Duopres 5/20

Indications

This medication is prescribed for the treatment of hypertension, either as a standalone option or in combination with other antihypertensive agents to effectively lower blood pressure. Duopres is particularly indicated as initial therapy for patients who may require multiple antihypertensive medications to achieve their blood pressure targets. The choice to initiate combination therapy should be tailored to each patient, considering factors such as baseline blood pressure, target goals, and the likelihood of reaching those goals with a combination versus monotherapy. Individual blood pressure objectives may vary based on each patient’s risk profile.

Always consult a registered healthcare professional before taking medication.

Pharmacology

Amlodipine is a dihydropyridine calcium channel blocker that limits the influx of calcium ions into vascular and cardiac smooth muscle. It primarily affects vascular smooth muscle, acting as a peripheral arterial vasodilator to reduce peripheral vascular resistance and lower blood pressure.

Olmesartan Medoxomil blocks the effects of angiotensin II, a potent vasoconstrictor that plays a key role in hypertension. By selectively inhibiting the binding of angiotensin II to the AT1 receptor found in various tissues, Olmesartan Medoxomil helps counteract the vasoconstrictive and aldosterone-secreting actions of angiotensin II. Notably, it does not inhibit angiotensin-converting enzyme (ACE), which converts angiotensin I to angiotensin II.

Dosage & Administration

For patients transitioning from individually titrated doses of Amlodipine and Olmesartan Medoxomil, this combination may be administered with adjusted dosages as needed.

Initial Therapy: Start with 5/20 mg once daily for 1 to 2 weeks, with the option to titrate up to a maximum of 10/40 mg once daily. Due to decreased clearance of Amlodipine in elderly patients, a starting dose of 2.5 mg is recommended for those aged 75 and older. Initial therapy with this combination is not advised for patients over 75 years due to the lowest available dose being 5/20 mg.

Always consult a registered healthcare professional for medication guidance.

Interactions

The antihypertensive effects of angiotensin II receptor antagonists like Olmesartan Medoxomil may be reduced by nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors. Close monitoring of blood pressure, renal function, and electrolytes is essential for patients on combination therapy or other agents affecting the renin-angiotensin system (RAS).

Contraindications

This medication should not be co-administered with Aliskiren in patients with diabetes.

Side Effects

Common side effects may include peripheral edema, headache, flushing, and dizziness. Additionally, it can cause intestinal issues known as sprue-like enteropathy.

Pregnancy & Lactation

Pregnancy Category D: The combination of Amlodipine and Olmesartan Medoxomil should not be used during the second and third trimesters, as it may result in fetal death. If pregnancy occurs, discontinuation of this medication should be considered promptly. The excretion of Olmesartan and Amlodipine in human milk is unknown; therefore, the decision to continue breastfeeding or discontinue the medication should be made based on the drug’s importance to the mother.

Precautions & Warnings

Caution is advised when using Amlodipine and Olmesartan Medoxomil, as there are risks for:

• Hypotension in patients who are volume- or salt-depleted.
• Vasodilation in those with severe aortic stenosis.
• Increased frequency, duration, or severity of angina or acute myocardial infarction in patients with severe obstructive coronary artery disease.

Use in Special Populations

• Pediatric Use: Safety and efficacy have not been established in pediatric patients.
• Geriatric Use: No significant differences in safety or efficacy were observed between patients aged 65 and older and younger individuals.
• Renal Impairment: There are no studies conducted on patients with renal impairment.
• Hepatic Impairment: Initial therapy is not recommended for patients with liver impairment.

Overdose Effects

There is currently no documented information regarding overdose effects in humans.

Therapeutic Class

Combined antihypertensive preparations

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of reach of children.