Generic Name and Formulations:
Amlodipine (as besylate), olmesartan medoxomil; 5mg/20mg, 10mg/20mg, 5mg/40mg, 10mg/40mg; tabs.
Take once daily. Initial therapy: initially 5/20mg; may increase after 1–2 weeks up to max 10/40mg; ≥75yrs old or hepatic impairment: not recommended. Replacement therapy: may be substituted for titrated components. Add-on therapy: may be used if not controlled on monotherapy. Individualize; titrate at 2-week intervals up to max 10/40mg once daily, usually by increasing dose of one or both components if BP not controlled on prior therapy. Maximum effects within 2 weeks after dose change.
Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Volume/salt depleted. Severe obstructive coronary disease. Severe aortic stenosis. Severe hepatic or renal impairment. Renal artery stenosis. Consider discontinuing if sprue-like enteropathy develops and no other etiology is identified. Monitor electrolytes periodically. Elderly (may need lower initial dose of amlodipine). Neonates. Pregnancy (Cat.D); monitor. Nursing mothers: not recommended.
See Contraindications. Potentiates simvastatin; limit simvastatin dose to 20mg/day. May potentiate cyclosporine, tacrolimus, lithium; monitor levels. Potentiated by CYP3A4 inhibitors; may need dose reduction. Antagonized by NSAIDs (including selective COX-2 inhibitors); may impair renal function (monitor). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Consider taking at least 4hrs before colesevelam HCl dose. Monitor BP with CYP3A4 inducers.
Calcium channel blocker (CCB) + angiotensin II receptor blocker (ARB).
Edema, dizziness; headache, hypotension, rash, pruritus, palpitation, urinary frequency, nocturia, hepatic or renal dysfunction, decreased hematocrit, decreased hemoglobin, hyperkalemia (rare).
Amlodipine: hepatic; 93% protein bound. Olmesartan: 99% protein bound.
Renal (primary); fecal.
Tabs—30, 90, 100, 1000
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