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.

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.

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.