- Stock: Out Of Stock
- Brand: ACI Pharmaceuticals
- Product ID: Olmesartan Medoxomil + Hydrochlorothiazide
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Abetis Plus 20mg Tablet — Olmesartan Medoxomil + Hydrochlorothiazide | Beximco Pharmaceuticals
| Generic Name | Olmesartan Medoxomil 20mg + Hydrochlorothiazide 12.5mg |
| Drug Class | ARB + Thiazide Diuretic (Fixed-Dose Combination) |
| Manufacturer | Beximco Pharmaceuticals Ltd. |
| Route | Oral (Tablet) |
| Prescription Status | Prescription Required |
Overview
Abetis Plus 20mg combines Olmesartan Medoxomil 20mg with Hydrochlorothiazide (HCTZ) 12.5mg in a single tablet. This fixed-dose combination provides complementary antihypertensive mechanisms — AT1 receptor blockade (olmesartan) plus renal sodium excretion (HCTZ) — achieving superior blood pressure control compared to either agent alone. Olmesartan simultaneously counteracts the potassium-wasting and renin-angiotensin system activation caused by the thiazide component. This combination is suitable for diabetic patients who require more than one antihypertensive but want single-tablet convenience.
Mechanism of Action
Olmesartan Medoxomil: Insurmountable AT1 receptor blocker — prevents angiotensin II-mediated vasoconstriction, aldosterone release, and sodium retention. Reduces intraglomerular pressure, protecting diabetic kidneys.
Hydrochlorothiazide 12.5mg: Inhibits sodium-chloride cotransporter (NCC) in the distal convoluted tubule, increasing urinary sodium and water excretion, reducing plasma volume and vascular resistance. HCTZ-induced renin-angiotensin system activation is directly blocked by olmesartan — explaining the potent synergy.
Indications
- Hypertension not adequately controlled on olmesartan 20mg alone
- Hypertension requiring combination therapy — single-tablet convenience
- Diabetic hypertension with oedema or fluid retention
- Volume-dependent hypertension
Dosage
| Indication | Dose | Notes |
|---|---|---|
| Suboptimal control on ARB monotherapy | 1 tablet once daily | Can replace olmesartan 20mg alone |
| Further titration needed | Switch to 40/12.5mg or 40/25mg | After 2–4 weeks assessment |
Take in the morning with or without food to avoid nocturia from the diuretic component.
Critical Diabetic Patient Information
- Glucose monitoring: HCTZ at 12.5mg has minimal effect on glucose but monitor fasting glucose 2–4 weeks after initiating, especially if on sulfonylureas or insulin
- Electrolytes: The potassium-losing (HCTZ) and potassium-retaining (olmesartan) effects partially offset each other. Net effect varies by individual — check K⁺, Na⁺ at 2–4 weeks and every 3–6 months
- Hydration: Diuretic component increases dehydration risk — maintain adequate fluid intake, especially in hot weather or during illness
- Renoprotection: Despite HCTZ addition, olmesartan continues to reduce intraglomerular pressure and urinary albumin — renoprotective benefit is maintained
- Gout / uric acid: HCTZ can raise uric acid. Monitor in patients with history of gout or hyperuricaemia
Side Effects
| System | Side Effect | Severity |
|---|---|---|
| Electrolytes | Hypokalaemia, hyponatraemia (HCTZ); partially offset by olmesartan | Moderate — monitor |
| Metabolic | Mild hyperglycaemia, hyperuricaemia (HCTZ — minimal at 12.5mg) | Mild |
| Cardiovascular | Hypotension, dizziness (especially first dose) | Common — Mild |
| Renal | Elevated creatinine (from ARB component) | Common — expected |
| Skin | Photosensitivity (HCTZ) — use sun protection | Rare |
| Serious (rare) | Angioedema, severe electrolyte disturbance | Rare — Serious |
Drug Interactions
| Drug | Interaction |
|---|---|
| ACE inhibitors / aliskiren | Contraindicated — dual RAS blockade |
| Lithium | HCTZ reduces lithium excretion — toxicity risk |
| NSAIDs | Reduce antihypertensive and diuretic effect; increase nephrotoxicity |
| Antidiabetics | HCTZ may impair glucose control; adjust dose if needed |
| Potassium-sparing diuretics | May counteract HCTZ potassium loss — monitor K⁺ |
Contraindications
- Pregnancy (second and third trimester)
- Hypersensitivity to olmesartan, HCTZ, or sulfonamides
- Anuria or eGFR <30 (HCTZ ineffective and potentially harmful)
- Severe hepatic impairment
- 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: Is Abetis Plus different from Abetis?
A: Yes. Abetis Plus contains both olmesartan (ARB) AND hydrochlorothiazide (diuretic). Abetis alone contains only olmesartan. The Plus version is for when ARB monotherapy is insufficient.
Q: Can diabetics take diuretics safely?
A: Yes — at the low 12.5mg HCTZ dose in Abetis Plus, metabolic effects are minimal. The olmesartan component also partially offsets any adverse metabolic effects of HCTZ. Regular monitoring is key.
Medical Disclaimer: Abetis Plus 20mg (Olmesartan + Hydrochlorothiazide) is a prescription-only medicine. Contraindicated in pregnancy, anuria, and severe renal/hepatic impairment. Monitor electrolytes, renal function, and glucose regularly. Do not combine with ACE inhibitors or aliskiren. This information is for educational purposes only. Always follow your physician's instructions.
