Olmesan Plus 20

Generic

Indications

Treatment of essential hypertension. This fixed-dose combination is suitable for adult patients whose blood pressure cannot be adequately controlled with olmesartan medoxomil alone.

Pharmacology

Hydrochlorothiazide inhibits na reabsorption in distal tubes. It causes an increase in water emissions containing Na and K and hydrogen ions.  

Olmesartan blocks the vasoconstructure effect of angiotensin II selectively blocking the junction of angiotensin II to the AT1 receptor in the vascular smooth muscle. Therefore, its action is irrelevant for the path of angiotensin II synthesis.

Although AT2 receptors are also found in many tissues, this receiver is not known to be associated with cardiovascular homeostasis. Olmesartan has an affinity of 12,500 times or more in relation to the AT1 receiver than the AT2 receiver.  

A blockade of the lenin's dial-up system having an ACE inhibitor that inhibits angiotensin II biosynthesis of angiotensin I is mechanisms of many medications used to treat hypertension. ACE inhibitors also inhibit the degradation of bradykinin and also inhibit reactions catalyzed by ACE. Olmesartan Medoxomil does not affect the reaction to Bradykinin because it does not inhibit the ACE. It is not yet known if this difference is clinically relevant. The angiotensin II receptor blocking inhibits the negative regulatory feedback of angiotensin II against renin secretion, but the increase in plasma renin activity and circulating angiotensin II levels do not exceed the effect of olmesartan in Blood pressure.   

Dosage & Administration

In patients without volume contraction, when used as a monotherapy, the usual recommended starting dose of olmesartan medoxomil was 20 mg once a day. For patients who need to further lower their blood pressure after 2 weeks of treatment, the dose can be increased from 
to 40 mg. For elderly patients, moderate to significant renal impairment (creatinine clearance <40 ml/min), or moderate to significant liver insufficiency, initial dose adjustment is not recommended. The effective dose of hydrochlorothiazide is 12.5 mg to 50 mg once a day. 

Alternative Therapy: Olmesartan and hydrochlorothiazide can replace their title ingredients.

Dose titration for clinical effects: The dose of olmesartan and hydrochlorothiazide tablets is once a day, one tablet each time. It is not recommended to take more than one tablet per day. Olmesartan and hydrochlorothiazide tablets can be combined with other antihypertensive drugs. Patients who cannot adequately control blood pressure with olmesartan or hydrochlorothiazide alone can switch to olmesartan and hydrochlorothiazide tablets once a day. The dosage must be individualized. Depending on the blood pressure response, the 
dose can be adjusted every 24 weeks. If olmesartan alone cannot control blood pressure, hydrochlorothiazide can be added at a starting dose of 12.5 mg, and then titrated to 25 mg once a day.

If the patient is taking hydrochlorothiazide, olmesartan can be added at a starting dose of 20 mg per day and then adjusted to 40 mg, for insufficient control of blood pressure. If you are using high-dose hydrochlorothiazide monotherapy and there is not enough volume or hyponatraemia, you should be careful when adding olmesartan or switching to olmesartan and hydrochlorothiazide tablets, because there may be a significant drop in blood pressure. Before adding olmesartan, consider reducing the dose of hydrochlorothiazide to 12.5 mg. The antihypertensive effect of Olmesartan and Hydrochlorothiazide is , which is related to the dose of the two components in the range of 10 mg / 12.5 mg to 40 mg / 25 mg.

Interaction

Olmesartan medoxomil: In healthy volunteers, olmesartan medoxomil was administered in combination with hydrochlorothiazide, digoxin or warfarin and no significant drug interactions were reported. 

Hydrochlorothiazide: When administered at the same time, the following drugs may interact with thiazide diuretics: alcohol, barbiturates or anesthetics, antidiabetic drugs, other antihypertensive drugs, cholestyramine and colestipol resin, corticosteroids, pressor amine 
(such as muscle relaxant) noradrenaline), lithium, non-steroidal anti-inflammatory drugs, etc.

Contraindications

This combination tablet is forbidden for patients who are allergic to any component of this product. Due to the component of hydrochlorothiazide, this product is contraindicated in patients who are anuria or allergic to other sulfa drugs.

Side Effects

The safety of this combination tablet has been evaluated in 1,243 hypertensive patients. It was well tolerated, with adverse events similar to placebo. The event is usually mild and short-lived and has nothing to do with the dosage of this compound tablet. Some common side effects include: headache, urinary tract infection, chest pain, back pain, peripheral edema, dizziness, 
abdominal pain, indigestion, gastroenteritis, diarrhea, elevated SGOT, elevated GGT, elevated SGPT, hyperlipidemia , Creatine phosphokinase elevated, hyperglycemia, arthritis, arthralgia, myalgia, cough, skin rash, etc.

Pregnancy & Lactation

Pregnancy categories C (early pregnancy) and D (second and third trimester). This combination drug should not be used during pregnancy.

Precautions & Warnings

Symptomatic hypotension, especially after the first dose, may occur in patients whose volume and/or sodium are depleted due to severe diuretic treatment, dietary salt restriction, diarrhea, or vomiting. These conditions should be corrected before using Olmesartan Medoxomil Hydrochlorothiazide.

Therapeutic Class

Combined antihypertensive preparations

Storage Conditions

Store in a cool, dry place, protected from light.

Pharmaceutical Name