Amlodipine is a dihydropyridine calcium channel blocker that prevents calcium ions from crossing the blood-brain barrier and entering vascular smooth muscle and cardiac muscle. Compared to cardiac muscle cells, amlodipine has a stronger effect on vascular smooth muscle cells. Amlodipine is a peripheral artery vasodilator that works by reducing peripheral vascular resistance and lowering blood pressure by acting directly on vascular smooth muscle.
Angiotensin II is a powerful vasoconstrictor, the principal vasoactive hormone of the Renin-angiotensin system, and an essential component in the pathogenesis of hypertension. It is generated from angiotensin I in a mechanism catalyzed by angiotensin-converting enzyme (ACE). It also causes the adrenal cortex to secrete more aldosterone.
By specifically blocking angiotensin II's binding to the AT1 receptor located in numerous tissues, Olmesartan Medoxomil reduces the vasoconstrictor and aldosterone-secreting effects of angiotensin II (e.g. vascular smooth muscle, adrenal gland). Olmesartan Medoxomil is a reversible, competitive AT1 receptor inhibitor, according to in vitro binding tests. Olmesartan Medoxomil has no effect on ACE (kinase II, the enzyme that converts angiotensin I to angiotensin II and degrades bradykinin).
Dosage & Administration
For patients using Amlodipine and Olmesartan Medoxomil, substitute individually titrated components. As needed, this combination can be administered with higher doses of Amlodipine, Olmesartan Medoxomil, or both.
Initial therapy: Start with 5/20 mg once daily for 1 to 2 weeks, then gradually increase to 10/40 mg once daily as needed. Because senior individuals' clearance of Amlodipine is reduced, the suggested beginning dose for people 75 years and older is 2.5 mg. Because the lowest dose of the combination is 5/20 mg, it is not suggested for people over the age of 75 to begin treatment with this combination medicine.
The antihypertensive effect of angiotensin II receptor antagonists, including Olmesartan Medoxomil may be attenuated by NSAIDs including selective COX-2 inhibitors. Blood pressure, renal function and electrolytes should be closely monitored in patients on combination therapy and other agents that affect the RAS.
In diabetic patients, this medication should not be taken together with Aliskiren.
Peripheral edema, headache, flushing, and dizziness are the most prevalent adverse effects. It can also cause sprue-like enteropathy, which is a type of intestinal issue.
Pregnancy & Lactation
Amlodipine with Olmesartan Medoxomil should not be used in the second and third trimesters of pregnancy since it can cause fetal mortality. This combination should be stopped as soon as possible if pregnancy is detected. Olmesartan and Amlodipine are not known to be excreted in human milk. Because of the risk of harm to the nursing infant, a decision should be taken on whether to stop breastfeeding or stop taking the medicine, taking into account the drug's importance to the mother.
Precautions & Warnings
The combination of Amlodipine and Olmesartan Medoxomil should be used with caution because it can cause-
Antihypertensive medications in combination
Do not store at temperatures above 30°C. Keep out of the reach of youngsters and away from light.