Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzymes (ACE, kinase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium. Azilsartan medoxomil is an orally administered prodrug that is rapidly converted by esterases during absorption to the Active moiety, azilsartan. Azilsartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is, therefore, independent of the pathway for angiotensin II synthesis. An AT2 receptor is also found in many tissues, but this receptor is not known to be associated with cardiovascular homeostasis. Azilsartan has more than a 10,000-fold greater affinity for the AT1 receptor than for the AT2 receptor. Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is widely used in the treatment of hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction catalyzed by ACE. Because azilsartan does not inhibit ACE (kinase II), it should not affect bradykinin levels. Whether this difference has clinical relevance is not yet known. Azilsartan does not bind to or block other receptors or ion channels known to be important in cardiovascular regulation. Blockade of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin Activity and angiotensin II circulating levels do not overcome the effect of azilsartan on blood pressure.

Do not take NEXSART 40MG TABLET 10'S if you are allergic to ‘azilsartan medoxomil’ or any other ingredients present in it. Inform your doctor if you have liver disease, heart problems, diabetes, or kidney problems, and taking blood pressure-lowering medication containing aliskiren. Also, inform your doctor if you are taking any prescription or non-prescription drugs and nutritional supplements. Take NEXSART 40MG TABLET 10'S with caution if you have kidney, severe liver disease, have a disease of the adrenal gland called primary hyperaldosteronism, have raised potassium levels in the blood, or if you are on dailysis. During treatment, seek medical attention if you experience severe, persistent diarrhoea and substantial weight loss.