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- Brand: ACI Pharmaceuticals
- Product ID: Olmesartan Medoxomil
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Abetis 20mg Tablet — Olmesartan Medoxomil | Beximco Pharmaceuticals
| Generic Name | Olmesartan Medoxomil 20mg |
| Drug Class | Angiotensin II Receptor Blocker (ARB) |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Route | Oral (Tablet) |
| Prescription Status | Prescription Required |
Overview
Abetis 20mg is the standard maintenance dose of Olmesartan Medoxomil — the most commonly prescribed ARB strength for hypertension management. It is the recommended starting dose for most adult patients and provides effective 24-hour blood pressure control. For diabetic patients, 20mg olmesartan provides clinically significant renoprotection, reducing microalbuminuria and slowing the progression of diabetic nephropathy. Doses can be uptitrated to 40mg if the target BP of <130/80 mmHg is not achieved.
Mechanism of Action
Olmesartan is a prodrug hydrolysed to its active form (RNH-6270) in the gut wall and liver. It binds selectively and insurmountably to the AT1 subtype of the angiotensin II receptor, blocking angiotensin II-mediated vasoconstriction, aldosterone release, and sodium-water retention. It also reduces intraglomerular hypertension — a key mechanism in diabetic nephropathy — more effectively than most other antihypertensives at equivalent blood pressure reduction.
Indications
- Hypertension — standard first-line therapy in adults
- Diabetic nephropathy — renoprotection in Type 2 diabetics with microalbuminuria or macroalbuminuria
- Hypertension in metabolic syndrome — preferred due to metabolic neutrality
- Heart failure with reduced ejection fraction (combination therapy)
Dosage
| Indication | Starting Dose | Maintenance | Maximum |
|---|---|---|---|
| Hypertension (adults) | 20mg once daily | 20mg once daily | 40mg once daily |
| Diabetic nephropathy | 20mg once daily | 20–40mg once daily | 40mg once daily |
| Elderly (>65 years) | 10–20mg once daily | 20mg | 40mg if tolerated |
Take at the same time each day with or without food. Maximum antihypertensive effect achieved within 2 weeks of a dose. Reassess response before uptitrating to 40mg.
Critical Diabetic Patient Information
- Preferred ARB dose for diabetics: 20mg is the recommended starting and maintenance dose for diabetics. It significantly reduces microalbuminuria (marker of early nephropathy) and cardiovascular risk
- Metabolic neutrality: Unlike thiazide diuretics or beta-blockers, olmesartan does not worsen insulin resistance, dyslipidaemia, or glucose control — particularly important in diabetic patients
- Potassium monitoring: ARBs reduce aldosterone-driven potassium excretion. Check serum K⁺ at baseline, 2 weeks after starting, and every 3–6 months, especially if eGFR <60 or on concurrent RAAS-affecting drugs
- Renal function: A 20–30% rise in creatinine after initiating therapy reflects reduced intraglomerular pressure and is beneficial. Larger rises warrant specialist assessment
- Avoid in pregnancy: Discontinue immediately if pregnancy is confirmed — olmesartan causes fetal renal failure and death in second/third trimester
Side Effects
| System | Side Effect | Severity |
|---|---|---|
| Renal | Elevated creatinine (initial, usually stabilises) | Common — usually acceptable |
| Electrolytes | Hyperkalaemia | Moderate — monitor |
| Cardiovascular | Hypotension, dizziness, headache | Common — Mild |
| GI | Olmesartan-associated enteropathy (severe diarrhoea — rare) | Rare |
| Respiratory | No drug cough (unlike ACE inhibitors) | — |
| Serious (rare) | Angioedema — discontinue and seek emergency care | Rare — Serious |
Drug Interactions
| Drug | Interaction |
|---|---|
| ACE inhibitors (e.g. enalapril, lisinopril) | Contraindicated combination — dual RAS blockade |
| Aliskiren | Contraindicated in diabetics (ALTITUDE trial) |
| Potassium-sparing diuretics / K⁺ supplements | Additive hyperkalaemia risk |
| NSAIDs (ibuprofen, diclofenac, naproxen) | Attenuate antihypertensive effect; worsen renal function |
| Antidiabetics (insulin, metformin, sulfonylureas) | May enhance insulin sensitivity — monitor blood glucose |
| Lithium | Increased lithium toxicity — monitor levels |
| Antacids (colesevelam) | May reduce olmesartan absorption — take 4 hours apart |
Contraindications
- Pregnancy (second and third trimester — fetal toxicity)
- Known hypersensitivity to olmesartan or any component
- Combination with aliskiren in patients with diabetes or eGFR <60
- Bilateral renal artery stenosis or single functioning kidney with renal artery stenosis
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Frequently Asked Questions
Q: Is 20mg the right dose for me?
A: For most adults, 20mg once daily is the standard maintenance dose. Your physician will assess your blood pressure response at 2–4 weeks and decide if uptitration to 40mg is needed.
Q: Can I take Abetis 20mg long-term?
A: Yes. ARBs are intended for long-term use and are among the best-tolerated antihypertensives available. Long-term use has demonstrated cardiovascular and renal protective benefits in diabetics.
Q: What happens if I miss a dose?
A: Take it as soon as you remember, unless it is almost time for your next dose — then skip the missed dose. Do not double up. Consistency is important for sustained blood pressure control.
Medical Disclaimer: Abetis 20mg (Olmesartan Medoxomil) is a prescription-only medicine. Contraindicated in pregnancy. Monitor renal function and potassium regularly. Do not combine with ACE inhibitors or aliskiren. This information is for educational purposes only. Always follow your physician's instructions.
