Duovas 5 mg+40 mg (Tablet)

Indications

• Treatment of hypertension alone or with other antihypertensive agents
• Use as initial therapy in patients likely to need multiple antihypertensive agents
• Individualized decision based on baseline blood pressure and target goal

Pharmacology

• Amlodipine: dihydropyridine calcium channel blocker
• Greater effect on vascular smooth muscle cells than on cardiac muscle cells
• Peripheral arterial vasodilator causing reduction in blood pressure
• Olmesartan Medoxomil: blocks vasoconstrictor and aldosterone-secreting effects of angiotensin II
• Selective blocker of angiotensin II binding to the AT1 receptor

Dosage & Administration

• Substitute individually titrated components for patients on Amlodipine and Olmesartan Medoxomil
• May be given with increased amounts of Amlodipine, Olmesartan Medoxomil, or both, as needed
• Initial therapy with 5/20 mg once daily, titrate up to a maximum of 10/40 mg once daily
• Recommended starting dose of Amlodipine is 2.5 mg in patients 75 years and older

Interaction

• Antihypertensive effect may be attenuated by NSAIDs including selective COX-2 inhibitors
• Close monitoring of blood pressure, renal function, and electrolytes

Contraindications

• Cannot be co-administered with Aliskiren in patients with diabetes

Side Effects

• Common side effects: peripheral edema, headache, flushing, dizziness
• May cause intestinal problems known as sprue-like enteropathy

Pregnancy & Lactation

• Pregnancy Category D
• Should not be used in 2nd and 3rd trimester
• Potential adverse effects on nursing infants

Precautions & Warnings

• Use with caution in volume- or salt depleted patients
• Risk of hypotension, vasodilation, and increased frequency/severity of angina
• Risk in patients with severe aortic stenosis or obstructive coronary artery disease

Use in Special Populations

• Pediatric use: safety and effectiveness not established
• No overall differences in safety or effectiveness in subjects 65 years of age or older
• No studies in patients with renal impairment
• Initial therapy not recommended in hepatically impaired patients

Overdose Effects

• No information on overdose in humans

Therapeutic Class

• Combined antihypertensive preparations

Storage Conditions

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

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