Olmetor Plus

Angiotensin-II is formed from angiotensin-I in a reaction catalyzed by angiotensin-converting enzyme (ACE). It is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system, and an important part of how hypertension develops. It also stimulates the adrenal cortex to secrete aldosterone.

Olmesartan, the first component of Olmesartan Medoxomil + Hydrochlorothiazide, blocks both the vasoconstrictor effect and the aldosterone-secreting effect of angiotensin-II. It does this by selectively blocking angiotensin-II from binding to the AT 1 receptor, which is found in many tissues (for example vascular smooth muscle and the adrenal gland). In-vitro-binding studies show that Olmesartan is a reversible and competitive inhibitor of the AT 1 receptor. It does not inhibit ACE (kinase-I), the enzyme that converts angiotensin-I to angiotensin-II and also breaks down bradykinin.

Hydrochlorothiazide is a thiazide diuretic. Thiazides act on the mechanisms in the renal tubules that reabsorb electrolytes, and they directly increase the excretion of Sodium and Chloride in approximately equivalent amounts. Indirectly, the diuretic action of Hydrochlorothiazide reduces plasma volume. This raises plasma renin activity, increases Aldosterone secretion and urinary Potassium loss, and lowers serum Potassium. Angiotensin-II mediates the link between renin and aldosterone, so giving an angiotensin-II receptor antagonist together with the diuretic tends to reverse the potassium loss these diuretics cause.

Nobody has established that Olmesartan Medoxomil + Hydrochlorothiazide is safe or works properly in pregnant women or in nursing mothers. For this reason, the medicine should be stopped in both situations.

Renal impairment: You can follow the usual treatment regimens with Olmesartan Medoxomil + Hydrochlorothiazide as long as the patient's creatinine clearance is above 30 ml/min. In more severe renal impairment, loop diuretics are preferred to thiazides, so this combination is not recommended.

Hepatic impairment: No dose adjustment is needed.

Paediatric use: Safety and effectiveness in paediatric patients have not been established.

Geriatric use: Clinical studies of the olmesartan and hydrochlorothiazide combination did not include enough subjects aged 65 and over to show whether they respond differently from younger subjects. In general, the dose for an elderly patient should be chosen with caution.

Olmesartan: There isn't much information on overdose in humans. The most likely effects of an overdose would be low blood pressure (hypotension) and a fast heartbeat (tachycardia). Supportive treatment should be started.

Hydrochlorothiazide: The signs and symptoms seen most often come from loss of electrolytes (hypokalemia, hypochloremia and dehydration), which happens because of excessive diuresis. If digitalis has also been given, hypokalemia may make cardiac arrhythmias worse.

Keep Olmesartan Medoxomil + Hydrochlorothiazide in a cool, dry place, away from light and moisture. Keep it out of the reach of children.