ARB effect. It can exhibit this role by the endogenous ACEI effect. While the frequency of angioedema associated with ACEI ranges from 0.1% to 1%, the frequency of ARB-induced angioedema is reported to range from 0.1% to 0.4%. A 38-year-old woman was diagnosed with primary hypertension and 20 mg/day OM was started for the management of hypertension. Following the second day of OM treatment, she was admitted to the emergency department because of a new episode of acute angioedema of the tongue, face and lips. OM induced angioedema was diagnosed. OM therapy was switched to a calcium channel blocker.