Olmepres AM
Generic Name
Olmesartan Medoxomil + Amlodipine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| olmepres am 5 mg tablet | ৳ 17.00 | ৳ 170.00 |
Description
Overview of the medicine
Olmepres AM is a combination medication containing Olmesartan Medoxomil and Amlodipine Besilate, used to treat high blood pressure (hypertension). Olmesartan is an angiotensin II receptor blocker (ARB) which relaxes blood vessels, and Amlodipine is a calcium channel blocker (CCB) which also relaxes blood vessels and improves blood flow. This combination helps to lower blood pressure more effectively.
Uses & Indications
Dosage
Adults
Initially 20 mg Olmesartan + 5 mg Amlodipine once daily. May be increased to 40 mg Olmesartan + 10 mg Amlodipine once daily as needed, based on blood pressure response.
Elderly
No special dosage adjustment required, but caution is advised due to potential age-related decrease in renal or hepatic function.
Renal_impairment
Caution advised. Dosage adjustment may be required for severe renal impairment. Regular monitoring of renal function is recommended.
How to Take
Take 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, preventing vasoconstriction and aldosterone secretion. Amlodipine inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle, resulting in vasodilation and reduced peripheral vascular resistance.
Pharmacokinetics
Onset
Blood pressure reduction seen within 2 hours for Amlodipine, and generally within 2 weeks for full effect of Olmesartan.
Excretion
Olmesartan: Primarily eliminated in bile (50-65%) and urine (35-50%). Amlodipine: Primarily excreted in urine as inactive metabolites (60%).
Half life
Olmesartan: 10-15 hours. Amlodipine: 30-50 hours.
Absorption
Olmesartan: Bioavailability 26%, peak plasma concentration at 1-2 hours. Amlodipine: Bioavailability 64-90%, peak plasma concentration at 6-12 hours.
Metabolism
Olmesartan is not metabolized by the cytochrome P450 system. Amlodipine is extensively metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to Olmesartan, Amlodipine, or any excipients
- Pregnancy (second and third trimesters)
- Severe hepatic impairment
- Bilateral renal artery stenosis
- Obstructive biliary disorders
- Cardiogenic shock
- Significant aortic stenosis
Drug Interactions
NSAIDs
Reduced antihypertensive effect; increased risk of renal impairment.
Simvastatin
Amlodipine increases exposure to Simvastatin; limit Simvastatin dose.
ACE inhibitors, diuretics
Increased risk of hypotension.
CYP3A4 inducers (e.g., rifampicin, St. John's wort)
Decreased exposure to Amlodipine.
CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir)
Increased exposure to Amlodipine; monitor for symptoms of hypotension and edema.
Potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium
Increased risk of hyperkalemia with Olmesartan.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Profound hypotension, reflex tachycardia, excessive peripheral vasodilation. Management: Supportive care, including monitoring of vital signs, fluid replacement, and if needed, vasopressors for hypotension. Calcium gluconate may be helpful for Amlodipine overdose.
Pregnancy & Lactation
Pregnancy: Contraindicated in the second and third trimesters due to risk of fetal injury/death. Discontinue immediately if pregnancy is detected. Lactation: Unknown if excreted in human milk. Caution advised; consider alternative treatment or discontinue breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to Olmesartan, Amlodipine, or any excipients
- Pregnancy (second and third trimesters)
- Severe hepatic impairment
- Bilateral renal artery stenosis
- Obstructive biliary disorders
- Cardiogenic shock
- Significant aortic stenosis
Drug Interactions
NSAIDs
Reduced antihypertensive effect; increased risk of renal impairment.
Simvastatin
Amlodipine increases exposure to Simvastatin; limit Simvastatin dose.
ACE inhibitors, diuretics
Increased risk of hypotension.
CYP3A4 inducers (e.g., rifampicin, St. John's wort)
Decreased exposure to Amlodipine.
CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir)
Increased exposure to Amlodipine; monitor for symptoms of hypotension and edema.
Potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium
Increased risk of hyperkalemia with Olmesartan.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Profound hypotension, reflex tachycardia, excessive peripheral vasodilation. Management: Supportive care, including monitoring of vital signs, fluid replacement, and if needed, vasopressors for hypotension. Calcium gluconate may be helpful for Amlodipine overdose.
Pregnancy & Lactation
Pregnancy: Contraindicated in the second and third trimesters due to risk of fetal injury/death. Discontinue immediately if pregnancy is detected. Lactation: Unknown if excreted in human milk. Caution advised; consider alternative treatment or discontinue breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
Clinical Trials
Several clinical trials have demonstrated the efficacy and safety of Olmesartan/Amlodipine combination in reducing blood pressure in patients with hypertension.
Lab Monitoring
- Blood pressure
- Renal function (serum creatinine, BUN)
- Serum electrolytes (especially potassium)
- Liver function tests
Doctor Notes
- Monitor blood pressure regularly.
- Assess renal function and serum electrolytes periodically, especially in patients with pre-existing renal impairment or those on diuretics.
- Advise patients on lifestyle modifications.
- Caution in patients with severe aortic stenosis or cardiogenic shock due to Amlodipine component.
Patient Guidelines
- Take regularly as prescribed
- Do not stop taking without consulting your doctor
- Report any unusual side effects
- Avoid potassium supplements unless advised by doctor
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or fatigue. Patients should be cautioned about driving or operating machinery until they know how Olmepres AM affects them.
Lifestyle Advice
- Maintain a healthy diet low in sodium
- Engage in regular physical activity
- Limit alcohol intake
- Quit smoking
- Manage stress
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