Duopres 5/20

Generic

Amlodipine Besilate + Olmesartan Medoxomil

Indications

To reduce blood pressure, it's used to treat hypertension alone or in combination with other antihypertensive drugs. This combination medicine is recommended as a first treatment for individuals who are likely to require numerous antihypertensive medications to reach their blood pressure objectives. Considerations such as baseline blood pressure, the objective goal, and the incremental chance of attaining goal with a combination vs monotherapy should all be considered when deciding whether to employ a combination as initial therapy. Depending on the patient's risk, blood pressure targets may differ.

Pharmacology

Amlodipine is a dihydropyridine calcium channel blocker that inhibits the flow of calcium ions through the membrane to vascular smooth muscle and myocardium. The effect of amlodipine on vascular smooth muscle cells is greater than that of cardiomyocytes. Amlodipine is a peripheral arterial vasodilator, which acts directly on vascular smooth muscle, causing a decrease in peripheral vascular resistance and blood pressure.

Angiotensin II is formed by angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE). It is an effective vasoconstrictor and the main vasoactive hormone of the renin-angiotensin system. It is also a high blood pressure An important part of pathophysiology. It also stimulates the adrenal cortex to secrete aldosterone.

Olmesartan medoxomil blocks the vasoconstriction and aldosterone secretion of angiotensin II by selectively blocking the binding of angiotensin II to AT1 receptors found in many tissues (such as vascular smooth muscle, adrenal glands). In vitro binding studies have shown that Olmesartan Medoxomil is a competitive and reversible AT1 receptor inhibitor. Olmesartan medoxomil does not inhibit ACE (kinase II, an enzyme that converts angiotensin I into angiotensin II and breaks down bradykinin).

Dosage & Administration

Substitute individually titrated components for patients on Amlodipine and Olmesartan Medoxomil. This combination may also be given with increased amounts of Amlodipine, Olmesartan Medoxomil, or both, as needed.

Initial therapy: Initiate with 5/20 mg once daily for 1 to 2 weeks and titrate as needed up to a maximum of 10/40 mg once daily. Due to decreased clearance of Amlodipine among elderly patients the recommended starting dose of Amlodipine is 2.5 mg in patients 75 years. The lowest dose of the combination is 5/20 mg; therefore, initial therapy with this combination drug is not recommended in patients >75 years old.

Interaction

NSAIDs such as selective COX-2 inhibitors may reduce the antihypertensive impact of angiotensin II receptor antagonists like Olmesartan Medoxomil. In patients receiving combination treatment or other drugs that impact the RAS, blood pressure, renal function, and electrolytes should be carefully monitored.

Contraindications

In diabetic individuals, this medication should not be taken along with Aliskiren.

Side Effects

Peripheral edema, headache, flushing, and dizziness are the most frequent adverse effects. It can also induce sprue-like enteropathy, which is a type of intestinal disease.

Pregnancy & Lactation

D is the pregnancy category. The combination of amlodipine and olmesartan medoxomil should not be taken in the second or third trimester since it might cause fetal mortality. This combination should be stopped as soon as possible if pregnancy is found. Olmesartan and Amlodipine are not known to be excreted in human milk. Because of the risk of harm to the nursing child, a choice should be taken on whether to stop breastfeeding or stop taking the medicine, taking into account the drug's value to the mother.

Precautions & Warnings

• Because of the potential of hypotension in volume- or salt-depleted individuals, the combination of Amlodipine and Olmesartan Medoxomil should be taken with care.
• Patients with severe aortic stenosis benefit from vasodilation.
• Angina or acute Ml with a higher frequency, length, or severity in individuals with significant obstructive coronary artery disease.

Therapeutic Class

Combined antihypertensive preparations

Storage Conditions

Do not store at temperatures above 30°C. Keep out of the reach of youngsters and away from light.

Pharmaceutical Name

Incepta Pharmaceuticals Ltd.

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