Amlosin Plus
Generic Name
Amlodipine Besilate + Olmesartan Medoxomil
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| amlosin plus 5 mg tablet | ৳ 5.00 | ৳ 50.00 |
Description
Overview of the medicine
Amlosin Plus 5 mg tablet is a combination medication containing Amlodipine and Olmesartan, primarily used to treat high blood pressure (hypertension). Amlodipine, a calcium channel blocker, and Olmesartan, an angiotensin II receptor blocker, work together to relax blood vessels and improve blood flow, thereby lowering blood pressure.
Uses & Indications
Dosage
Adults
The usual starting dose is one tablet daily. The dose may be adjusted by the physician based on individual patient response and blood pressure control. Maximum recommended dose is Amlodipine 10 mg / Olmesartan 40 mg once daily.
Elderly
No specific initial dose adjustment is generally required, but caution should be exercised. Start with the lowest effective dose and monitor renal function.
Renal_impairment
For mild to moderate renal impairment, no initial dose adjustment is necessary. For severe renal impairment, lower doses or alternative treatments may be considered under strict medical supervision.
How to Take
Take the tablet orally, once daily, with or without food. Swallow whole with water. Do not chew or crush. It is advisable to take it at the same time each day.
Mechanism of Action
Amlodipine inhibits the influx of calcium ions into cardiac and vascular smooth muscle, leading to vasodilation and decreased peripheral vascular resistance. Olmesartan selectively blocks the binding of angiotensin II to the AT1 receptor, preventing vasoconstriction and aldosterone secretion, thereby lowering blood pressure.
Pharmacokinetics
Onset
Amlodipine: Gradual, peak plasma concentrations 6-12 hours. Olmesartan: Peak plasma concentrations 1-2 hours.
Excretion
Amlodipine: Primarily renal excretion of inactive metabolites (approximately 60%). Olmesartan: Approximately 35-50% excreted in urine and 50-65% in feces.
Half life
Amlodipine: 30-50 hours. Olmesartan: 10-15 hours.
Absorption
Amlodipine is well absorbed orally, with bioavailability of 64-90%. Olmesartan medoxomil is rapidly and completely converted to olmesartan during absorption from the gastrointestinal tract, with an absolute bioavailability of 26%. Food does not affect olmesartan absorption.
Metabolism
Amlodipine: Extensively metabolized in the liver to inactive metabolites. Olmesartan: Not significantly metabolized by the cytochrome P450 system.
Side Effects
Contraindications
- •Hypersensitivity to Amlodipine, Olmesartan, or any component of the formulation.
- •Severe hypotension.
- •Cardiogenic shock.
- •Obstruction of the outflow tract of the left ventricle (e.g., high-grade aortic stenosis).
- •Hemodynamically unstable heart failure after acute myocardial infarction.
- •Second and third trimesters of pregnancy.
- •Biliary obstruction.
- •Concomitant use with Aliskiren in patients with diabetes or renal impairment (GFR < 60 mL/min/1.73 m²).
Drug Interactions
Lithium
Increased serum lithium concentrations and toxicity. Monitor serum lithium levels closely.
CYP3A4 Inducers
May decrease exposure to Amlodipine (e.g., rifampicin, St. John's Wort). Monitor blood pressure.
CYP3A4 Inhibitors
May increase exposure to Amlodipine (e.g., ketoconazole, itraconazole, ritonavir). Monitor for symptoms of hypotension and edema.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Olmesartan and increase the risk of renal impairment, especially in elderly or dehydrated patients. Monitor renal function.
Potassium-sparing diuretics/Potassium supplements
May increase serum potassium levels due to Olmesartan. Monitor serum potassium.
Dual blockade of the RAAS (e.g., with ACE inhibitors or Aliskiren)
Increased risk of hypotension, hyperkalemia, and renal function changes. Avoid, especially in patients with diabetes or renal impairment.
Storage
Store in a cool and dry place, below 30°C (86°F). Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include excessive peripheral vasodilation with marked hypotension and possibly reflex tachycardia. Management involves symptomatic and supportive measures. If recent ingestion, gastric lavage or activated charcoal may be considered. Intravenous fluids and vasopressors may be needed for hypotension. Calcium gluconate may be beneficial for Amlodipine overdose.
Pregnancy & Lactation
Pregnancy: Contraindicated in the second and third trimesters due to fetal toxicity risk associated with Olmesartan. Use in the first trimester only if potential benefit outweighs risk. Lactation: Not recommended. It is unknown if Amlodipine or Olmesartan is excreted in human milk. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the manufacturing date, consult product packaging for exact details.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generics available
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Global Brand Names
International brand names for this medicine
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