Amlodipine and olmesartan medoxomil is a combination medication used to treat high blood pressure. This medication combines two different types of blood pressure-lowering drugs. By working through distinct mechanisms, this combination effectively reduces blood pressure, which can lower the risk of serious cardiovascular events like strokes and heart attacks.
How This Combination Works
Amlodipine, a dihydropyridine calcium channel blocker (CCB), acts by inhibiting the influx of calcium ions into vascular smooth muscle cells and cardiac muscle cells. This action causes the smooth muscles in the arterial walls to relax, leading to vasodilation, or the widening of blood vessels. The resulting reduction in peripheral vascular resistance allows blood to flow more easily and decreases the workload on the heart, thereby lowering blood pressure.
Olmesartan medoxomil is an angiotensin II receptor blocker (ARB). It works by selectively blocking the binding of angiotensin II to the angiotensin II type 1 (AT1) receptors found in various tissues, including the smooth muscle cells of blood vessels. Angiotensin II is a potent natural substance that causes blood vessels to narrow and stimulates the release of aldosterone, a hormone that promotes sodium and water retention. By blocking these effects, olmesartan medoxomil allows blood vessels to relax and widen, and it also reduces fluid retention, further contributing to blood pressure reduction.
The combination of amlodipine and olmesartan medoxomil offers an additive antihypertensive effect. Amlodipine directly relaxes blood vessels, while olmesartan medoxomil blocks the effects of a substance that constricts them. This dual approach addresses hypertension through two distinct pathways, providing more effective and sustained blood pressure control over a 24-hour period with once-daily dosing. Studies show this combination leads to greater reductions in both systolic and diastolic blood pressure compared to monotherapy.
Key Usage Guidelines
Amlodipine and olmesartan medoxomil is an oral tablet taken once daily. The usual starting dose for adults is 5 mg of amlodipine and 20 mg of olmesartan. This dosage can be adjusted after one to two weeks, up to a maximum of 10 mg of amlodipine and 40 mg of olmesartan once daily, to achieve optimal blood pressure control. Take the medication at the same time each day to maintain consistent blood levels; it can be taken with or without food.
If a dose is missed, take it as soon as remembered. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the regular schedule; never take a double dose. This medication is a long-term treatment for hypertension, and patients should not stop taking it without consulting their healthcare provider.
Store amlodipine and olmesartan medoxomil tablets at room temperature, between 68°F to 77°F (20°C to 25°C). Protect them from moisture and excessive heat. Short excursions between 59°F to 86°F (15°C to 30°C) are permitted. Keep the medication in a tightly closed container and away from direct light to preserve its stability.
Potential Effects and Interactions
Common side effects of amlodipine and olmesartan medoxomil include swelling in the ankles or feet, dizziness, and headache. These effects are mild and temporary as the body adjusts to the medication. Patients may also experience fatigue, flushing, or nausea. Report any bothersome or persistent side effects to a healthcare provider.
More serious, though less common, side effects require immediate medical attention. These include signs of a severe allergic reaction like hives, difficulty breathing, or swelling of the face, lips, tongue, or throat. Other serious effects include new or worsening chest pain, signs of kidney problems like a significant change in urine output, or symptoms of high potassium levels such as muscle weakness, tingling, or an irregular heartbeat. Severe or ongoing diarrhea with weight loss has been reported with olmesartan and requires prompt reporting to a doctor.
Drug interactions can occur with amlodipine and olmesartan medoxomil. Concomitant use with aliskiren, another blood pressure medication, is avoided, particularly in patients with diabetes or kidney disease, due to increased risks of hypotension, high potassium, and changes in kidney function. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the blood pressure-lowering effect and increase the risk of kidney impairment. Potassium supplements and salt substitutes should be avoided unless specifically advised by a doctor, as they can contribute to high potassium levels. Inform your healthcare provider about all current medications, including over-the-counter drugs, supplements, and herbal products, to prevent potential interactions.
The medication is contraindicated. It should not be used by pregnant women, especially during the second and third trimesters, as it can cause harm to the unborn baby. Women who are pregnant or planning to become pregnant should inform their doctor immediately. Use with caution in patients with severe liver or kidney disease, severe heart failure, or severe aortic stenosis, as these conditions can affect how the medication is processed or increase the risk of adverse effects.
Monitoring and Management
Regular monitoring of blood pressure is an important part of managing hypertension with amlodipine and olmesartan medoxomil. Patients should routinely check their blood pressure at home, in addition to regular measurements at their doctor’s office. These consistent readings help healthcare providers assess the medication’s effectiveness and make any necessary dosage adjustments.
Beyond blood pressure checks, routine blood tests are performed to monitor kidney function and electrolyte levels, especially potassium, as olmesartan can affect these parameters. Monitoring helps to detect potential issues early and ensures the medication is being tolerated well. Patients should also be aware that conditions like vomiting, diarrhea, or heavy sweating can lead to low blood pressure and should communicate such occurrences to their doctor.
Lifestyle adjustments complement medication in managing hypertension. Adopting a healthy diet, such as the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes whole grains, fruits, vegetables, and low-fat dairy, can significantly lower blood pressure. Reducing dietary sodium intake, aiming for less than 2,300 mg per day, or 1,500 mg for most adults, also contributes to blood pressure control.
Regular physical activity, such as at least 30 minutes of moderate aerobic exercise most days of the week, can lower blood pressure. Losing excess weight, quitting smoking, and managing stress through techniques like meditation or yoga are additional lifestyle changes that support overall cardiovascular health and enhance the effectiveness of medication. Hypertension management is a lifelong process, requiring consistent adherence to medication and lifestyle modifications, along with ongoing collaboration with healthcare providers.