Duovas 5/40 Tablet 7pcs

✔️ Uses of Duovas 5/40 Tablet

Treatment of Hypertension (high blood pressure)

✔️ How does Duovas 5/40 Tablet work?

• 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 Duovas 5/40 Tablet

Possible side effects include headaches, drowsiness, ankle swelling, nausea, dizziness, and low blood pressure. Most side effects are mild and transient.

✔️ Quick Suggestions:

• Aim for a body mass index (BMI) between 19.5 and 24.9. Excess weight can contribute to high blood pressure, so focus on achieving and maintaining a healthy weight through a balanced diet and regular exercise.
• Engage in at least 150 minutes of moderate-intensity aerobic activity, such as brisk walking, cycling, or swimming, each week. This can help lower elevated blood pressure by approximately 5 mmHg.
• Adopt a diet rich in whole grains, fruits, vegetables, and low-fat dairy products. These foods are high in essential nutrients and fiber, which can help lower blood pressure and improve overall heart health.
• Reduce your daily sodium chloride (table salt) intake to 2300 mg or less per day. Ideally, aim for less than 1500 mg of sodium per day, especially if you have high blood pressure or are at risk for cardiovascular disease.
• If you drink alcohol, do so in moderation. Limit intake to one serving per day for women and up to two servings per day for men. Excessive alcohol consumption can raise blood pressure and increase the risk of heart disease.
• Smoking is a significant risk factor for heart disease and can contribute to high blood pressure. Quitting smoking is one of the most effective ways to reduce the risk of heart disease and lower blood pressure.
• Chronic stress can elevate blood pressure, so it's essential to find healthy ways to manage stress. Practice relaxation techniques such as deep breathing, meditation, yoga, or spending time with loved ones.
• Keep track of your blood pressure regularly, especially if you have hypertension or are at risk for high blood pressure. If you notice significant fluctuations in your blood pressure readings, consult your doctor promptly.
• Include foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel, trout), flaxseeds, chia seeds, and walnuts, in your diet. These healthy fats can help lower blood pressure and reduce the risk of heart disease.
• Opt for heart-healthy cooking oils like olive oil, soybean oil, canola oil, and coconut oil. These oils contain unsaturated fats and can help improve cholesterol levels and lower blood pressure when used in moderation.

✔️ Blood pressure

Blood pressure is a vital measure of the force exerted by the heart to pump blood throughout the body. When blood pressure remains persistently high, it leads to a condition called hypertension. This chronic condition can have severe health consequences, including:

• Hardened Arteries: Hypertension can cause the arteries (blood vessels) to become stiff and narrow, reducing the flow of blood and oxygen to the heart. This can result in complications such as angina (chest pain) and myocardial infarction (heart attack).
• Brain Damage: Elevated blood pressure increases the risk of stroke by damaging the blood vessels in the brain. A stroke occurs when the blood supply to a part of the brain is disrupted, leading to neurological deficits and potentially life-threatening consequences.
• Kidney Failure: High blood pressure can damage the blood vessels in the kidneys, impairing their ability to filter waste products from the blood effectively. Over time, this can result in kidney failure, necessitating dialysis or kidney transplantation.

Diagnosing hypertension typically involves measuring blood pressure using a sphygmomanometer, which records two values:

• Systolic Pressure: This is the pressure exerted by the heart when pumping blood out during a heartbeat.
• Diastolic Pressure: This is the pressure in the arteries when the heart is at rest between beats.

For example, a blood pressure reading of 140/90 mmHg indicates a systolic pressure of 140 mmHg and a diastolic pressure of 90 mmHg. The ideal blood pressure range is typically considered to be between 90/60 mmHg and 120/80 mmHg.

Monitoring blood pressure regularly and maintaining it within the normal range is essential for preventing cardiovascular complications and ensuring overall health and well-being. Lifestyle modifications, such as a healthy diet, regular exercise, stress management, and avoiding tobacco and excessive alcohol consumption, play a crucial role in managing blood pressure.

✔️ Pharmacology

Amlodipine, a dihydropyridine calcium channel blocker, works by inhibiting the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle cells. It primarily affects vascular smooth muscle cells, leading to peripheral arterial vasodilation, reduced peripheral vascular resistance, and lowered blood pressure.

Olmesartan Medoxomil, on the other hand, blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking its binding to the AT1 receptor. This action prevents angiotensin II from exerting its effects on tissues such as vascular smooth muscle and the adrenal gland. Olmesartan Medoxomil is a reversible, competitive inhibitor of the AT1 receptor and does not inhibit ACE, the enzyme responsible for converting angiotensin I to angiotensin II.

Together, the combination of amlodipine and olmesartan medoxomil helps to further reduce blood pressure by targeting different pathways involved in the regulation of vascular tone and blood volume. This combination of medication is effective in managing hypertension and reducing the risk of cardiovascular events.

✔️ Dosage & Administration of Duovas 5/40 Tablet

When substituting individually titrated components for patients currently on Amlodipine and Olmesartan Medoxomil, the following approach can be taken:

1. Evaluate the current doses of Amlodipine and Olmesartan Medoxomil the patient is taking.
2. Determine the equivalent dose of each component in the combination medication (e.g., 5/20 mg or 10/40 mg).
3. Titrate the doses of Amlodipine and Olmesartan Medoxomil individually based on the patient's blood pressure response and tolerability.
4. Monitor the patient closely for any signs of hypotension, dizziness, or other adverse effects during the titration process.
5. Adjust the doses of Amlodipine and Olmesartan Medoxomil as needed to achieve the desired blood pressure control, up to a maximum of 10/40 mg once daily.

For initial therapy, the combination of 5/20 mg can be started once daily for 1 to 2 weeks. If necessary, the doses can be titrated upwards to achieve optimal blood pressure control. However, it's important to note that the lowest dose of the combination is 5/20 mg, so initial therapy with this combination drug may not be suitable for patients over 75 years old due to decreased clearance of Amlodipine among elderly patients. In such cases, individual components can be titrated separately to achieve the desired therapeutic effect.

Can be taken with or without food, with a glass of water. Do not chew, bite, or break the tablet.

✔️ Interaction

A. Drug-Drug Interactions:

Before taking Duovas 5/40 Tablet, inform your doctor if you are taking any of the following medicines:

1. Other blood pressure-lowering medicines: ACE inhibitors (e.g., enalapril, lisinopril, ramipril) or aliskiren.
2. Potassium-containing medicines: Potassium supplements, salt substitutes containing potassium (e.g., losartan potassium), and diuretics (e.g., spironolactone).
3. Non-Steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, aspirin, diclofenac.
4. Certain antacids: Aluminium hydroxide or magnesium hydroxide.
5. Medicines for controlling blood cholesterol levels: Colesevelam, simvastatin.
6. Medicines for HIV infection: Ritonavir, nelfinavir, indinavir.
7. Medicines for fungal infections: Ketoconazole, itraconazole.
8. Immunosuppressants: Tacrolimus, sirolimus, temsirolimus, everolimus, cyclosporin.
9. Heparin: Used for blood thinning and prevention of blood clots.
10. Lithium: Used to treat depression or other mental illnesses.
11. Diltiazem and verapamil: Used to treat abnormal heart rhythm and high blood pressure.
12. Rifampicin: Used to treat tuberculosis.
13. Erythromycin or clarithromycin: Used to treat bacterial infections.
14. St. John’s Wort: Herbal medicine used to treat depression.
15. Dantrolene: Used to treat muscle spasms or rigidity.

B. Drug-Food Interaction:

Avoid consuming grapefruit or grapefruit juice while taking Duovas 5/40 Tablet. Grapefruit can increase the levels of amlodipine in the blood, leading to an unpredictable decrease in blood pressure.

✔️ Contraindications

Avoid if you have low blood pressure (hypotension) or cardiogenic shock. Do not consume grapefruit juice or St. John's wort while taking Duovas 5/40 Tablet.

✔️ Pregnancy & Lactation

The combination of Amlodipine and Olmesartan Medoxomil is classified as Pregnancy Category D, indicating a risk of harm to the fetus if used during the 2nd and 3rd trimesters of pregnancy. Therefore, it is not recommended for use during this time period. If pregnancy is detected while a patient is taking this combination medication, it should be discontinued as soon as possible under the guidance of a healthcare professional.

It is not known whether Olmesartan and Amlodipine are excreted in human milk. Due to the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother's health. It's essential for breastfeeding mothers to consult with their healthcare provider to weigh the risks and benefits before making a decision regarding the use of this medication.

✔️ Precautions & Warnings

Inform your doctor if you have kidney, liver, heart disease, or diabetes. Not recommended during pregnancy or breastfeeding. Avoid use in children under 12 years of age.

✔️ Storage Conditions:

Store in a cool and dry place away from sunlight