Indications

Abetis Plus is a tablet indicated for the treatment of hypertension (high blood pressure).

Pharmacology

Abetis Plus is a combination medication containing Olmesartan and Hydrochlorothiazide. Olmesartan is an angiotensin II receptor blocker. It works by preventing the vasoconstrictor angiotensin II from binding to its receptor (AT1), which in turn lowers blood pressure and reduces aldosterone secretion. Hydrochlorothiazide is a thiazide diuretic. It works in the kidneys to increase the excretion of sodium and chloride, which reduces plasma volume. This diuretic action can increase plasma renin activity and cause potassium loss, but the Olmesartan component helps counteract this potassium loss.

Dosage & Administration

The dosage must be individualized. The usual starting dose is one 20/12.5 mg tablet once daily. The dose can be increased every 2-4 weeks to two 40/25 mg tablets once daily, depending on the blood pressure response.

Interaction

• Olmesartan: No significant interactions have been reported when co-administered with hydrochlorothiazide, digoxin, or warfarin. Since Olmesartan is not metabolized by the cytochrome P450 system, it is not expected to interact with drugs that affect these enzymes.
• Hydrochlorothiazide: This component can interact with other drugs. Alcohol, barbiturates, or narcotics can increase the risk of orthostatic hypotension. The dosage of antidiabetic drugs may need to be adjusted. It has an additive effect with other antihypertensive medications. It can also interact with corticosteroids, ACTH, and lithium.

Contraindications

This combination medication is contraindicated in patients who are hypersensitive to any of its components. Due to the Hydrochlorothiazide component, it should not be used by patients with anuria (lack of urine) or a hypersensitivity to other sulfonamide-derived drugs.

Side Effects

Common side effects include nausea, headache, dizziness, increased uric acid, upper respiratory tract infections, and urinary tract infections. Other reported side effects include chest pain, back pain, peripheral edema, abdominal pain, indigestion, gastroenteritis, and diarrhea.

Pregnancy & Lactation

The safety and effectiveness of Abetis Plus have not been established for pregnant or nursing mothers. It should be discontinued during these conditions.

Precautions & Warnings

Regular monitoring of serum electrolytes is important to detect potential imbalances such as low potassium, low sodium, and hypochloremic alkalosis. Some patients on thiazide therapy may experience high uric acid levels. Use with caution in patients with impaired renal function.

Use in Special Populations

• Renal Impairment: This product is not recommended for patients with a creatinine clearance below 30 ml/min.
• Hepatic Impairment: No dosage adjustment is necessary.
• Paediatric use: The safety and effectiveness in children have not been established.
• Geriatric use: Dose selection for elderly patients should be cautious, as clinical studies did not include enough subjects 65 and older to determine if their response differs from younger adults.

Overdose Effects

• Olmesartan: Overdose would likely cause low blood pressure and a fast heart rate. Supportive treatment would be necessary.
• Hydrochlorothiazide: Overdose symptoms are typically caused by excessive fluid and electrolyte loss, which can lead to low potassium levels, dehydration, and cardiac arrhythmias if the patient is also taking digitalis.

Therapeutic Class

This is a combined antihypertensive preparation.

Storage Conditions

Store in a cool and dry place, protected from light and moisture. Keep out of the reach of children.