Calnor 5 mg+20 mg

Description

Indications
Calnor is prescribed for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive medications, to effectively lower blood pressure. It is also recommended as an initial therapy for patients who are likely to require multiple antihypertensive agents to achieve optimal blood pressure control. The decision to initiate combination therapy should be based on individual patient factors, including baseline blood pressure levels, target goals, and the probability of reaching those goals more effectively with a combination rather than a single agent. Blood pressure targets may vary depending on the patient’s specific health risks.

Pharmacology Amlodipine is a long-acting dihydropyridine calcium channel blocker that works by inhibiting the influx of calcium ions across cell membranes in vascular smooth muscle and cardiac muscle. It has a more pronounced effect on vascular smooth muscle, leading to peripheral arterial vasodilation, a decrease in vascular resistance, and reduced blood pressure levels.

Olmesartan Medoxomil, an angiotensin II receptor blocker (ARB), prevents the binding of angiotensin II to the AT1 receptors located in various tissues, including vascular smooth muscle and the adrenal gland. Angiotensin II is a key factor in hypertension, acting as a potent vasoconstrictor and stimulating aldosterone secretion. By blocking its effects, Olmesartan Medoxomil helps reduce blood pressure and alleviate hypertension without inhibiting angiotensin-converting enzyme (ACE), thereby avoiding the breakdown of bradykinin.

Dosage & Administration For patients already taking Amlodipine and Olmesartan Medoxomil separately, this combination may be used as a substitute. Dosages can be adjusted by increasing either or both components as necessary.

• Initial Therapy: Start with 5/20 mg once daily for 1 to 2 weeks, with titration as needed up to a maximum dosage of 10/40 mg once daily.
• Elderly Patients: Due to reduced clearance of Amlodipine in elderly individuals, a starting dose of 2.5 mg is recommended for those aged 75 years and older. Since the lowest available combination dose is 5/20 mg, initial combination therapy is not recommended for patients over 75 years of age.

Drug Interactions

• The antihypertensive effects of angiotensin II receptor blockers, including Olmesartan Medoxomil, may be diminished by NSAIDs, including selective COX-2 inhibitors.
• Patients on combination therapy should be monitored closely for blood pressure, renal function, and electrolyte balance, particularly if taking other agents that influence the renin-angiotensin system.

Contraindications

• Should not be co-administered with Aliskiren in diabetic patients.

Side Effects Common side effects include:

• Peripheral edema
• Headache
• Flushing
• Dizziness

Rarely, it may cause intestinal issues resembling sprue-like enteropathy.

Pregnancy & Lactation

• Pregnancy: Classified as Pregnancy Category D. This combination should not be used during the second and third trimesters due to the risk of fetal harm or death. If pregnancy is detected, the medication should be discontinued immediately.
• Lactation: It is not known whether Olmesartan or Amlodipine is excreted in human breast milk. Due to potential risks to the nursing infant, a decision should be made whether to discontinue the medication or cease breastfeeding, based on the mother’s clinical need.

Precautions & Warnings

• Patients with volume or salt depletion should use this medication with caution to prevent hypotension.
• Severe aortic stenosis may increase the risk of excessive vasodilation.
• Patients with severe coronary artery disease may experience increased frequency or severity of angina or myocardial infarction (MI).

Use in Special Populations

• Pediatric Use: The safety and effectiveness in children have not been established.
• Geriatric Use: No significant differences in efficacy or safety have been noted between elderly patients and younger individuals.
• Renal Impairment: No studies are available regarding the use of this combination in patients with renal impairment.
• Hepatic Impairment: Initial therapy is not recommended for patients with hepatic impairment.

Overdose Effects There is limited data available on overdose in humans. In case of overdose, appropriate supportive treatment should be administered based on symptoms.

Therapeutic Class Combination antihypertensive agents

Storage Conditions

• Store below 30°C.
• Protect from light.
• Keep out of reach of children.