سعر افيروثيازيد 10/40/12.5 مجم 30 قرص 2023

Amlodipine 10 mg + olmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg film-coated tablets, 30 tablets; triple antihypertensive combination (Averroes Pharma, Egypt).

• Treatment of hypertension, alone or with other antihypertensive agents, to lower blood pressurePopulation: AdultsDailyMed (U.S. National Library of Medicine)

• Most frequent adverse reactions with the highest-strength combination (≥2%): peripheral edema 7.7%, headache 6.4%, fatigue 4.2%, nasopharyngitis 3.5%, muscle spasms 3.1%, nausea 3.0%, upper respiratory tract infection 2.8%, diarrhea 2.6%, urinary tract infection 2.4% and joint swelling 2.1%; dizziness and syncope (1%) also reported.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Anuria; hypersensitivity to any component or to other sulfonamide-derived drugs; co-administration with aliskiren in patients with diabetes.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Symptomatic hypotension may occur in volume- or salt-depleted patients (e.g. on high-dose diuretics); correct before starting.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Amlodipine: increased angina and/or myocardial infarction may occur on starting or increasing the dose, particularly in severe obstructive coronary artery disease.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Impaired renal function (2.1% vs 0.2-1.3% with dual combinations); consider withholding or discontinuing if progressive renal impairment occurs; hepatic impairment increases amlodipine/olmesartan exposure.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• NSAIDs including selective COX-2 inhibitorsMay cause deterioration of renal function (possible acute renal failure) in elderly, volume-depleted or renally impaired patients and attenuate the antihypertensive and diuretic effects; monitor renal function.DailyMed (U.S. National Library of Medicine)
• Other renin-angiotensin system blockers (ARBs, ACE inhibitors, aliskiren)Dual blockade increases hypotension, hyperkalemia and renal dysfunction; avoid; aliskiren contraindicated in diabetes and to be avoided if GFR <60 mL/min.DailyMed (U.S. National Library of Medicine)
• ColesevelamReduces olmesartan exposure; give olmesartan at least 4 hours before colesevelam.DailyMed (U.S. National Library of Medicine)

• Boxed warning - fetal toxicity: drugs acting on the renin-angiotensin system during the second and third trimesters reduce fetal renal function and increase fetal and neonatal morbidity and death; discontinue as soon as pregnancy is detected and consider alternative therapy.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Amlodipine and hydrochlorothiazide are present in human milk and olmesartan in rat milk; breastfeeding is not recommended during treatment.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Amlodipine: Inhibits transmembrane calcium influx into vascular smooth muscle and cardiac muscle; peripheral arterial vasodilator.
• Olmesartan medoxomil: Prodrug hydrolysed to olmesartan, which blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II at the AT1 receptor.
• Hydrochlorothiazide: Promotes renal excretion of sodium and chloride, reducing intravascular volume.