Duopres 5/20mg Tablet (Box)

Duopres is prescribed for managing high blood pressure (hypertension), either on its own or alongside other antihypertensive medications. It is also suitable as an initial treatment for individuals who are expected to need more than one medication to meet their blood pressure targets. The choice to begin with a combination therapy should be tailored to the patient, considering factors like baseline blood pressure, treatment goals, and the likelihood of success with combination therapy versus monotherapy. Blood pressure targets may vary depending on the individual’s risk profile.

Always take this medication as directed by a registered physician.

Pharmacology

Amlodipine is a calcium channel blocker (dihydropyridine type) that limits calcium entry into vascular smooth muscle and cardiac muscle. It primarily relaxes peripheral blood vessels, reducing resistance and lowering blood pressure.

Olmesartan Medoxomil blocks the action of angiotensin II, a hormone that narrows blood vessels and stimulates the release of aldosterone, leading to increased blood pressure. It works by selectively inhibiting angiotensin II from binding to the AT1 receptor, especially in blood vessels and the adrenal glands. Unlike ACE inhibitors, Olmesartan does not affect the enzyme that breaks down bradykinin.

Dosage & Administration

For patients already on Amlodipine and Olmesartan separately, Duopres can be substituted. The dosage may be increased based on clinical need.

Initial dose: 5 mg Amlodipine / 20 mg Olmesartan once daily for 1–2 weeks.

Maximum dose: Up to 10 mg Amlodipine / 40 mg Olmesartan once daily.

In patients aged 75 or older, Amlodipine clearance may be reduced. Since the combination’s lowest strength is 5/20 mg, it’s not advised to start treatment with this combination in this age group.

Always take this medication as directed by a registered physician.

Drug Interactions

NSAIDs, including selective COX-2 inhibitors, may reduce the blood pressure-lowering effect of Olmesartan. When used together, closely monitor blood pressure, kidney function, and electrolyte levels.

Contraindications

Do not use this combination with Aliskiren in patients with diabetes.

Side Effects

Common side effects include:

Swelling (especially in the legs or feet)

Headache

Flushing

Dizziness

Rarely, it may lead to sprue-like enteropathy, an intestinal disorder.

Pregnancy & Lactation

Pregnancy Category D: Use during the 2nd and 3rd trimesters can result in fetal harm or death. Discontinue as soon as pregnancy is confirmed.

It’s unclear whether these drugs are excreted in breast milk. A decision should be made to either stop breastfeeding or stop the medication, depending on the importance of the drug to the mother.

Precautions

Use with caution in patients with:

Low blood volume or sodium levels (risk of hypotension)

Severe aortic stenosis (risk of excessive vasodilation)

Coronary artery disease (may worsen angina or cause a heart attack)

Use in Special Populations

Children: Safety and effectiveness not established.

Elderly: No significant differences in response between older and younger patients.

Kidney impairment: No specific studies available.

Liver impairment: Not recommended to initiate therapy in patients with liver issues.

Overdose

No specific data available on overdose in humans.

Therapeutic Class

This medication falls under combined antihypertensive agents.

Storage

Store below 30°C. Protect from light and keep out of children’s reach.