Duofast

• Hypertension (high blood pressure)
• Patients likely to need multiple antihypertensive agents
• When monotherapy fails to achieve blood pressure goals

Amlodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Amlodipine has a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.

Angiotensin II, formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Olmesartan Medoxomil blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues. Olmesartan Medoxomil does not inhibit ACE (kinase II).

Adult Dose:

• Initial therapy: 5/20 mg once daily for 1-2 weeks, titrate as needed up to maximum 10/40 mg once daily
• For elderly patients (≥75 years): Starting dose of Amlodipine is 2.5 mg
• Drugs acting on renin-angiotensin system can cause fetal injury in 2nd and 3rd trimesters
• Discontinue as soon as pregnancy is detected
• Symptomatic hypotension may occur in volume and/or salt-depleted patients
• Caution in renal impairment; monitor serum creatinine and potassium periodically
• Avoid use in severe renal & hepatic impairment
• Caution in aortic or mitral valve stenosis, obstructive hypertrophic cardiomyopathy

Renal Dose: Dose adjustment may be needed for patients with renal impairment.

• Sleepiness
• Taste change
• Ankle swelling
• Headache
• Flushing (sense of warmth in the face, ears, neck and trunk)
• Dizziness
• Tiredness
• Palpitations
• Upset stomach
• Increased potassium level in blood

[CONSULT YOUR DOCTOR] Amlodipine + Olmesartan Medoxomil is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby (Pregnancy Category D - second and third trimesters). However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. When pregnancy is detected, discontinue as soon as possible. Please consult your doctor.

[UNSAFE] Amlodipine + Olmesartan Medoxomil may cause side effects which could affect your ability to drive. May cause dizziness, headaches, nausea or tiredness, all of which could affect your ability to concentrate and drive.

Get up slowly when rising from a sitting or lying position. Avoid consuming alcohol as it may enhance the blood pressure lowering effect. If you experience ankle or foot swelling, raise your legs while sitting and talk to your doctor if it does not go away.

Caution in patients with severe aortic stenosis, severe obstructive coronary artery disease, renal impairment, hepatic impairment. Do not take if you are pregnant, planning to conceive or breastfeeding.

There is no information on overdosage in humans. Overdose may cause hypotension. Unabsorbed drugs may be removed by gastric lavage or administration of activated charcoal. Symptomatic treatment is suggested.

Do not store above 30°C. Keep away from light and out of the reach of children.