Olmesartan + Amlodipine + Chlorthalidone Tablets

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Therapeutic Indication

Hypertension (high blood pressure)
Cardiovascular risk reduction
Adjunct therapy in patients uncontrolled on dual therapy
Renal protection in hypertensive diabetics
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Olmesartan + Amlodipine + Chlorthalidone

Tablet

Tablet contains a combination of three medicines, Telmisartan, Amlodipine and Chlorthalidone which help to control high blood pressure. Lowering blood pressure helps to reduce your risk of having a heart attack or a stroke in the future. Olmesartan belongs to the angiotensin II receptor blocker (ARB) family of drugs. ARBs selectively bind to angiotensin receptor 1 (AT1) and prevent the protein angiotensin II from binding and exerting its hypertensive effects, which include vasoconstriction, stimulation and synthesis of aldosterone and ADH, cardiac stimulation, and renal reabsorption of sodium, among others. Amlodipine is indicated for hypertension. Lowering blood pressure prevents cardiovascular diseases such as stroke or heart attack. Chlorthalidone is a thiazide-like diuretic used for the treatment of hypertension and for management of edema caused by conditions such as heart failure or renal impairment. Chlorthalidone improves blood pressure and swelling by preventing water absorption from the kidneys through inhibition of the Na+/Cl− symporter in the distal convoluted tubule cells in the kidney.

Speciality Cardiology | Internal Medicine | Nephrology
Tags Antihypertensive | ARB + CCB + Diuretic | Cardiovascular
Strength
  • Olmesartan 20 mg
  • Amlodipine 5 mg
  • Chlorthalidone 6.25 mg
Packing Size
  • 10 Tablets

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Mechanism

Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation and renal reabsorption of sodium. Olmesartan blocks the vasoconstrictor effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in vascular smooth muscle. Its action is, therefore, independent of the pathways for angiotensin II synthesis. Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is a mechanism of many drugs used to treat hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction also catalyzed by ACE. Because olmesartan medoxomil does not inhibit ACE (kininase II), it does not affect the response to bradykinin.

Pharmacokinetics

  • Absorption: Olmesartan bioavailability ~26%; Amlodipine ~60–65%; Chlorthalidone well absorbed orally.
  • Distribution: All highly protein bound.
  • Metabolism: Olmesartan minimal hepatic metabolism; Amlodipine via CYP3A4; Chlorthalidone minimally metabolized.
  • Elimination: Olmesartan renal and fecal; Amlodipine renal and fecal; Chlorthalidone renal.
  • Half-life: Olmesartan ~13 hrs; Amlodipine ~30–50 hrs; Chlorthalidone ~40–60 hrs.

Side Effects

  • Dizziness
  • Peripheral edema
  • Headache
  • Fatigue
  • Electrolyte imbalance (Chlorthalidone)
  • Rare: Hypotension

Contraindication

  • Hypersensitivity to Olmesartan, Amlodipine, or Chlorthalidone
  • Pregnancy (especially 2nd and 3rd trimester)
  • Severe hepatic impairment
  • Severe renal impairment
  • Cardiogenic shock (Amlodipine contraindicated)

Interaction

  • Other antihypertensives (additive effect)
  • CYP3A4 inhibitors (increase Amlodipine levels)
  • NSAIDs (may reduce antihypertensive effect)
  • Potassium-sparing diuretics (risk of hyperkalemia with Olmesartan)

Warning and Precautions

  • Use under medical supervision only
  • Monitor blood pressure and electrolytes regularly
  • Caution in renal impairment

Dosage

As directed by the Physician.