- Stock: Out Of Stock
- Brand: ACI Pharmaceuticals
- Product ID: Amlodipine + Olmesartan Medoxomil
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Abecab 20/5mg Tablet — Olmesartan Medoxomil + Amlodipine Besilate | Beximco Pharmaceuticals
| Generic Name | Olmesartan Medoxomil 20mg + Amlodipine Besilate 5mg |
| Drug Class | ARB + Dihydropyridine Calcium Channel Blocker (Fixed-Dose Combination) |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Route | Oral (Tablet) |
| Prescription Status | Prescription Required |
Overview
Abecab 20/5mg combines Olmesartan Medoxomil 20mg (ARB) and Amlodipine Besilate 5mg (dihydropyridine CCB) in a single tablet. ARB + CCB is among the most evidence-supported antihypertensive pairings — the ACCOMPLISH trial confirmed it reduces major cardiovascular events more than ARB + diuretic at equivalent BP control. For diabetic patients this combination is especially advantageous: both agents are metabolically neutral, while olmesartan provides renoprotection via AT1 receptor blockade.
Mechanism of Action
Olmesartan Medoxomil 20mg: Insurmountable AT1 receptor blockade prevents angiotensin II-mediated vasoconstriction, aldosterone release, and sodium retention. Reduces intraglomerular hypertension to protect diabetic kidneys. Blocks compensatory RAAS activation triggered by amlodipine vasodilation — the key synergy.
Amlodipine Besilate 5mg: Long-acting dihydropyridine CCB (half-life 35–50h). Blocks L-type calcium channels in vascular smooth muscle → sustained peripheral vasodilation, no reflex tachycardia. Adds antianginal and anti-atherosclerotic effects beyond BP lowering.
Indications
- Hypertension not controlled on ARB or CCB monotherapy alone
- Diabetic hypertension — preferred combination for metabolic neutrality and CV protection
- Hypertension with ischaemic heart disease or angina
- Diabetic nephropathy — olmesartan reduces proteinuria; amlodipine reduces cardiac risk
- Hypertension in patients intolerant of thiazide diuretics
Dosage
| Indication | Dose | Notes |
|---|---|---|
| Combination therapy initiation | 1 tablet (20/5mg) once daily | Consistent daily timing |
| Uptitration if insufficient | Switch to Abecab 40/5mg or 40/10mg | After 2–4 weeks assessment |
Critical Diabetic Patient Information
- Guideline-preferred combination in diabetes: Metabolically neutral — no adverse effects on glucose, lipids, or uric acid. Olmesartan may slightly improve insulin sensitivity
- Ankle oedema: Amlodipine causes pedal oedema in ~10% of patients — vasodilatory effect, NOT cardiac fluid retention. Olmesartan partially mitigates this
- Renal monitoring: Check creatinine and K⁺ 2 weeks after starting (olmesartan component). Routine 6-monthly checks if stable
- BP target: <130/80 mmHg in diabetics. Full amlodipine effect takes 1–2 weeks due to long half-life
- No dual RAS blockade: Never combine with ACE inhibitor or aliskiren
Side Effects
| System | Side Effect | Severity |
|---|---|---|
| Peripheral | Ankle/pedal oedema (amlodipine) — not cardiac | Common (~10%) — Mild |
| Cardiovascular | Flushing, palpitations, dizziness | Common — Mild |
| Blood pressure | Hypotension (especially first dose, volume-depleted patients) | Common — Mild |
| Renal | Elevated creatinine (ARB-mediated, expected) | Common — monitor |
| Electrolytes | Mild hyperkalaemia (olmesartan) | Mild — routine monitoring |
| Serious (rare) | Angioedema — discontinue immediately | Rare — Serious |
Drug Interactions
| Drug | Interaction |
|---|---|
| ACE inhibitors / aliskiren | Contraindicated in diabetics |
| CYP3A4 inhibitors (clarithromycin, itraconazole, grapefruit juice) | Increase amlodipine levels → enhanced hypotension |
| Simvastatin | Amlodipine raises simvastatin AUC — limit to 20mg/day or use atorvastatin |
| NSAIDs | Reduce ARB efficacy; increase renal risk |
| Cyclosporin | Amlodipine increases cyclosporin levels |
Contraindications
- Pregnancy (second and third trimester)
- Hypersensitivity to olmesartan, amlodipine, or dihydropyridines
- Severe aortic stenosis
- Cardiogenic shock
- Combination with aliskiren in diabetics or eGFR <60
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Frequently Asked Questions
Q: Why is ARB + amlodipine preferred in diabetes?
A: The ACCOMPLISH trial showed this combination reduces cardiovascular events ~20% more than ARB + diuretic at equivalent BP. Both agents are metabolically neutral — no worsening of glucose, lipids, or uric acid.
Q: My ankles swelled — should I stop?
A: Ankle swelling from amlodipine is a vasodilatory effect, not heart failure. It is not dangerous but can be uncomfortable. Discuss with your physician — elevating legs helps; dose adjustment may resolve it.
Medical Disclaimer: Abecab 20/5mg (Olmesartan + Amlodipine) is a prescription-only medicine. Contraindicated in pregnancy and severe aortic stenosis. Do not combine with ACE inhibitors or aliskiren. This information is for educational purposes only. Always follow your physician's instructions.
