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نشرة الممارس الصحي نشرة معلومات المريض بالعربية نشرة معلومات المريض بالانجليزية صور الدواء بيانات الدواء
  SFDA PIL (Patient Information Leaflet (PIL) are under review by Saudi Food and Drug Authority)

Olcontro® belongs to a group of medicines called angiotensin-II receptor antagonists. They lower blood pressure by relaxing the blood vessels.

Olcontro® is used for the treatment of high blood pressure (also known as ‘hypertension’). High blood pressure can damage blood vessels in organs such as the heart, kidneys, brain and eyes. In some cases this may lead to a heart attack, heart or kidney failure, stroke or blindness. Usually high blood pressure has no symptoms. It is important to have your blood pressure checked to prevent damage occurring.

High blood pressure can be controlled with medicines such as Olcontro® tablets. Your doctor has probably also recommended that you make some changes in your lifestyle to help lower your blood pressure (for example losing weight, giving up smoking, reducing the amount of alcohol you drink and reducing the amount of salt in your diet). Your doctor may also have urged you to take regular exercise, such as walking or swimming. It is important to follow this advice from your doctor.


Do not take Olcontro®:

If you are allergic (hypersensitive) to olmesartan medoxomil or any of the other ingredients of Olcontro®.

If you are more than 3 months pregnant. (It is also better to avoid Olcontro® tablets in early pregnancy).

Olcontro® should not be co-administered with aliskiren in patients with diabetes mellitus or renal impairment

If you suffer from yellowing of the skin and eyes (jaundice) or problems with drainage of the bile from the gallbladder (biliary obstruction e.g. gallstones).

Take special care with Olcontro®

Before you take the tablets, tell your doctor if you have any of the following health problems:

Dual Blockade of the Renin-Angiotensin-aldosterone System (RAAS):

Combination of Olcontro® with ACE inhibitors, or aliskiren may cause increased risks of hyperkalemia, worsening of kidney function and hypotension. Therefore, this combination should not be used, especially in patients with kidney problems.

Kidney problems.

Liver disease.

Heart failure or problems with your heart valves or heart muscle.

Severe vomiting, diarrhoea, treatment with high doses of water tablets (diuretics) or if you are on a low salt diet.

Increased levels of potassium in your blood.

Problems with your adrenal glands.

As with any medicine which reduces blood pressure, an excessive drop in blood pressure in patients with blood flow disturbances of the heart or brain could lead to a heart attack or stroke. Your doctor will therefore check your blood pressure carefully.

You must tell your doctor if you think you are (or might become) pregnant. Olcontro® is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage.

Other medicines and Olcontro®

Please tell your doctor or pharmacist if you are taking or have recently taken any of the following medicines:

Dual RAAS Blockade, The combination of Olcontro® with Aliskiren, ACEIs or other ARBs is contraindicated in patients with diabetes mellitus or renal impairment.

Dual blockade (e.g by adding ACE inhibitor to Olcontro®) should not be used, especially in patients with kidney problems.

Potassium supplements, a salt substitute which contains potassium, water tablets (diuretics) or heparin (for thinning the blood). Using these medicines at the same time as Olcontro® may raise the levels of potassium in your blood.

Lithium (a medicine used to treat mood swings and some types of depression) used at the same time, as Olcontro® may increase the toxicity of lithium. If you have to take lithium, your doctor will measure your lithium blood levels.

Non-Steroidal Anti-Inflammatory (NSAIDs) medicines (medicines used to relieve pain, swelling and other symptoms of inflammation, including arthritis) used at the same time as Olcontro® may increase the risk of kidney failure and the effect of Olcontro® can be decreased by NSAIDs.

Other blood pressure lowering medicines, as the effect of Olcontro® can be increased.

Certain antacids (indigestion remedies), as the effect of Olcontro® can be slightly decreased.

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Taking Olcontro® with food and drink

Olcontro® can be taken with or without food. Swallow the tablets with a little water. If possible, take your daily dose at the same time each day, for example at breakfast time.

Children and adolescents (under 18)

Olcontro® is not recommended for children and adolescents under the age of 18.

Elderly patients

If you are over 65 years of age and your doctor decides to increase your dose of Olcontro® to 40 mg daily, then you need to have your blood pressure regularly checked by your doctor to make sure that your blood pressure does not become too low.

Black patients

As with other similar drugs the blood pressure lowering effect of Olcontro® is somewhat less in black patients.

Pregnancy and breastfeeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Olcontro® before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Olcontro®. Olcontro® is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Olcontro® is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

It is unlikely that Olcontro® will affect your ability to drive or operate machinery. However, dizziness or fatigue can occasionally occur during the treatment of high blood pressure. If you notice such effects, do not drive or use machines until the symptoms wear off. Ask your doctor for advice.

Olcontro® contains lactose

This medicine contains lactose (a type of sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.


Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The tablets can be taken with or without food. Swallow the tablets with a little water. If possible, take your daily dose at the same time each day, for example at breakfast time.

The usual starting dose is one 10 mg tablet once a day. However, if your blood pressure is not controlled, your doctor may decide to change your dose up to 20 or 40 mg once a day, or prescribe additional medicines.

In patients with mild to moderate kidney disease, your dose will not be higher than 20 mg once a day.

If you take more Olcontro® than you should

If you take more tablets than you should or if a child accidentally swallows some, go to your doctor or nearest emergency department immediately and take your medicine pack with you.

If you forget to take Olcontro®

If you forget a dose, take your normal dose on the following day as usual. Do not take any extra tablet to make up for the missed dose.

If you stop taking Olcontro®

It is important to continue to take Olcontro® unless your doctor tells you to stop. 

If you have any further questions on the use of this product, ask your doctor or pharmacist.


Like all medicines, Olcontro® can cause side effects, although not everybody gets them. If they do occur, they are often mild and do not require treatment to be stopped.

Although not many people may get them, the following two side effects can be serious:

On very rare occasions the following allergic reactions have been reported:

Swelling of the face, mouth and/or larynx (voice box) together with itching and rash may occur during treatment with olmesartan. If this happens stop taking Olcontro® and contact your doctor immediately.

Rarely (but slightly more often in elderly people) olmesartan can cause the blood pressure to fall too low in susceptible individuals. This could cause severe light-headedness or fainting. If this occurs stop taking Olcontro®, contact your doctor immediately and lie down flat.

To give you an idea of how many patients might get side effects, they have been listed as common, uncommon, rare and very rare. These mean the following:

Common (less than 1 in 10 people).

Uncommon (less than 1 in 100 people).

Rare (less than 1 in 1,000 people).

Very rare (less than 1 in 10,000 people).

Common side effects:

Dizziness, nausea, indigestion, diarrhea, stomach ache, gastroenteritis, tiredness, sore throat, runny or stuffy nose, bronchitis, flu-like symptoms, cough, pain in the chest, back, bones or joints, infection of the urinary tract, swelling of ankles, feet, legs, hands, or arms, blood in the urine.

Some changes in blood test results have also been seen and include the following:

Increased fat levels (hypertriglyceridaemia), increased uric acid levels (hyperuricaemia), increases in tests of liver and muscle function.

Uncommon side effects:

Vertigo, skin rash, angina (pain or uncomfortable feeling in the chest).

Rare side effects:

Rarely, blood test results have shown increased potassium levels (hyperkalaemia).

Very rare side effects:

Headache, muscle cramps and muscular pain, impaired kidney function, kidney failure, weakness, lack of energy, feeling unwell, vomiting, itching, exanthema (skin eruption).

Some changes in blood test results have also been seen. These include increased levels of compounds related to kidney function and reduced numbers of a type of blood cell, known as platelets (thrombocytopenia).

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Not known:

Sprue-like enteropathy, you should contact your healthcare professional right away if you experience severe diarrhea, diarrhea that does not go away, or significant weight loss.

If any of the side effects get serious or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist


Keep out of the reach and sight of children.

Do not use Olcontro® tablets after the expiry date (EXP) which is stated on the blister and the carton.

The expiry date refers to the last day of that month.

Olcontro® tablets: Store below 30°C.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.


What Olcontro® tablets contain

The active substance is olmesartan medoxomil.

The other ingredients are Lactose monohydrate spray dried, microcrystalline cellulose, sodium starch glycolate, hydroxypropyl cellulose, colloidal silicon dioxide, magnesium stearate, instacoat universal white (HPMC/Hypromellose, Titanium Dioxide, talc).


Olcontro® 20 mg: White, round, biconvex, film-coated tablets engraved with “I31” on one side and plain on other side, presented in Alu/Alu blisters, intended for oral use. Pack size: 28 Film Coated tablets (7 Film Coated tablets / Blister, 4 blisters/pack). Olcontro® 40 mg: White, oval, biconvex, film-coated tablets tablets engraved with “I33” on one side and plain on other side, presented in Alu/Alu blisters, intended for oral use. Pack size: 28 Film Coated tablets (7 Film Coated tablets / Blister, 4 blisters/pack).

Med City Pharma-KSA.

1st Industrial city, Phase 5, Jeddah –KSA.

Tel: 00966920003288

Mobile: 00966555786968

P.O .Box: 4072 - Jeddah 22429

E-mail: info@medcitypharma.com


05/2024
  نشرة الدواء تحت مراجعة الهيئة العامة للغذاء والدواء (اقرأ هذه النشرة بعناية قبل البدء في استخدام هذا المنتج لأنه يحتوي على معلومات مهمة لك)

ينتمي أولكونترو® إلى مجموعة من الأدوية تعرف بمضادات مستقبلات إنزيم أنجيوتنسين-ǁ. والتي تعمل على خفض ضغط الدم عن طريق إرخاء الأوعية الدموية.

يستعمل أولكونترو® لعلاج ارتفاع ضغط الدم. من الممكن أن يسبب ارتفاع ضغط الدم تلف الأوعية الدموية في الأعضاء مثل القلب، الكلى، الدماغ و العيون. في بعض الحالات قد يؤدي هذا إلى نوبة قلبية، قصور وظيفة عضلة القلب أو قصور وظيفة الكلى، سكتة دماغية أو فقدان البصر. عادة لا يسبب ارتفاع ضغط الدم أي أعراض. لذلك من المهم مراقبة ضغط الدم للوقاية من حدوث تلف.

من الممكن السيطرة على ارتفاع ضغط الدم عن طريق استعمال أدوية مثل أقراص أولكونترو®. من المحتمل أيضا أن يوصي طبيبك بإجراء بعض التغييرات في نمط حياتك للمساعدة في خفض ضغط الدم (مثلا فقدان الوزن، الإقلاع عن التدخين، تقليل كمية الكحول التي تتناولها وتقليل كمية الملح في النظام الغذائي). قد يطلب الطبيب منك أيضا الالتزام بممارسة التمارين الرياضية بشكل منتظم، مثل المشي أو السباحة. من المهم أن تتبع هذه النصيحة من طبيبك.

يجب عدم تناول أولكونترو® في الحالات التالية:

إذا كنت تعاني من التحسس (فرط التحسس) لأولميسارتان ميدوكسوميل أو لأي مكونات أخرى في أولكونترو®.

إذا كان عمر الحمل يزيد عن ثلاثة أشهر. (يفضل أيضا تجنب تناول أقراص أولكونترو® خلال الأشهر الأولى من الحمل).

تجنب تناول أولكونترو® بالتزامن مع أليسكرين عند الأشخاض الذين يعانون من داء السكري أو قصور في وظيفة الكلى.

إذا كنت تعاني من اصفرار الجلد و المنطقة البيضاء في العيون (اليرقان) أو مشاكل متعلقة  في إفراز الصفراء من الحويصلة الصفراوية (انسداد صفراوي مثل الحصاة الصفراوية).

الاحتياطات الخاصة مع أولكونترو®

أخبر طبيبك إذا كنت تعاني من أي من المشاكل الصحية التالية، قبل أن تتناول الأقراص:

الحصر المزدوج لنظام رينين-أنجيوتنسين-ألدوستيرون:

تناول أولكونترو® بالتزامن مع مثبطات الإنزيم المحول للأنجيوتنسين أو أليسكرين قد يسبب زيادة خطر فرط البوتاسيوم في الدم، ازدياد وظيفة الكلى سوءا و انخفاض ضغط الدم. لذلك، يجب تجنب تناولهما معا، خاصة عند المرضى الذين يعانون من مشاكل في الكلى.

مشاكل في الكلى.

أمراض في الكبد.

قصور وظيفة عضلة القلب أو مشاكل في صمامات القلب أو عضلة القلب.

قيء حاد، إسهال، العلاج باستعمال جرعات عالية من أقراص الماء (مدرات البول) أو إذا كنت تتبع نظام غذائي منخفض الأملاح.

زيادة مستويات البوتاسيوم في الدم.

 مشاكل في الغدد الكظرية.

كما هو الحال مع أي دواء يخفض من ضغط الدم، قد يؤدي الانخفاض المفرط في ضغط الدم عند المرضى الذين يعانون من اضطرابات في تدفق الدم من القلب أو إلى الدماغ إلى نوبة قلبية أو سكتة دماغية. لذلك، سوف يراقب طبيبك ضغط الدم بحذر. يجب عليك إخبار طبيبك إذا كنت تعتقدين بأنك حامل (أو من المحتمل حصول الحمل). لا يوصى باستعمال أولكونترو® خلال الأشهر الأولى من الحمل، ويجب عدم تناوله إذا كان عمر الحمل يزيد عن ثلاثة أشهر، حيث قد يؤدي استعماله في هذه المرحلة إلى حدوث أذى خطير على الجنين.

الأدوية الأخرى و أولكونترو ®

الرجاء إخبار طبيبك أو الصيدلي إذا كنت تتناول أو تناولت مؤخرا أي من الأدوية التالية:

الحصر المزدوج لنظام رينين-أنجيوتنسين-ألدوستيرون. يجب عدم تناول أولكونترو® بالتزامن مع أليسكرين، مثبطات الإنزيم المحول للأنجيوتنسين أو مضادات مستقبلات الأنجيوتنسين عند المرضى الذين يعانون من داء السكري أو قصور في وظيفة الكلى.

يجب عدم استعمال الحصر المزدوج (مثلا، عن طريق إضافة مثبطات الإنزيم المحول للأنجيوتنسين إلى أولكونترو®) خاصة عند المرضى الذين يعانون من مشاكل في الكلى.

مكملات البوتاسيوم، بدائل الملح المحتوية على البوتاسيوم، أقراص الماء (مدرات البول) أو الهيبارين (للوقاية من تجلط الدم). قد يؤدي استعمال هذه الأدوية بالتزامن مع أولكونترو® إلى ارتفاع مستويات البوتاسيوم في الدم.

الليثيوم (دواء يستعمل لعلاج تقلبات المزاج و بعض أنواع الاكتئاب) قد يسبب تناوله بشكل متزامن مع أولكونترو® زيادة سمية الليثيوم. إذا كان من الضروري تناول الليثيوم، سيقوم طبيبك بفحص مستوى الليثيوم في الدم.

الأدوية غير الستيرويدية المضادة للالتهاب (أدوية تستعمل لتخفيف الألم، التورم وأعراض الالتهاب الأخرى، بما في ذلك التهاب المفاصل) قد يزيد استعماله في نفس الوقت مع أولكونترو® من خطر حدوث قصور في وظيفة الكلى و قد يقل مفعول أولكونترو® عند استعماله بشكل متزامن مع الأدوية غير الستيرويدية المضادة للالتهاب.

الأدوية الأخرى لخفض ضغط الدم، حيث قد يزيد تأثير أولكونترو®.

بعض مضادات الحموضة (أدوية عسر الهضم)، حيث قد ينخفض تأثير أولكونترو® بشكل قليل.

الرجاء إخبار طبيبك أو الصيدلي إذا كنت تتناول أو تناولت مؤخرا أي أدوية أخرى، بما في ذلك الأدوية التي يتم الحصول عليها بدون وصفة طبية.

تناول أولكونترو® مع الطعام و الشراب

يمكن تناول أولكونترو® مع أو بدون تناول الطعام. تناول الأقراص مع شرب القليل من الماء. إذا أمكن، قم بتناول الجرعة اليومية في نفس الوقت من كل يوم، على سبيل المثال عند وقت الإفطار. 

الأطفال والمراهقون (الأقل من 18 عام)

لا يوصى باستعمال أولكونترو® للأطفال و المراهقين الذين تقل أعمارهم عن 18 عام.

المرضى كبار السن

إذا كان عمرك يزيد عن 65 عاما وقرر طبيبك زيادة جرعة أولكونترو® إلى 40 ملغم يوميا، بعد ذلك تحتاج إلى مراقبة ضغط الدم بشكل منتظم من قبل طبيبك للتأكد من عدم انخفاضه بشكل كبير.

المرضى ذوو البشرة السمراء

كما هو الحال مع الأدوية المشابهة إن تأثير أولكونترو® الخافض لضغط الدم يكون أقل عند المرضى ذوو البشرة السمراء.

الحمل والرضاعة الطبيعية

الحمل

يجب أن تخبري طبيبك إذا كنت تعتقدين بأنك حامل (أو من المحتمل حصول الحمل). سيقوم طبيبك عادة بنصحك بالتوقف عن تناول أولكونترو® قبل حصول الحمل أوعند معرفتك بحصول الحمل وسيقوم بنصحك بتناول دواء آخر بدلا من أولكونترو ®. لا يوصى باستعمال أولكونترو® خلال الأشهر الأولى من الحمل، ويجب عدم استعماله إذا كان عمر الحمل يزيد عن ثلاثة أشهر، حيث قد يسبب أذى خطير على الجنين في حال استعماله بعد الشهر الثالث من الحمل.

الرضاعة الطبيعية

أخبري طبيبك إذا كنت مرضعة أو على وشك البدء بالرضاعة الطبيعية. لا يوصى باستعمال أولكونترو® للأمهات المرضعات، و قد يختار طبيبك علاج آخر إذا كنت ترغبين في الإرضاع، خاصة إذا كان طفلك حديث الولادة، أو ولد قبل أوانه.

استشيري طبيبك أو الصيدلي قبل تناول أي دواء.

القيادة و استخدام الآلات

من غير المحتمل أن أولكونترو® سيؤثرعلى قدرتك على القيادة أو تشغيل الآلات. مع ذلك، قد يسبب الشعور بالدوار أو الشعور التعب أحيانا أثناء علاج ارتفاع ضغط الدم. إذا لاحظت مثل هذه الآثار، تجنب القيادة أو استخدام الآلات إلى أن تختفي الأعراض. استشر طبيبك.

يحتوي أولكونترو® على اللاكتوز.

يحتوي هذا الدواء على اللاكتوز (نوع من السكر) إذا أخبرت من قبل الطبيب بأنك تعاني من عدم القدرة على تحمل بعض أنواع السكريات، اتصل مع طبيبك قبل تناول هذا الدواء.

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دائما تناول هذا الدواء تماما كما أخبرك طبيبك. تأكد من طبيبك أو الصيدلي إذا لم تكن متأكدا.

من الممكن تناول الأقراص مع أو بدون تناول طعام. تناول الأقراص مع شرب القليل من الماء. إذا أمكن، قم بتناول الجرعة اليومية في نفس الوقت من كل يوم، على سبيل المثال عند وقت الإفطار. 

الجرعة الابتدائية المعتادة هي قرص واحد 10 ملغم مرة واحدة يوميا. لكن، إذا لم يتم السيطرة على ضغط الدم، قد يقرر طبيبك تغيير الجرعة لتصل لغاية 20 ملغم أو 40 ملغم مرة واحدة يوميا، أو وصف أدوية إضافية.

عند المرضى الذين يعانون من مرض معتدل إلى متوسط في الكلى، لن تزيد الجرعة عن 20 ملغم مرة  واحدة يوميا.

إذا تناولت أولكونترو® أكثر مما يجب

إذا تناولت أقراص أكثر مما يجب أو إذا تناول طفلك عن طريق الخطأ بعض منها، اذهب إلى طبيبك أو أقرب قسم طوارئ فورا و اصطحب معك عبوة الدواء.

إذا نسيت تناول جرعة أولكونترو®

إذا نسيت تناول جرعة، تناول جرعتك المعتادة في اليوم التالي كالمعتاد. لا تتناول جرعة إضافية لتعويض الجرعة التي نسيتها.

إذا توقفت عن تناول أولكونترو®

من المهم الاستمرار في تناول أولكونترو® ما لم يخبرك طبيبك بالتوقف عن تناوله.

إذا كان لديك أي أسئلة إضافية عن استعمال هذا الدواء، اسأل طبيبك أو الصيدلي.

مثل جميع الأدوية، قد يسبب أولكونترو® آثار جانبية، على الرغم من عدم حدوثها لدى الجميع. إذا حدثت آثار جانبية، غالبا تكون معتدلة و لا تحتاج التوقف عن تناول العلاج.

على الرغم من عدم حدوثها عند الكثير من الأشخاص، قد يكون الأثرين الجانبيين التاليين خطيرين:

في حالات نادرة جدا تم تسجيل التفاعلات التحسسية التالية:

تورم الوجه، الفم و/أو الحنجرة الذي يرافقه حكة و طفح قد يحدث خلال فترة العلاج باستعمال أولميسارتان. إذا حصل هذا، توقف عن تناول أولكونترو® و اتصل مع طبيبك فوراً.

قد يسبب أولميسارتان بشكل نادر (لكن بتكرار أكبر بشكل بسيط عند كبار السن) انخفاض كبير في ضغط الدم عند بعض الأشخاص المعرضين لذلك. قد يسبب هذا دوار حاد أو إغماء. إذا حصل هذا، توقف عن تناول أولكونترو®، و اتصل مع طبيبك فورا و استلقي بشكل مستقيم.

لإعطائك فكرة عن عدد المرضى الذين قد يعانون من آثار جانبية، تم تصنيفها كشائعة، غير شائعة، نادرة، ونادرة جدا. هذه التصنيفات تعني ما يلي:

شائعة (أقل من شخص واحد من كل 10 أشخاص).

غير شائعة (أقل من شخص واحد من كل 100 شخص).

نادرة (أقل من شخص واحد من كل 1,000 شخص).

نادرة جدا (أقل من شخص واحد من كل 10,000 شخص).

آثار جانبية شائعة:

الشعور بالدوار، الشعور بالغثيان، عسر الهضم، إسهال، ألم في المعدة، التهاب المعدة والأمعاء، الشعور بالتعب، تقرحات في الحلق، سيلان أو انسداد الأنف، التهاب القصبات الهوائية، أعراض مشابهة لأعراض الانفلونزا، سعال، ألم في الصدر، الظهر، العظام أو المفاصل، التهاب المسالك البولية، تورم الكاحلين، القدمين، الساقين، اليدين أو الذراعين، ظهور الدم في البول.

تم ملاحظة بعض التغيرات أيضا في نتائج فحوصات الدم و تتضمن ما يلي:

زيادة مستويات الدهون في الدم (ارتفاع مستوى الدهون الثلاثية في الدم)، زيادة مستويات حمض اليوريك في الدم، ارتفاع قيم نتائج فحوصات وظائف الكبد والعضلات في الدم.

آثار جانبية غير شائعة:

دوخة، طفح جلدي، ذبحة صدرية (ألم أو الشعور بعدم الراحة في منطقة الصدر).

آثار جانبية نادرة:

بشكل نادر، اظهرت نتائج فحوصات الدم ارتفاع مستويات البوتاسيوم.

آثار جانبية نادرة جدا:

صداع، تشنجات العضلات و ألم في العضلات، قصور وظيفة الكلى، فشل الكلى، الشعور بالضعف، نقص الطاقة، الشعور بأنك لست على ما يرام، قيء، حكة، طفح ظاهر.

 تم ملاحظة بعض التغييرات في نتائج فحوصات الدم. هذه تتضمن الزيادة في مستويات المركبات المرتبطة بوظيفة الكلى و انخفاض عدد نوع من خلايا الدم، تعرف بالصفائح الدموية.

إذا أصبحت أي من هذه الآثار الجانبية خطيرة، أو إذا لاحظت أي آثار جانبية غير مذكورة في هذه النشرة، الرجاء إخبار طبيبك أو الصيدلي.

غير معروفة:

اعتلال الأمعاء شبيه بالذرب (و هو سوء الامتصاص الذي يوجد عادة في المناطق الإستوائية)، يجب التواصل مع ممارس الرعاية الصحية فورا إذا عانيت من إسهال حاد، إسهال مستمر، أو فقدان الوزن بشكل ملحوظ.

إذا أصبحت أي من هذه الآثار الجانبية خطيرة، أو إذا لاحظت أي آثار جانبية غير مذكورة في هذه النشرة، الرجاء إخبار طبيبك أو الصيدلي.

يحفظ بعيدا عن متناول الأطفال و نظرهم.

لا تستعمل أقراص أولكونترو® بعد تاريخ انتهاء الصلاحية (EXP) المذكورعلى الشريط و العلبة الخارجية.

تاريخ الانتهاء يشير إلى اليوم الأخير من ذلك الشهر.

أقراص أولكونترو®: يحفظ  بدرجة حرارة دون 30 °م.

يجب أن لا يتم التخلص من الأدوية عن طريق مياه الصرف الصحي أو النفايات المنزلية. اسأل الصيدلي عن كيفية التخلص من الأدوية التي لم تعد مطلوبة. وسوف تساعد هذه التدابير في حماية البيئة.

ماذا تحتوي أقراص أولكونترو®

المادة الفعالة هي أولميسارتان ميدوكسوميل.

المكونات الأخرى هي لاكتوز أحادي الهيدرات مجفف بالرذاذ، ميكروكريستالين سيليلوز، جلايكوليت نشا الصوديوم، هيدروكسي بروبيل سيليلوز، ثاني أكسيد السيليكون الغروي، ستيرات المغنيسيوم، إنستاكوت يونيڤيرسال أبيض (هيدروكسي بروبيل ميثيل سيليلوز/هيبروميلوز، ثاني أكسيد التيتانيوم، تلك).

أولكونترو® 20 ملغم: أقراص مغلفة دائرية الشكل ذات لون أبيض، محدبة الوجهين، محفور على أحد الأوجه "I31"، معبأة في أشرطة ألومنيوم/ألومنيوم، معدة للاستعمال عن طريق الفم.

حجم العبوة: 28 قرص مغلف (7 أقراص/شريط، 4 أشرطة/ عبوة).

أولكونترو® 40 ملغم: أقراص مغلفة بيضوية الشكل ذات لون أبيض، محدبة الوجهين، محفور على أحد الأوجه "I33"، معبأة في أشرطة ألومنيوم/ألومنيوم، معدة للاستعمال عن طريق الفم.

حجم العبوة: 28 قرص مغلف (7 أقراص/شريط، 4 أشرطة/ عبوة).

مدينة الدواء للصناعات الدوائية - المملكة العربية السعودية.

المدينة الصناعية الأولى، المرحلة الخامسة، جدة- المملكة العربية السعودية.

الهاتف: 00966920003288 

جوال: 00966555786968

ص.ب: 4072 – جدة 22429

البريد الإلكتروني: info@medcitypharma.com

05/2024
 Read this leaflet carefully before you start using this product as it contains important information for you

Olcontro® 20 mg Film Coated Tablets. Olcontro® 40 mg Film Coated Tablets.

Olcontro® 20 mg: Each film-coated tablet contains 20 mg olmesartan medoxomil. Olcontro® 40 mg: Each film-coated tablet contains 40 mg olmesartan medoxomil. For a full list of excipients: see section 6.

Film-coated tablets. Olcontro® 20 mg: White, round, biconvex, film-coated tablets engraved with "I31" on one side and plain on other side, presented in Alu/Alu blisters, intended for oral use. Olcontro® 40 mg: White, oval, biconvex, film-coated tablets tablets engraved with "I33" Pack size: 28 Film Coated tablets (7 Film Coated tablets / Blister, 4 blisters/pack).

Treatment of essential hypertension.


Adults
The recommended starting dose of Olmesartan medoxomil is 10 mg once daily. In
patients whose blood pressure is not adequately controlled at this dose, the dose of
Olmesartan medoxomil may be increased to 20 mg once daily as the optimal dose. If
additional blood pressure reduction is required, Olmesartan medoxomil dose may be
increased to a maximum of 40 mg daily or hydrochlorothiazide therapy may be
added.
The antihypertensive effect of Olmesartan medoxomil is substantially present within
2 weeks of initiating therapy and is maximal by about 8 weeks after initiating
therapy. This should be borne in mind when considering changing the dose regimen
for any patient.

In order to assist compliance, it is recommended that Olcontro® tablets be taken at
about the same time each day, with or without food, for example at breakfast time.
Elderly
No adjustment of dosage is generally required in elderly patients (see below for dose
recommendations in patients with renal impairment). If up-titration to the maximum
dose of 40 mg daily is required, blood pressure should be closely monitored.
Renal impairment

The maximum dose in patients with mild to moderate renal impairment (creatinine
clearance of 20 – 60 mL/min) is 20 mg Olmesartan medoxomil once daily, owing to
limited experience of higher dosages in this patient group. The use of Olmesartan
medoxomil in patients with severe renal impairment (creatinine clearance < 20
mL/min) is not recommended, since there is only limited experience in this patient
group (see sections 4.4, 5.2).

Hepatic impairment

No adjustment of dosage recommendations is required for patients with mild
hepatic impairment. In patients with moderate hepatic impairment, an initial dose of
10 mg Olmesartan medoxomil once daily is recommended and the maximum dose
should not exceed 20 mg once daily. Close monitoring of blood pressure and renal
function is advised in hepatically-impaired patients who are already receiving
diuretics and/or other antihypertensive agents. There is no experience of
Olmesartan medoxomil in patients with severe hepatic impairment, therefore use is
not recommended in this patient group (see sections 4.4 and 5.2). Olmesartan
medoxomil should not be used in patients with biliary obstruction (see 4.3).
Children and adolescents

Olcontro® is not recommended for use in children below 18 years due to a lack of data
on safety and efficacy.


Hypersensitivity to the active substance or to any of the excipients (see section 6.1). Second and third trimesters of pregnancy (see sections 4.4 and 4.6). Biliary obstruction (see section 5.2). The use of angiotensin II antagonists is contraindicated during the second and third trimester of pregnancy Olmesartan should not be co-administered with aliskiren in patients with diabetes mellitus or renal impairment.

I

Dual Blockade of the Renin-Angiotensin-aldosterone System (RAAS):

Combination of Olmesartan with ACE inhibitors, or aliskiren may cause increased
risks of hyperkalemia, worsening of kidney function and hypotension. Therefore, this
combination should not be used, especially in patients with kidney problems.
Intravascular volume depletion:

Symptomatic hypotension, especially after the first dose, may occur in patients who
are volume and/or sodium depleted by vigorous diuretic therapy, dietary salt
restriction, diarrhoea or vomiting. Such conditions should be corrected before the
administration of Olmesartan medoxomil.

Other conditions with stimulation of the renin-angiotensin-aldosterone system:

In patients whose vascular tone and renal function depend predominantly on the
activity of the renin-angiotensin-aldosterone system (e.g. patients with severe
congestive heart failure or underlying renal disease, including renal artery stenosis),
treatment with other drugs that affect this system has been associated with acute
hypotension, azotaemia, oliguria or, rarely, acute renal failure. The possibility of
similar effects cannot be excluded with angiotensin II receptor antagonists.
Renovascular hypertension:

There is an increased risk of severe hypotension and renal insufficiency when
patients with bilateral renal artery stenosis or stenosis of the artery to a single
functioning kidney are treated with medicinal products that affect the reninangiotensin-aldosterone system.

Renal impairment and kidney transplantation:

When Olmesartan medoxomil is used in patients with impaired renal function,
periodic monitoring of serum potassium and creatinine levels is recommended. Use
of Olmesartan medoxomil is not recommended in patients with severe renal
impairment (creatinine clearance < 20 mL/min) (see sections 4.2, 5.2). There is no
experience of the administration of Olmesartan medoxomil in patients with a recent
kidney transplant or in patients with end-stage renal impairment (i.e. creatinine
clearance <12 mL/min).

Hepatic impairment:

There is no experience in patients with severe hepatic impairment and therefore use
of Olmesartan medoxomil in this patient group is not recommended (see section 4.2
for dosage recommendations in patients with mild or moderate hepatic
impairment).
Hyperkalaemia:
The use of medicinal products that affect the renin-angiotensin-aldosterone system
may cause hyperkalaemia.

The risk, that may be fatal, is increased in elderly, in patients with renal insufficiency
and in diabetic patients, in patients concomitantly treated with other medicinal
products that may increase potassium levels, and/or in patients with intercurrent
events.
Before considering the concomitant use of medicinal products that affect the reninangiotensin-aldosterone system, the benefit risk ratio should be evaluated and other
alternatives considered.

The main risk factors for hyperkalaemia to be considered are:

-Diabetes, renal impairment, age (> 70 years).

-Combination with one or more other medicinal products that affect the reninangiotensin-aldosterone system and/or potassium supplements. Some medicinal
products or therapeutic class of medicinal products may provoke a hyperkalaemia:

salt substitutes containing potassium, potassium-sparing diuretics, ACE inhibitors,
angiotensin II receptors antagonists, non steroidal anti-inflammatory drugs
(including selective COX-2 inhibitors), heparin, immunosuppressor as ciclosporin or
tacrolimus, trimethoprim.

- Intercurrent events, in particular dehydration, acute cardiac decompensation,
metabolic acidosis, worsening of renal function, sudden worsening of the renal
condition (e.g. infectious diseases), cellular lysis (e.g. acute limb ischemia,
rhabdomyolysis, extended trauma).

Close-monitoring of serum potassium in at risk patients is recommended (see section
4.5).
Lithium:
As with other angiotensin-II receptor antagonists, the combination of lithium and
Olmesartan medoxomil is not recommended (see section 4.5).
Aortic or mitral valve stenosis; obstructive hypertrophic cardiomyopathy:

As with other vasodilators, special caution is indicated in patients suffering from
aortic or mitral valve stenosis, or obstructive hypertrophic cardiomyopathy.
Primary aldosteronism:

Patients with primary aldosteronism generally will not respond to antihypertensive
drugs acting through inhibition of the renin-angiotensin system. Therefore, the use
of Olmesartan medoxomil is not recommended in such patients.
Ethnic differences:

As with all other angiotensin II antagonists, the blood pressure lowering effect of
Olmesartan medoxomil is somewhat less in black patients than in non-black patients,
possibly because of a higher prevalence of low-renin status in the black hypertensive
population.
Sprue-like Enteropathy

Severe, chronic diarrhea with substantial weight loss has been reported in patients
taking olmesartan months to years after drug initiation. Intestinal biopsies of
patients often demonstrated villous atrophy. If a patient develops these symptoms
during treatment with olmesartan, exclude other etiologies. Consider
discontinuation of Olcontro® in cases where no other etiology is identified.
Pregnancy:
Angiotensin II antagonists should not be initiated during pregnancy. Unless
continued angiotensin II antagonists therapy is considered essential, patients
planning pregnancy should be changed to alternative anti-hypertensive treatments
which have an established safety profile for use in pregnancy. When pregnancy is
diagnosed, treatment with angiotensin II antagonists should be stopped immediately
and, if appropriate, alternative therapy should be started (see sections 4.3 and 4.6).
Other:
As with any antihypertensive agent, excessive blood pressure decrease in patients
with ischaemic heart disease or ischaemic cerebrovascular disease could result in a
myocardial infarction or stroke.

This medicinal product contains lactose. Patients with rare hereditary problems of
galactose intolerance, the Lapp-lactase deficiency or glucose-galactose
malabsorption should not take this medicinal product.


Interaction studies have only been performed in adults.

Dual RAAS Blockade:

The combination of Olmesartan with Aliskiren, ACEIs or other ARBs is contraindicated in patients with diabetes mellitus or renal impairment. Dual blockade (e.g by adding ACE inhibitor to Olmesartan) should not be used, especially in patients with Kidney problems.
Effects of other medicinal products on Olmesartan medoxomil:

·       Potassium supplements and potassium sparing diuretics:

Based on experience with the use of other drugs that affect the renin-angiotensin
system, concomitant use of potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium or other drugs that may increase serum potassium levels (e.g. heparin) may lead to increases in serum potassium (see section 4.4). Such concomitant use is therefore not recommended.

·       Other antihypertensive medications:

The blood pressure lowering effect of Olmesartan medoxomil can be increased by
concomitant use of other antihypertensive medications.

·       Non-steroidal anti-inflammatory drugs (NSAIDs):

NSAIDs (including acetylsalicylic acid at doses> 3 g/day and also COX-2 inhibitors)
and angiotensin-II receptor antagonists may act synergistically by decreasing
glomerular filtration. The risk of the concomitant use of NSAIDs and angiotensin II
antagonists is the occurrence of acute renal failure. Monitoring of renal function at
the beginning of treatment should be recommended as well as regular hydration of
the patient.

Additionally, concomitant treatment can reduce the antihypertensive effect of angiotensin II receptor antagonists, leading to their partial loss of efficacy.

Other compounds:

After treatment with antacid (aluminium magnesium hydroxide), a modest reduction
in bioavailability of Olmesartan was observed. Coadministration of warfarin and
digoxin had no effect on the pharmacokinetics of Olmesartan.

Effects of Olmesartan medoxomil on other medicinal products:

·       Lithium:

Reversible increases in serum lithium concentrations and toxicity have been
reported during concomitant administration of lithium with angiotensin converting
enzyme inhibitors and angiotensin II antagonists. Therefore use of Olmesartan
medoxomil and lithium in combination is not recommended (see section 4.4). If use of the combination proves necessary, careful monitoring of serum lithium levels is
recommended.

·       Other compounds:

Compounds which have been investigated in specific clinical studies in healthy
volunteers include warfarin, digoxin, an antacid (magnesium aluminium hydroxide),
hydrochlorothiazide and pravastatin. No clinically relevant interactions were
observed and in particular Olmesartan medoxomil had no significant effect on the
pharmacokinetics or pharmacodynamics of warfarin or the pharmacokinetics of
digoxin.
Olmesartan had no clinically relevant inhibitory effects on in vitro human
cytochrome P450 enzymes 1A1/2, 2A6, 2C8/9, 2C19, 2D6, 2E1 and 3A4, and had no
or minimal inducing effects on rat cytochrome P450 activities. Therefore in vivo
interaction studies with known cytochrome P450 enzyme inhibitors and inducers
were not conducted, and no clinically relevant interactions between Olmesartan and
drugs metabolised by the above cytochrome P450 enzymes are expected.


Pregnancy:
The use of angiotensin II antagonists is not recommended during the first trimester
of pregnancy (see section 4.4). The use of angiotensin II antagonists is
contraindicated during the second and third trimester of pregnancy (see sections 4.3
and 4.4).

Epidemiological evidence regarding the risk of teratogenicity following exposure to
ACE inhibitors during the first trimester of pregnancy has not been conclusive;
however a small increase in risk cannot be excluded. Whilst there is no controlled
epidemiological data on the risk with angiotensin II antagonists, similar risks may
exist for this class of drugs. Unless continued angiotensin receptor blocker therapy is
considered essential, patients planning pregnancy should be changed to alternative
anti-hypertensive treatments which have an established safety profile for use in
pregnancy. When pregnancy is diagnosed, treatment with angiotensin II antagonists
should be stopped immediately, and, if appropriate, alternative therapy should be
started.
Angiotensin II antagonists therapy exposure during the second and third trimesters is
known to induce human fetotoxicity (decreased renal function, oligohydramnios,
skull ossification retardation) and neonatal toxicity (renal failure, hypotension,
hyperkalaemia). (See also 5.3 “Preclinical Safety Data”.)
Should exposure to angiotensin II antagonists have occurred from the second
trimester of pregnancy, ultrasound check of renal function and skull is
recommended.
Infants whose mothers have taken angiotensin II antagonists should be closely
observed for hypotension (see also sections 4.3 and 4.4).

Lactation:
Olmesartan is excreted in the milk of lactating rats but it is not known whether
Olmesartan is excreted in human milk. Because no information is available regarding
the use of Olcontro® during breast-feeding, Olcontro® is not recommended and
alternative treatments with better established safety profiles during breast-feeding
are preferable, especially while nursing a newborn or preterm infant.

 


No studies on the effect on the ability to drive and use machines have been
performed. With respect to driving vehicles or operating machines, it should be
taken into account that occasionally dizziness or fatigue may occur in patients taking
antihypertensive therapy.

 


a.     Tabulated list of Adverse reaction:

Market experience

The following adverse reactions have been reported in post-marketing experience.
They are listed by System Organ Class and ranked under headings of frequency using
the following convention: very common (≥1/10); common (≥1/100, <1/10);
uncommon (≥1/1,000, <1/100); rare (≥1/10,000, <1/1,000); very rare (<1/10,000)
including isolated reports.

System Organ Class

Very Rare

Blood and lymphatic system disorders

Thrombocytopenia

Immune system disorders

Anaphylactic reaction

Metabolism and nutrition disorders

Hyperkalaemia

Respiratory, thoracic and mediastinal disorders

Cough

Gastrointestinal disorders

Abdominal pain, Nausea, Vomiting

Skin and subcutaneous tissue disorders

Pruritus, Exanthema, Rash

 

Allergic condition such as angioneurotic oedema, dermatitis allergic, face oedma and utricaria.

Musculoskeletal and connective tissue disorders

Muscle Cramp, Myalgia

Renal and urinary disorders

Acute renal failure, Renal insufficiency

(see also under Investigation).

General disorders and administration site conditions

Asthenic conditions, such as Asthenia, Fatigue, Lethargy, Malaise

 

Investigations

Abnormal Renal function test such as

Blood creatinine increased and Blood urea increased

 

Clinical trials

In double-blind, placebo-controlled monotherapy studies, the overall incidence of
treatment-emergent adverse events was 42.4% on olmesartan medoxomil and
40.9% on placebo.

In placebo-controlled monotherapy studies, the only adverse drug reaction that was
unequivocally related to treatment was dizziness (2.5% incidence on olmesartan
medoxomil and 0.9% on placebo).

In long-term (2-year) treatment, the incidence of withdrawals due to adverse events
on olmesartan medoxomil 10 – 20 mg once daily was 3.7%. The following adverse
events have been reported across all clinical trials with olmesartan medoxomil
(including trials with active as well as placebo control), irrespective of causality or
incidence relative to placebo. They are listed by body system and ranked under
headings of frequency using the conventions described:

MedDRA

System organ class

Adverse reaction/Frequency

Common

Rare

Uncommon

Not Known

Central nervous system

Dizzness

 

Vertigo

 

Cardiovascular disorder

 

Hypotension

Angina pectoris

 

Respiratory system disorder

Bronchitis, cough, pharyngitis, rhinitis

 

 

 

Gastrointestinal disorder

Abdominal pain, diarrhoea, dyspepsia, gastroenteritis, nausea

 

 

Sprue-like enteropathy

Skin and appendages disorder

 

 

Rash

 

 

Musculoskeletal disorders

Arthritis, back pain, skeletal pain

 

 

 

Urinary system disorders

Hematuria, urinary tract infection

 

 

 

General disorders

Chest pain, fatigue, influenza-like symptoms, peripheral oedema, pain

 

 

 

Metabolic and nutritional disorders

Increased creatinine phosphokinas, hypertriglyceridaemia, hyperuricaemia.

Hyperkalaemia

 

 

 

 

Liver and biliary diorders

Liver enzyme elevation

 

 

 

Additional information on special populations

In elderly patients the frequency of hypotension is slightly increased from rare to uncommon.
b. Description of selected adverse reaction:

Single cases of rhabdomyolysis have been reported in temporal association with the
intake of angiotensin II receptor blockers. A causal relationship, however, has not
been established.

Post Marketing Experience

Data from one controlled trial and an epidemiologic study have suggested that highdose olmesartan may increase cardiovascular (CV) risk in diabetic patients, but the
overall data are not conclusive. The randomized, placebo-controlled, double-blind
ROADMAP trial (Randomized Olmesartan And Diabetes MicroAlbuminuria
Prevention trial, n=4447) examined the use of olmesartan, 40 mg daily, vs. placebo in
patients with type 2 diabetes mellitus, normoalbuminuria, and at least one
additional risk factor for CV disease. The trial met its primary endpoint, decrease in
time-to-onset of microalbuminuria, but olmesartan had no beneficial effect on
decline in glomerular filtration rate (GFR). There was a finding of increased CV
mortality (adjudicated sudden cardiac death, fatal myocardial infarction, fatal stroke,
revascularization death) in the olmesartan group compared to the placebo group (15
olmesartan vs. 3 placebo, HR 4.9, 95% confidence interval [CI], 1.4, 17), but the risk
of non-fatal myocardial infarction was lower with olmesartan (HR 0.64, 95% CI 0.35,
1.18).
The epidemiologic study included patients 65 years and older with overall exposure
of >300,000 patient-years. In the sub-group of diabetic patients receiving high-dose
olmesartan (40 mg/d) for > 6 months, there appeared to be an increased risk of
death (HR 2.0, 95% CI 1.1, 3.8) compared to similar patients taking other angiotensin
receptor blockers. In contrast, high-dose olmesartan use in non-diabetic patients
appeared to be associated with a decreased risk of death (HR 0.46, 95% CI 0.24,
0.86) compared to similar patients taking other angiotensin receptor blockers. No
differences were observed between the groups receiving lower doses of olmesartan
compared to other angiotensin blockers or those receiving therapy for < 6 months.
Overall, these data raise a concern of a possible increased CV risk associated with the
use of high-dose olmesartan in diabetic patients. There are, however, concerns with
the credibility of the finding of increased CV risk, notably the observation in the large
epidemiologic study for a survival benefit in non-diabetics of a magnitude similar to
the adverse finding in diabetics.

c. Other special population:

Renal impairment and kidney transplantation:

When Olmesartan medoxomil is used in patients with impaired renal function,
periodic monitoring of serum potassium and creatinine levels is recommended. Use
of Olmesartan medoxomil is not recommended in patients with severe renal
impairment (creatinine clearance < 20 mL/min) (see sections 4.2, 5.2). There is no
experience of the administration of Olmesartan medoxomil in patients with a recent
kidney transplant or in patients with end-stage renal impairment (i.e. creatinine
clearance <12 mL/min).

Hepatic impairment:

There is no experience in patients with severe hepatic impairment and therefore use
of Olmesartan medoxomil in this patient group is not recommended (see section 4.2
for dosage recommendations in patients with mild or moderate hepatic
impairment).
Pregnancy:
The use of angiotensin II antagonists is not recommended during the first trimester
of pregnancy (see section 4.4). The use of angiotensin II antagonists is
contraindicated during the second and third trimester of pregnancy.
Elderly
No adjustment of dosage is generally required in elderly patients (see below for dose
recommendations in patients with renal impairment). If up-titration to the maximum
dose of 40 mg daily is required, blood pressure should be closely monitored.
Children and adolescents

Olcontro® is not recommended for use in children below 18 years due to a lack of data
on safety and efficacy.


To­­ report any side effect(s):

•Saudi Arabia:

The National Pharmacovigilance Center (NPC):

SFDA Call Center: 19999

E-mail: npc.drug@sfda.gov.sa

Website: https://ade.sfda.gov.sa/

•Other GCC States:

Please contact the relevant competent authority.


Only limited information is available regarding over dosage in humans. The most
likely effect of over dosage is hypotension. In the event of over dosage, the patient
should be carefully monitored and treatment should be symptomatic and
supportive.
No information is available regarding the dialysability of Olmesartan.


Pharmaco-therapeutic group: Angiotensin II antagonists, ATC code: C09C A 08.
Olmesartan medoxomil is a potent, orally active, selective angiotensin II receptor (type AT1) antagonist. It is expected to block all actions of angiotensin II mediated by
the AT1 receptor, regardless of the source or route of synthesis of angiotensin II. The
selective antagonism of the angiotensin II (AT1) receptors results in increases in
plasma renin levels and angiotensin I and II concentrations, and some decrease in
plasma aldosterone concentrations.

Angiotensin II is the primary vasoactive hormone of the renin-angiotensinaldosterone system and plays a significant role in the pathophysiology of hypertension via the type 1 (AT1) receptor.

In hypertension, Olmesartan medoxomil causes a dose-dependent, long-lasting
reduction in arterial blood pressure. There has been no evidence of first-dose
hypotension, of tachyphylaxis during long-term treatment, or of rebound
hypertension after cessation of therapy.

Once daily dosing with Olmesartan medoxomil provides an effective and smooth
reduction in blood pressure over the 24 hour dose interval. Once daily dosing
produced similar decreases in blood pressure as twice daily dosing at the same total
daily dose. With continuous treatment, maximum reductions in blood pressure are achieved by 8 weeks after the initiation of therapy, although a substantial proportion of the blood pressure lowering effect is already observed after 2 weeks of treatment. When
used together with hydrochlorothiazide, the reduction in blood pressure is additive
and coadministration is well tolerated.

The effect of Olmesartan on mortality and morbidity is not yet known.
 


Absorption and distribution

Olmesartan medoxomil is a prodrug. It is rapidly converted to the pharmacologically
active metabolite, Olmesartan, by esterases in the gut mucosa and in portal blood
during absorption from the gastrointestinal tract.

No intact Olmesartan medoxomil or intact side chain medoxomil moiety have been
detected in plasma or excreta. The mean absolute bioavailability of Olmesartan from
a tablet formulation was 25.6%.

The mean peak plasma concentration (Cmax) of Olmesartan is reached within about 2
hours after oral dosing with Olmesartan medoxomil, and Olmesartan plasma
concentrations increase approximately linearly with increasing single oral doses up
to about 80 mg.

Food had minimal effect on the bioavailability of Olmesartan and therefore
Olmesartan medoxomil may be administered with or without food.

No clinically relevant gender-related differences in the pharmacokinetics of Olmesartan have been observed.

Olmesartan is highly bound to plasma protein (99.7%), but the potential for clinically
significant protein binding displacement interactions between Olmesartan and other
highly bound coadministered drugs is low (as confirmed by the lack of a clinically
significant interaction between Olmesartan medoxomil and warfarin). The binding of
Olmesartan to blood cells is negligible. The mean volume of distribution after
intravenous dosing is low (16 – 29 L).

Metabolism and elimination

Total plasma clearance was typically 1.3 L/h (CV, 19%) and was relatively slow
compared to hepatic blood flow (ca 90 L/h). Following a single oral dose of 14C
labelled Olmesartan medoxomil, 10 - 16% of the administered radioactivity was
excreted in the urine (the vast majority within 24 hours of dose administration) and
the remainder of the recovered radioactivity was excreted in the faeces. Based on
the systemic availability of 25.6%, it can be calculated that absorbed Olmesartan is
cleared by both renal excretion (ca 40%) and hepato-biliary excretion (ca 60%). All
recovered radioactivity was identified as Olmesartan. No other significant metabolite
was detected. Enterohepatic recycling of Olmesartan is minimal. Since a large
proportion of Olmesartan is excreted via the biliary route, use in patients with biliary
obstruction is contraindicated (see section 4.3).

The terminal elimination half life of Olmesartan varied between 10 and 15 hours
after multiple oral dosing. Steady state was reached after the first few doses and no
further accumulation was evident after 14 days of repeated dosing. Renal clearance
was approximately 0.5 – 0.7 L/h and was independent of dose.

Pharmacokinetics in special populations

Elderly:
In hypertensive patients, the AUC at steady state was increased by ca 35% in elderly
patients (65 – 75 years old) and by ca 44% in very elderly patients ( 75 years old)
compared with the younger age group. This may be at least in part related to a mean
decrease in renal function in this group of patients.
Renal impairment:

In renally impaired patients, the AUC at steady state increased by 62%, 82% and
179% in patients with mild, moderate and severe renal impairment, respectively,
compared to healthy controls (see sections 4.2, 4.4).

Hepatic impairment:

After single oral administration, Olmesartan AUC values were 6% and 65% higher in
mildly and moderately hepatically impaired patients, respectively, than in their
corresponding matched healthy controls. The unbound fraction of Olmesartan at 2
hours post-dose in healthy subjects, in patients with mild hepatic impairment and in
patients with moderate hepatic impairment was 0.26%, 0.34% and 0.41%,
respectively. Following repeated dosing in patients with moderate hepatic
impairment, Olmesartan mean AUC was again about 65% higher than in matched
healthy controls. Olmesartan mean Cmax values were similar in hepatically-impaired
and healthy subjects. Olmesartan medoxomil has not been evaluated in patients
with severe hepatic impairment (see sections 4.2, 4.4).


In chronic toxicity studies in rats and dogs, Olmesartan medoxomil showed similar
effects to other AT1 receptor antagonists and ACE inhibitors: raised blood urea (BUN)
and creatinine (through functional changes to the kidneys caused by blocking AT1
receptors); reduction in heart weight; a reduction of red cell parameters
(erythrocytes, haemoglobin, haematocrit); histological indications of renal damage
(regenerative lesions of the renal epithelium, thickening of the basal membrane,
dilatation of the tubules). These adverse effects caused by the pharmacological
action of Olmesartan medoxomil have also occurred in preclinical trials on other AT1
receptor antagonists and ACE inhibitors and can be reduced by simultaneous oral
administration of sodium chloride.

In both species, increased plasma renin activity and hypertrophy/hyperplasia of the
juxtaglomerular cells of the kidney were observed. These changes, which are a
typical effect of the class of ACE inhibitors and other AT1 receptor antagonists, would
appear to have no clinical relevance.

Like other AT1 receptor antagonists Olmesartan medoxomil was found to increase
the incidence of chromosome breaks in cell cultures in vitro. No relevant effects
were observed in several in vivo studies using Olmesartan medoxomil at very high
oral doses of up to 2000 mg/kg. The overall data of a comprehensive genotoxicity
testing suggest that Olmesartan is very unlikely to exert genotoxic effects under
conditions of clinical use.

Olmesartan medoxomil was not carcinogenic, neither in rats in a 2 year study nor in
mice when tested in two 6 month carcinogenicity studies using transgenic models.
In reproductive studies in rats, Olmesartan medoxomil did not affect fertility and
there was no evidence of a teratogenic effect. In common with other angiotensin II
antagonists, survival of offspring was reduced following exposure to Olmesartan
medoxomil and pelvic dilatation of the kidney was seen after exposure of the dams
in late pregnancy and lactation. In common with other antihypertensive agents,
Olmesartan medoxomil was shown to be more toxic to pregnant rabbits than to
pregnant rats, however, there was no indication of a fetotoxic effect.


Lactose monohydrate spray dried, microcrystalline cellulose, sodium starch glycolate, hydroxypropyl cellulose, colloidal silicon dioxide, magnesium stearate, instacoat universal white (HPMC/Hypromellose, Titanium Dioxide, talc).


None.


36 months.

Store below 30°C.


Olcontro® 20 mg: White, round, biconvex, film-coated tablets engraved with "I31" on one side and plain on other side, presented in Alu/Alu blisters, intended for oral use.

Pack size: 28 Film Coated tablets (7 Film Coated tablets / Blister, 4 blisters/pack).

Olcontro® 40 mg: White, oval, biconvex, film-coated tablets engraved with "I33" on one side and plain on other side, presented in Alu/Alu blisters, intended for oral use.

Pack size: 28 Film Coated tablets (7 Film Coated tablets / Blister, 4 blisters/pack).


No special requirements.


Med City Pharma-KSA. 1st Industrial city, Phase 5, Jeddah –KSA. Tel: 00966920003288 Mobile: 00966555786968 P.O .Box: 4072 - Jeddah 22429 E-mail: info@medcitypharma.com

05/2024
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