Abetis Plus 40 mg+12.5 mg

Description

Abetis Plus Tablet

Indications

Abetis Plus tablet is prescribed for the treatment of hypertension (high blood pressure).
Take this medication only as directed by a registered physician.

Pharmacology

Angiotensin-II, formed from angiotensin-I through an enzymatic reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor. It plays a crucial role in regulating blood pressure and is a key component in the renin-angiotensin system. Angiotensin-II also stimulates the adrenal cortex to secrete aldosterone.

Olmesartan, a key component of this medication, works by selectively inhibiting the binding of angiotensin-II to the AT1 receptor, which is found in various tissues such as vascular smooth muscle and the adrenal gland. By blocking this binding, Olmesartan prevents vasoconstriction and reduces aldosterone secretion. In vitro studies suggest that Olmesartan is a reversible and competitive inhibitor of the AT1 receptor. Unlike ACE inhibitors, Olmesartan does not interfere with ACE activity or bradykinin degradation.

Hydrochlorothiazide, the second active ingredient, is a thiazide diuretic that influences the renal tubular reabsorption of electrolytes. It enhances sodium and chloride excretion in approximately equal amounts, leading to a reduction in plasma volume. This, in turn, triggers an increase in plasma renin activity, aldosterone secretion, and urinary potassium excretion while lowering serum potassium levels. Since the renin-aldosterone system is mediated by angiotensin-II, co-administration with an angiotensin-II receptor blocker like Olmesartan helps counteract potassium depletion caused by Hydrochlorothiazide.

Dosage & Administration

For the management of hypertension, the usual starting dose is one tablet (20 mg Olmesartan / 12.5 mg Hydrochlorothiazide) once daily. The dosage should be adjusted based on individual patient response. If needed, the dose may be increased at intervals of 2-4 weeks to a maximum of two tablets (40 mg Olmesartan / 25 mg Hydrochlorothiazide) once daily.
Use only as directed by a registered physician.

Drug Interactions

Olmesartan:

• No significant interactions have been reported when taken with hydrochlorothiazide, digoxin, or warfarin.
• Olmesartan is not metabolized by the cytochrome P450 enzyme system, making it unlikely to interact with drugs affecting these enzymes.

Hydrochlorothiazide:

• Alcohol, Barbiturates, or Narcotics: May enhance orthostatic hypotension.
• Antidiabetic Medications (Oral Agents & Insulin): Dose adjustments may be necessary.
• Other Antihypertensive Medications: May have an additive effect.
• Corticosteroids & ACTH: May impact electrolyte balance.
• Lithium: Concomitant use should be avoided due to the risk of toxicity.

Contraindications

This medication should not be used in patients with:

• Known hypersensitivity to Olmesartan, Hydrochlorothiazide, or any other ingredient in the formulation.
• Anuria (inability to produce urine).
• Hypersensitivity to sulfonamide-derived drugs, as Hydrochlorothiazide is a sulfonamide derivative.

Side Effects

Common side effects may include:

• Nausea
• Headache
• Dizziness
• Hyperuricemia (elevated uric acid levels)
• Upper respiratory tract infections
• Urinary tract infections

Less common adverse effects may include:

• Chest pain
• Back pain
• Peripheral edema (swelling in the extremities)
• Abdominal pain
• Indigestion (dyspepsia)
• Gastroenteritis
• Diarrhea

Pregnancy & Lactation

The safety of this medication during pregnancy and breastfeeding has not been established. It should be discontinued if pregnancy is detected or if breastfeeding is planned.

Precautions & Warnings

• Regular monitoring of serum electrolytes is recommended to detect imbalances such as hypokalemia, hyponatremia, and hypochloremic alkalosis.
• Patients receiving thiazide diuretics may experience elevated uric acid levels.
• Use with caution in individuals with impaired kidney function.

Use in Special Populations

Patients with Renal Impairment:

• This medication can be used in patients with a creatinine clearance of more than 30 ml/min.
• In cases of severe renal impairment, loop diuretics are preferred over thiazides. Therefore, Abetis Plus is not recommended for such patients.

Patients with Hepatic Impairment:

• No dosage adjustment is required for individuals with liver impairment.

Pediatric Use:

• Safety and efficacy in children have not been established.

Geriatric Use:

• Clinical studies have not determined whether elderly patients respond differently from younger individuals. Dose selection for elderly patients should be done with caution.

Overdose Effects

Olmesartan:

• Limited data are available regarding overdose in humans.
• Symptoms may include low blood pressure (hypotension) and increased heart rate (tachycardia). Supportive care should be provided.

Hydrochlorothiazide:

• Overdose symptoms are typically related to excessive diuresis and electrolyte imbalances, such as hypokalemia, hypochloremia, and dehydration.
• If digitalis is being used simultaneously, hypokalemia may worsen cardiac arrhythmias.

Therapeutic Class

Combination antihypertensive medication.

Storage Conditions

• Store in a cool and dry place, away from direct light and moisture.
• Keep out of reach of children.