Tablet, Generic Name: Olmesartan 20mg & Hydrochlorothiazide 12.5mg, Manufacturer: Incepta Pharmaceuticals Ltd.
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Indications
The combination of Olmesartan, Medoxomil, and Hydrochlorothiazide is used to treat hypertension.
Pharmacology
Angiotensin-II is a strong vasoconstrictor, the major vasoactive hormone of the renin-angiotensin system, and a key component in the pathophysiology of hypertension. It is produced from angiotensin-I in a process catalyzed by the angiotensin-converting enzyme (ACE). It also increases the adrenal cortex's production of aldosterone. Olmesartan inhibits angiotensin-vasoconstrictor II's and aldosterone-secreting actions by specifically inhibiting angiotensin-II binding to the AT 1 receptor, which is present in numerous tissues (e.g. vascular smooth muscle, adrenal gland). Olmesartan is a reversible and competitive inhibitor of the AT 1 receptor, according to in-vitro binding tests. Olmesartan has no effect on ACE (kinase-I, the enzyme that converts angiotensin-I to angiotensin-II and degrades bradykinin).
A thiazide diuretic is hydrochlorothiazide. Thiazides act on the renal tubular processes of electrolyte reabsorption, increasing sodium and chloride excretion in about equal quantities. Hydrochlorothiazide's diuretic effect indirectly reduces plasma volume, which raises plasma renin activity, increases Aldosterone production and urinary potassium loss, and decreases serum potassium. Angiotensin-II mediates the renin-aldosterone connection. As a result, taking an angiotensin-II receptor antagonist with these diuretics helps to reverse the potassium loss.
Dosage & Administration
Hypertension: The usual starting dose is 20/12.5 mg one tablet once daily. Dosing should be individualized. Depending on the blood pressure response, the dose may be titrated at intervals of 2-4 weeks to two tablets 40/25 once daily.
Interaction
Olmesartan: In trials in which Olmesartan Medoxomil was co-administered with hydrochlorothiazide, digoxin, or warfarin, no significant medication interactions were found in healthy volunteers. Olmesartan Medoxomil is not metabolized by the cytochrome P450 system and has no impact on P450 enzymes; thus, interactions with medications that inhibit, induce, or are metabolized by those enzymes are unlikely.
Hydrochlorothiazide: The following medications may interact with Thiazide diuretics when used concurrently:
Alcohol, barbiturates, or narcotics may cause orthostatic hypotension.
Antidiabetic medications (oral agents and insulin): The antidiabetic drug's dosage may need to be adjusted.
Other antihypertensive medications have an additive impact.
ACTH, corticosteroids
Lithium.
Contraindications
In individuals who are hypersensitive to either component of this medication, the combination of Olmesartan and Hydrochlorothiazide is contraindicated. This medication is contraindicated in individuals with anuria or hypersensitivity to other sulfonamide-derived medicines due to the Hydrochlorothiazide component.
Side Effects
Nausea, headache, dizziness, hyperuricemia, upper respiratory tract infection, and urinary tract infection are the most frequent adverse effects. Chest discomfort, back pain, peripheral edema, stomach pain, dyspepsia, gastroenteritis, and diarrhea are some of the other side effects.
Pregnancy & Lactation
There is no evidence of safety or efficacy in breastfeeding mothers or during pregnancy. During these situations, the medication should be stopped.
Precautions & Warnings
Periodic electrolyte determinations should be conducted at suitable intervals to detect potential electrolyte imbalances such as hypokalemia, hyponatremia, and hypochloremic alkalosis.
Certain individuals undergoing thiazide treatment may develop hyperuricemia.
Renal function impairment.
Storage Conditions
Keep cool and dry, and keep away from light and moisture. Keep out of children's reach.
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