Ardance-L
Generic Name
Olmesartan Medoxomil + Amlodipine Besylate
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ardance l 10 mg tablet | ৳ 35.00 | ৳ 350.00 |
| ardance l 25 mg tablet | ৳ 50.00 | ৳ 500.00 |
Description
Overview of the medicine
Ardance-L is a combination medicine containing Olmesartan (an Angiotensin II Receptor Blocker) and Amlodipine (a Calcium Channel Blocker). It is primarily used to treat essential hypertension (high blood pressure) in adult patients.
Uses & Indications
Dosage
Adults
The recommended starting dose is 20 mg Olmesartan / 5 mg Amlodipine orally once daily. The dose may be increased after 1 to 2 weeks of therapy, up to a maximum of 40 mg Olmesartan / 10 mg Amlodipine once daily, based on blood pressure response.
Elderly
No special dose adjustment is required for elderly patients, but caution should be exercised. Start with the lowest effective dose.
Renal_impairment
No dose adjustment is needed for patients with mild to moderate renal impairment. For severe renal impairment, use with caution and monitor renal function.
How to Take
Take Ardance-L orally once daily, with or without food. Swallow the tablet whole with water. Do not crush or chew.
Mechanism of Action
Olmesartan blocks the binding of angiotensin II to its AT1 receptor, leading to vasodilation and reduction in aldosterone secretion, thus lowering blood pressure. Amlodipine inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle by blocking L-type calcium channels, resulting in peripheral arterial vasodilation and reduced peripheral vascular resistance.
Pharmacokinetics
Onset
Amlodipine's antihypertensive effect begins gradually, peaking at 6-12 hours, with full effect taking several days. Olmesartan's effect is typically seen within 2 weeks.
Excretion
Olmesartan is primarily eliminated via bile/feces (~50-65%) and urine (~35-50%). Amlodipine's metabolites are primarily excreted in the urine (60%) and feces (20-25%).
Half life
Olmesartan: ~13 hours. Amlodipine: 30-50 hours.
Absorption
Olmesartan has a low oral bioavailability (~26%), while Amlodipine is well-absorbed after oral administration (absolute bioavailability 64-90%). Peak plasma concentrations are reached in 1-2 hours for Olmesartan and 6-12 hours for Amlodipine.
Metabolism
Olmesartan is largely eliminated unchanged, with minimal hepatic metabolism. Amlodipine is extensively metabolized in the liver to inactive metabolites (approximately 90%).
Side Effects
Contraindications
- •Hypersensitivity to Olmesartan, Amlodipine, or any component of the formulation.
- •Second and third trimesters of pregnancy.
- •Concomitant use with aliskiren in patients with diabetes.
- •Severe hepatic impairment.
Drug Interactions
NSAIDs
May reduce the antihypertensive effect and increase the risk of renal function deterioration. Monitor blood pressure and renal function.
Lithium
Increased serum lithium concentrations and lithium toxicity have been reported. Monitor serum lithium levels carefully.
Diuretics
Increased hypotensive effect. Monitor blood pressure.
CYP3A4 inducers (e.g., Rifampicin)
May decrease Amlodipine exposure. Monitor blood pressure and adjust Amlodipine dose as needed.
CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir)
May increase Amlodipine exposure, leading to increased risk of hypotension and edema. Dose adjustment of Amlodipine may be necessary.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia, especially in renal impairment. Monitor serum potassium.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include marked hypotension and possibly reflex tachycardia. Management involves symptomatic treatment and supportive care. If ingestion is recent, activated charcoal may be considered. IV fluids and vasopressors may be needed for severe hypotension. Close monitoring of cardiac and respiratory function is essential.
Pregnancy & Lactation
Ardance-L is contraindicated during the second and third trimesters of pregnancy due to potential fetal harm (renal dysfunction, oligohydramnios, skeletal deformations, fetal death). Discontinue as soon as pregnancy is detected. It is not recommended during lactation as both drugs may pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
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Global Brand Names
International brand names for this medicine
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