Azilsartan Medoxomil Study in Hypertensive Children

Inclusion Criteria:

For Pediatric Subjects:

• Must have a diagnosis of hypertension.
• For Cohorts 1 and 2 only, is within the weight range of 44 pounds to 220 pounds, inclusive, at Screening.
• For Cohort 3 only, weighs at least 8.0 kg (17.6 pounds) at Screening.
• Subjects greater than or equal to 6 years of age must have the ability to swallow a tablet of the size 6.0 millimeter diameter and 3.5 millimeter thickness.
• Has no known history of hepatitis B, hepatitis C, and human immunodeficiency virus.
• For Cohort 3 only, may be renal transplant patient if all other inclusion and none of the exclusion criteria are met, along with additional criteria.
• Must have been at a constant weight, or expected weight gain for that particular age, for 30 days with no change to the dose of their diuretic drugs.

For Healthy Adult Subjects:

• Weighs at least 50 kilograms (110 pounds) and has a screening body mass index between 18 and 32 kilograms/m2, inclusive.
• Is in good health as determined by the physician
• Has a negative test result for hepatitis B surface antigen and antibody to hepatitis C virus, and has no known history of human immunodeficiency virus.
• Must have a negative urine test result for selected substances of abuse .
• Has a diastolic blood pressure between 60 and 90 mm Hg, inclusive, and a systolic blood pressure between 100 and 140 mm Hg, inclusive.

For All Subjects:

• Females of child bearing potential who are sexually active, as well as sexually active male subjects, agree to routinely use adequate contraception from Screening until 30 days after receiving the last dose of study medication.
• Has clinical laboratory results within the reference range for the testing laboratory unless the results are deemed not clinically significant by the investigator.

Exclusion Criteria:

For Pediatric Subjects:

• Is currently treated with more than 2 antihypertensive agents.
• Has sitting trough clinic systolic blood pressure greater than 15 mm Hg or diastolic blood pressure greater than 10 mm Hg above the 99th percentile for age, gender, and height at Check-in .
• Has renovascular disease affecting both kidneys or a solitary kidney, dialysis treatment, severe nephrotic syndrome and not in remission.
• For Cohort 1 and 2 only, a previous renal transplant.
• Has a creatinine clearance less than 30 mL/min/1.73 m2.

For all subjects:

• Has previously received azilsartan or azilsartan medoxomil.
• Has a known hypersensitivity or allergy to any angiotensin type II receptor blockers or to any of the excipients in the azilsartan medoxomil formulation to be taken.
• Has a history or clinical manifestations of severe cardiovascular disease, psychiatric disease, and any conditions that would interfere with gastrointestinal absorption.
• Has hemodynamically significant left ventricular outflow obstruction due to aortic valvular disease, cardiomyopathy, or uncorrected coarctation of the aorta.
• Has been diagnosed with malignant or accelerated hypertension.
• Has severe hepatic impairment.
• Has a serum albumin less than 2.5 g/dL.
• Has a glycosylated hemoglobin value greater than 8.5%.
• Has alanine aminotransferase, aspartate aminotransferase greater than 2 times the upper limit of normal, or total bilirubin greater than 1.5 times the upper limit of normal, active liver disease, or jaundice.
• Has hyperkalemia as defined by the laboratory normal reference range or any pertinent electrolyte disorders.
• Is participating in another investigational study or has taken an investigational drug within 30 days prior to Check-in .
• Has a history of drug abuse or a history of alcohol abuse within 1 year prior to study Check-in.
• Has a history of abdominal surgery or thoracic or nonperipheral vascular surgery within 6 months prior to study Check-in .
• Has a history of cancer, other than basal cell carcinoma or stage I squamous cell carcinoma of the skin that has not been in remission for at least 5 years prior to study Check-in .
• Has taken any cytotoxic drugs within 12 months prior to study Check-in .
• Has a history or presence of a clinically significant abnormal 12-lead electrocardiogram as determined by the investigator or sponsor/designee.
• Has poor peripheral venous access.
• Has any other condition or prior therapy that, in the opinion of the investigator, would make the subject unsuitable for the study.

• Has taken or requires the use of any medications, supplements, or food products within the stated time periods, including:

  • Pediatric subjects taking angiotensin-converting enzyme inhibitors and other angiotensin II receptor blockers will be required to withhold these medications from the morning of Day -1 until the 24 hour pharmacokinetic sample is completed on Day 2.
  • Only pediatric subjects will be allowed to take medications for primary renal or urologic conditions or hypertension as long as they have been on a stable dose of their medication for at least 30 days prior to Check-in (Day -1) and those medications are not potent cytochrome P-450 inhibitors or inducers.
  • Nutraceuticals including herbal or dietary preparations such as ginseng, kava kava, and ginkgo biloba.
  • Over-the-counter medications.
  • Vitamin supplements except for pediatric subjects only.
  • Alcohol-containing products.
  • Products that contain caffeine or xanthine-related compounds.
  • Foods or beverages containing grapefruit juice or Seville-type oranges.