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- Brand: ACI Pharmaceuticals
- Product ID: Olmesartan Medoxomil
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Abetis 40mg Tablet — Olmesartan Medoxomil | Beximco Pharmaceuticals
| Generic Name | Olmesartan Medoxomil 40mg |
| Drug Class | Angiotensin II Receptor Blocker (ARB) |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Route | Oral (Tablet) |
| Prescription Status | Prescription Required |
Overview
Abetis 40mg is the maximum approved dose of Olmesartan Medoxomil. The 40mg dose is used when lower doses (10–20mg) fail to achieve target blood pressure. It is particularly important in diabetic patients with resistant hypertension or significant proteinuria, where maximum RAS blockade provides the greatest renoprotective benefit. Studies show 40mg olmesartan achieves superior reduction in urinary albumin excretion compared to lower doses.
Mechanism of Action
Olmesartan is hydrolysed after oral absorption to its active form (RNH-6270), which selectively and insurmountably blocks the AT1 receptor. At 40mg, AT1 receptor blockade is more complete and sustained, providing superior 24-hour blood pressure control and greater reduction in intraglomerular hypertension — the key driver of diabetic nephropathy progression.
Indications
- Resistant hypertension — when 20mg is insufficient after 2–4 weeks
- Diabetic nephropathy with significant proteinuria or rapidly declining eGFR
- High cardiovascular risk patients requiring tight BP control (<130/80 mmHg)
- Combination therapy (with amlodipine, HCTZ) in more severe hypertension
Dosage
| Indication | Dose | Notes |
|---|---|---|
| Resistant hypertension | 40mg once daily | Maximum dose — do not exceed |
| Diabetic nephropathy | 40mg once daily | Most effective dose for proteinuria reduction |
| Uptitration protocol | 20mg → 40mg after 2–4 weeks | Reassess BP before increasing |
40mg is the ceiling dose. Exceeding it does not improve efficacy and increases adverse events.
Critical Diabetic Patient Information
- Maximum renoprotection: 40mg olmesartan reduces proteinuria more than lower doses. Diabetic patients with macroalbuminuria or declining eGFR benefit most from the 40mg dose
- Heightened hyperkalaemia risk: Monitor potassium within 1 week of dose increase to 40mg and every 3 months, especially if eGFR <60
- Blood pressure targets: At 40mg, many patients reach <130/80 mmHg. Hypotension risk increases — monitor especially in the elderly, volume-depleted, or those on diuretics
- Absolute prohibition of dual RAS blockade: Never combine with ACE inhibitor or aliskiren at any dose, especially 40mg
Side Effects
| System | Side Effect | Severity |
|---|---|---|
| Renal | Elevated creatinine (expected — stabilises) | Common — usually acceptable |
| Electrolytes | Hyperkalaemia — more likely at 40mg | Moderate — monitor closely |
| Cardiovascular | Hypotension, dizziness, orthostatic symptoms | Common — Mild to Moderate |
| GI | Olmesartan-associated enteropathy (severe diarrhoea) | Rare — may require discontinuation |
| Serious (rare) | Angioedema — discontinue immediately | Rare — Serious |
Drug Interactions
| Drug | Interaction |
|---|---|
| ACE inhibitors | Contraindicated — dual RAS blockade |
| Aliskiren | Contraindicated in diabetics |
| Potassium-sparing diuretics | Significant hyperkalaemia risk at 40mg |
| NSAIDs | Blunt antihypertensive effect; worsen nephrotoxicity |
| Insulin / sulfonylureas | Monitor glucose — improved insulin sensitivity may require dose adjustment |
| Lithium | Increased lithium toxicity |
Contraindications
- Pregnancy (second and third trimester)
- Known hypersensitivity to olmesartan
- Combination with aliskiren in diabetics or eGFR <60
- Bilateral renal artery stenosis
- Severe hepatic impairment
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Frequently Asked Questions
Q: Is 40mg olmesartan the strongest ARB available?
A: 40mg is the maximum approved dose for olmesartan. For stronger RAS blockade, physicians may add amlodipine or HCTZ rather than exceed 40mg olmesartan.
Q: My doctor increased me to 40mg — what monitoring do I need?
A: Get blood tests (renal function + K⁺) within 1–2 weeks of the dose increase. Watch for dizziness on standing. Report any severe diarrhoea to your physician promptly.
Medical Disclaimer: Abetis 40mg (Olmesartan Medoxomil) is a prescription-only medicine. Maximum approved dose — do not exceed. Contraindicated in pregnancy. Requires regular monitoring of renal function and potassium. Do not combine with ACE inhibitors or aliskiren. This information is for educational purposes only. Always follow your physician's instructions.
