Duopres 5/20mg Tablet

✔️ Uses of Duopres 5/20mg Tablet

• Treats High Blood Pressure (among patients who remain unresponsive to therapy with either Olmesartan or Amlodipine alone)

✔️ How does Duopres 5/20mg Tablet work?

Duopres 5/20mg Tablet is a combination of Amlodipine and Olmesartan. 

• Amlodipine works by relaxing your heart muscles and blood vessels so that blood can flow more easily.
• Olmesartan relaxes and widens your blood vessels. This lowers your blood pressure and makes it easier for your heart to pump blood throughout your body.

✔️ Side Effects of Duopres 5/20mg Tablet

Common side effects of Duopres 5/20mg Tablet include dizziness, headache, swelling in hands/feet, tiredness, bronchitis, sore throat, runny nose, cough, nausea, diarrhea, constipation, joint or bone pain, back pain, urinary tract infections, chest pain, flu-like symptoms, visual disturbances, and difficulty breathing.

Less common side effects encompass dizziness upon standing, lack of energy, tingling/numbness in hands/feet, vertigo, awareness of heartbeat, fast heartbeat, low blood pressure symptoms, cough, vomiting, dry mouth, upper abdominal pain, skin rash, cramps, pain in arms/legs, increased urge to urinate, sexual inactivity, and difficulty with erection.

Rare side effects involve fainting, severe allergic reactions, redness/warmth in the face, red and itchy bumps, and swelling of the face. Seek medical help immediately if you experience severe allergic reactions, signs of hypotension, severe persistent diarrhea with weight loss, or jaundice-like symptoms.

✔️ Quick Suggestions:

• Duopres 5/20mg Tablet is a combination of two medicines that provides better blood pressure control than either medicine alone.
• It may cause dizziness or sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
• It may cause you to feel lightheaded or weak especially when you stand up.  Rise slowly if you have been sitting or lying down.
• Avoid consuming alcohol as it may enhance the blood pressure lowering effect of Amlodipine + Olmesartan Medoxomil.
• It can cause ankle or foot swelling. Raise your legs while you are sitting down and talk to your doctor if it does not go away.
• Do not take Amlodipine + Olmesartan Medoxomil Tablet if you are pregnant, planning to conceive or breastfeeding.

✔️ Indication of Duopres 5/20mg Tablet

Hypertension or high blood pressure is a condition in which the force exerted by the circulating blood on the walls of the blood vessel is high. Duopres 5/20mg Tablet is used to control high blood pressure.

✔️ Pharmacology

Amlodipine, a dihydropyridine calcium channel blocker, primarily affects vascular smooth muscle cells by reducing the flow of calcium ions through their membranes. This leads to vasodilation in peripheral arterial vasculature, lowering peripheral vascular resistance and blood pressure. Amlodipine's impact on vascular smooth muscle cells is more significant compared to its effect on cardiomyocytes.

Angiotensin II, a potent vasoconstrictor and key hormone in the renin-angiotensin system, is generated from angiotensin I via the action of angiotensin-converting enzyme (ACE). It plays a crucial role in the pathophysiology of hypertension and stimulates the adrenal cortex to release aldosterone.

Olmesartan medoxomil works by specifically inhibiting the binding of angiotensin II to AT1 receptors, present in various tissues such as vascular smooth muscle and adrenal glands. This inhibition leads to reduced vasoconstriction and aldosterone secretion. Olmesartan medoxomil is a competitive and reversible AT1 receptor antagonist, demonstrated through in vitro binding studies. Unlike ACE inhibitors, olmesartan medoxomil does not interfere with ACE (kinase II), which converts angiotensin I to angiotensin II and also breaks down bradykinin.

✔️ Dosage & Administration of Duopres 5/20mg Tablet

For patients who are currently taking Amlodipine and Olmesartan Medoxomil individually and need a substitute, the components can be titrated as follows:

• Amlodipine: The starting dose of Amlodipine can be adjusted based on the patient's condition. If an increased amount of Amlodipine is required, it can be titrated as needed.
• Olmesartan Medoxomil: Similarly, the starting dose of Olmesartan Medoxomil can be adjusted based on the patient's condition. If an increased amount of Olmesartan Medoxomil is needed, it can be titrated accordingly.
• The combination of Amlodipine and Olmesartan Medoxomil can also be given with increased amounts of either or both components, as needed for effective blood pressure control.
• For initial therapy with the combination of Amlodipine and Olmesartan Medoxomil, it is recommended to start with 5/20 mg once daily for 1 to 2 weeks. The dose can be titrated as necessary, but the maximum recommended dose is 10/40 mg once daily.
• In elderly patients (75 years and above), due to decreased clearance of Amlodipine, the recommended starting dose of Amlodipine is 2.5 mg. However, the lowest dose available in the combination of Amlodipine and Olmesartan Medoxomil is 5/20 mg. Therefore, initial therapy with this combination drug is not recommended in patients older than 75 years.

Take Duopres 5/20mg Tablet as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of Duopres 5/20mg Tablet for you depending on your age, body weight, and disease condition.

✔️ Interaction

Duopres 5/20mg Tablet can interact with several medications:

Drug-Drug Interactions:

• It may interact with other high blood pressure-lowering medications like metoprolol, ramipril, and hydrochlorothiazide.
• Interactions can occur with drugs used to control lipid levels in the blood such as atorvastatin and simvastatin.
• Medicines used to treat erectile dysfunction like sildenafil might have interactions.
• Antibiotics like erythromycin and rifampin, as well as antifungal medications itraconazole and ketoconazole, can interact with Duopres 5/20mg Tablet.
• Anti-HIV drugs like ritonavir, anti-epilepsy medicines including carbamazepine, phenytoin, phenobarbital, and primidone, and immune-suppressing drugs like cyclosporine and tacrolimus might have interactions.
• Painkillers like ibuprofen and aspirin can interact with Duopres 5/20mg Tablet.

Drug-Food Interactions:

• Duopres 5/20mg Tablet can interact with grapefruit, grapefruit juices, and St. John’s wort, a plant used to treat depression. Therefore, it's recommended to avoid these while taking Duopres 5/20mg Tablet.

Drug-Disease Interactions:

• Duopres 5/20mg Tablet should not be given to individuals with conditions such as cardiogenic shock (when the heart fails to pump sufficient blood), heart valve problems (stenosis), low blood pressure (hypotension), liver disease, or heart failure.

✔️ Contraindications

• If you are allergic to amlodipine or olmesartan or any ingredients of Duopres 5/20mg Tablet.
• If you are pregnant or may be pregnant.
• If you have any medical conditions such as liver or kidney disease or any kind of heart disorder.
• If you have diabetes or kidney-related disorders and taking Aliskiren to treat high blood pressure.
• If you suffer from severe low blood pressure or experienced shock recently.

✔️ Pregnancy & Lactation

The pregnancy category for the combination of amlodipine and olmesartan medoxomil is "D." This means that there is evidence of risk to the fetus, and the use of this combination should be avoided during the second and third trimesters of pregnancy due to the potential for fetal mortality. If pregnancy is detected, this combination should be discontinued as soon as possible.

Both olmesartan and amlodipine are not known to be excreted in human milk. However, due to the potential risk of harm to the nursing child, a decision should be made whether to discontinue breastfeeding or to discontinue taking the medicine, considering the benefits of the medication for the mother.

✔️ Precautions & Warnings

• Duopres 5/20mg Tablet should not be taken by individuals who are allergic to the medication or any of its ingredients.
• It is also contraindicated for those with low blood pressure (less than 90 mmHg), a history of heart attack, kidney disease, liver disease, and for pregnant or breastfeeding women.
• Additionally, individuals with conditions such as low blood pressure (hypotension), cardiogenic shock (sudden cessation of blood flow to the heart), and aortic stenosis (a heart valve problem) should not take Duopres 5/20mg Tablet.
• The medication can pass into breast milk, but its effect on the nursing baby is not well known. Therefore, if you are taking Duopres 5/20mg Tablet and breastfeeding, it's important to inform your doctor.
• Grapefruit juice and St. John's wort plant should be avoided while taking Duopres 5/20mg Tablet as they are contraindicated. Drinking alcohol while using Duopres 5/20mg Tablet can lead to low blood pressure, so it's advisable to avoid alcoholic beverages.

✔️ Storage Conditions

Store it in a cool and dry place away from light and moisture. Keep it out of the reach of children and pets.