{"id":59863,"date":"2024-02-28T06:20:59","date_gmt":"2024-02-28T06:20:59","guid":{"rendered":"https:\/\/medsname.com\/olmezest-am\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"olmezest-am","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/olmezest-am\/","title":{"rendered":"Olmezest AM"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">&#9889; Quick Answer &mdash; What is Olmezest AM?<\/h3>\n<p style=\"margin:0;\"><strong>Olmezest AM<\/strong> je <strong>20\/5 mg fixn\u00ed kombinovan\u00e1 tableta<\/strong> z <strong>olmesartanu 20 mg<\/strong> (blok\u00e1tor angiotenzinov\u00e9ho II receptoru) a <strong>amlodipinu 5 mg<\/strong> (a dihydropyridine calcium-channel blocker) from Mankind Pharma. ARB + CCB is one of the <strong>t\u0159\u00ed v\u011bdecky podlo\u017een\u00fdch dvouslo\u017ekov\u00fdch kombinac\u00ed<\/strong> pro hypertenzi (vedle kombinac\u00ed ARB+thiazid a CCB+thiazid) a byla v\u00edt\u011bznou v\u011btv\u00ed studie <strong>ACCOMPLISH (2008)<\/strong>, kter\u00e1 prok\u00e1zala 20% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod oproti benazeprilu+HCTZ u pacient\u016f s vysokorizikovou hypertenz\u00ed. Ob\u011b slo\u017eky p\u016fsob\u00ed n\u00e1sledovn\u011b <strong>komplement\u00e1rn\u00edch mechanism\u016f<\/strong>: olmesartan blokuje AT<sub>1<\/sub> receptor (vazokonstrikce, aldosteron, sympatick\u00fd tonus); amlodipin blokuje L-typ kalciov\u00fdch kan\u00e1l\u016f ve vaskul\u00e1rn\u00ed hladk\u00e9 svalovin\u011b (arteriol\u00e1rn\u00ed dilatace). Unik\u00e1tn\u011b mezi kombinacemi, <strong>p\u0159id\u00e1n\u00ed olmesartanu k amlodipinu sni\u017euje v\u00fdskyt otok\u016f kotn\u00edk\u016f zp\u016fsoben\u00fdch amlodipinem p\u0159ibli\u017en\u011b o 50%<\/strong> \u2014 ven\u00f3zn\u00ed \u00fa\u010dinek ARB vyrovn\u00e1v\u00e1 arteriol\u00e1rn\u00ed dilataci amlodipinu, \u010d\u00edm\u017e zlep\u0161uje kapil\u00e1rn\u00ed hydrostatick\u00fd tlak. Obvykl\u00e9 d\u00e1vkov\u00e1n\u00ed: jedna tableta jednou denn\u011b. <strong>Absolutn\u011b kontraindikov\u00e1n v t\u011bhotenstv\u00ed<\/strong> (olmesartan), t\u011b\u017ek\u00e1 symptomatick\u00e1 hypotenze, t\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za a obstruk\u010dn\u00ed kardiomyopatie. Sledujte hladinu drasl\u00edku, kreatininu a otoky kotn\u00edk\u016f.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">What Is Olmezest AM?<\/h2>\n<p>Olmezest AM is an oral fixed-dose combination tablet supplying <strong>olmesartanu 20 mg<\/strong> (olmesartan medoxomil) a <strong>amlodipinu 5 mg<\/strong> (amlodipine besilate) in a single pill. Made by Mankind Pharma, supplied in 30-180 tablets.<\/p>\n<p>Olmesartan je blok\u00e1tor receptoru angiotenzinu II (ARB), kter\u00fd byl uveden na trh spole\u010dnost\u00ed Daiichi-Sankyo v roce 2002 pod n\u00e1zvem Benicar\/Olmetec; polo\u010das rozpadu 13 hodin; pat\u0159\u00ed mezi \u00fa\u010dinn\u011bj\u0161\u00ed ARB na miligram. Amlodipin je dlouhodob\u011b p\u016fsob\u00edc\u00ed dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f, kter\u00fd byl uveden na trh spole\u010dnost\u00ed Pfizer v roce 1990 pod n\u00e1zvem Norvasc; polo\u010das rozpadu 30-50 hodin poskytuje v\u00fdjime\u010dn\u011b rovnom\u011brn\u00e9 24hodinov\u00e9 pokryt\u00ed krevn\u00edho tlaku.<\/p>\n<h2 class=\"wp-block-heading\">Pro\u010d kombinovat ARB s blok\u00e1torem kalciov\u00fdch kan\u00e1l\u016f?<\/h2>\n<p>Kombinace ARB + dihydropyridinov\u00e9ho CCB je dvoul\u00e9kov\u00e1 kombinace doporu\u010den\u00e1 v guidelines pro hypertenzi. Od\u016fvodn\u011bn\u00ed:<\/p>\n<ul>\n<li><strong>Dopl\u0148kov\u00e9 mechanismy.<\/strong> Olmesartan blokuje vazokonstrikci \u0159\u00edzenou angiotenzinem II a aldosteronovou slo\u017eku; amlodipin blokuje vaskul\u00e1rn\u00ed hladkosvalovou kontrakci \u0159\u00edzenou v\u00e1pn\u00edkem. Spole\u010dn\u011b zp\u016fsobuj\u00ed aditivn\u00ed sn\u00ed\u017een\u00ed krevn\u00edho tlaku o 10-15 mmHg systolick\u00e9ho ve srovn\u00e1n\u00ed s monoterapi\u00ed.<\/li>\n<li><strong>Metabolick\u00e1 neutralita.<\/strong> Na rozd\u00edl od kombinac\u00ed s thiazidy, ARB+CCB <strong>nezhor\u0161uje gluk\u00f3zovou toleranci, lipidov\u00fd profil ani hladinu kyseliny mo\u010dov\u00e9 v s\u00e9ru<\/strong>. To \u010din\u00ed tuto kombinaci zvl\u00e1\u0161t\u011b vhodnou pro pacienty s metabolick\u00fdm syndromem, diabetem nebo dnou.<\/li>\n<li><strong>Kompenza\u010dn\u00ed regulace otok\u016f kotn\u00edk\u016f zp\u016fsoben\u00fdch amlodipinem.<\/strong> Amlodipin preferen\u010dn\u011b dilatuje prekapil\u00e1rn\u00ed arterioly, \u010d\u00edm\u017e zvy\u0161uje kapil\u00e1rn\u00ed hydrostatick\u00fd tlak a vytla\u010duje tekutinu do tk\u00e1n\u00ed \u2014 klinicky se to projevuje jako otok kotn\u00edk\u016f u 10-20 % pacient\u016f. ARB tuto reakci vyva\u017euj\u00ed dilatac\u00ed postkapil\u00e1rn\u00edho \u017eiln\u00edho \u0159e\u010di\u0161t\u011b, \u010d\u00edm\u017e sni\u017euj\u00ed kapil\u00e1rn\u00ed hydrostatick\u00fd tlak. <strong>P\u0159id\u00e1n\u00ed ARB k amlodipinu p\u0159ibli\u017en\u011b sn\u00ed\u017e\u00ed v\u00fdskyt otok\u016f kotn\u00edk\u016f na polovinu.<\/strong> Toto je nejsiln\u011bj\u0161\u00ed klinick\u00fd argument pro kombinaci ARB+CCB oproti monoterapii kter\u00fdmkoli z t\u011bchto l\u00e9k\u016f.<\/li>\n<li><strong>RAAS kontra-regulace.<\/strong> Vazodilatace vyvolan\u00e1 amlodipinem reflexn\u011b aktivuje syst\u00e9m renin-angiotensin; ARB blokuje tuto kompenza\u010dn\u00ed reakci, \u010d\u00edm\u017e umo\u017e\u0148uje pln\u00fd \u00fa\u010dinek amlodipinu na krevn\u00ed tlak bez sympatick\u00e9 tachykardie, kter\u00e1 se vyskytuje u n\u011bkter\u00fdch kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00edch CCB.<\/li>\n<\/ul>\n<p><strong>D\u016fkazn\u00ed z\u00e1kladna:<\/strong><\/p>\n<ul>\n<li><strong>ACCOMPLISH (2008)<\/strong> \u2014 kombinace benazepril+amlodipin sn\u00ed\u017eila v\u00fdskyt kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod o 20 % ve srovn\u00e1n\u00ed s benazepril+HCTZ u pacient\u016f s vysokorizikovou hypertenz\u00ed. Tento z\u00e1v\u011br byl \u0161iroce extrapolov\u00e1n na kombinace ARB+amlodipin.<\/li>\n<li><strong>ASCOT-BPLA (2005)<\/strong> \u2014 re\u017eim zalo\u017een\u00fd na amlodipinu (\u010dasto s p\u0159idan\u00fdm perindoprilem) p\u0159ekonal re\u017eim zalo\u017een\u00fd na atenololu z hlediska kardiovaskul\u00e1rn\u00edch v\u00fdsledk\u016f a v\u00fdskytu mrtvice.<\/li>\n<li><strong>Studie COACH (2010)<\/strong> \u2014 fixn\u00ed kombinace olmesartan\/amlodipin dos\u00e1hly c\u00edlov\u00fdch hodnot krevn\u00edho tlaku u 60-70 % pacient\u016f ve srovn\u00e1n\u00ed s 35-50 % u monoterapie.<\/li>\n<li><strong>Metaanal\u00fdzy<\/strong> konzistentn\u011b ukazuj\u00ed, \u017ee kombinace ARB+CCB vykazuje ni\u017e\u0161\u00ed v\u00fdskyt kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod na ka\u017ed\u00fd mmHg sn\u00ed\u017een\u00ed TK ve srovn\u00e1n\u00ed s ARB+thiazidem.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed &amp; Titrace<\/h2>\n<p><strong>Standardn\u00ed d\u00e1vka:<\/strong> jedna tableta 20\/5 mg jednou denn\u011b. Denn\u00ed doba pod\u00e1n\u00ed nem\u00e1 klinick\u00fd v\u00fdznam; u\u017e\u00edvejte ve stejnou denn\u00ed dobu.<\/p>\n<p><strong>When to start Olmezest AM:<\/strong><\/p>\n<ul>\n<li>TK nekontrolovan\u00fd p\u0159i <a href=\"https:\/\/medsbase.com\/cs\/olmesar\/\">olmesartan<\/a> nebo <a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">amlodipin<\/a> monoterapii v c\u00edlov\u00e9 d\u00e1vce po dobu 4-6 t\u00fddn\u016f<\/li>\n<li>Hypertenze 2. stupn\u011b (\u2265160\/100) jako po\u010d\u00e1te\u010dn\u00ed dvoukombinace dle preferenc\u00ed AHA\/ACC<\/li>\n<li>Pos\u00edlen\u00ed l\u00e9\u010dby p\u0159i intolerovateln\u00e9m otoku kotn\u00edk\u016f zp\u016fsoben\u00e9m monoterapi\u00ed amlodipinem \u2013 p\u0159id\u00e1n\u00ed ARB \u010dasto sn\u00ed\u017e\u00ed otok na polovinu p\u0159i sou\u010dasn\u00e9m zlep\u0161en\u00ed TK<\/li>\n<li>Pacienti s metabolick\u00fdm syndromem, diabetem nebo dnou, kde je ARB+CCB metabolicky v\u00fdhodn\u011bj\u0161\u00ed ne\u017e ARB+thiazid<\/li>\n<\/ul>\n<p><strong>Titrace:<\/strong> most manufacturers supply 20\/5, 40\/5, 20\/10, and 40\/10 mg strengths. Start at 20\/5; increase to 40\/5 if BP responds well but target not reached; increase to 40\/10 for maximum single-pill effect. Beyond 40\/10, add a third class &mdash; typically a thiazide (Olmezest AM + HCTZ = ARB+CCB+thiazide triple).<\/p>\n<p><strong>Monitorovac\u00ed pl\u00e1n:<\/strong><\/p>\n<ul>\n<li><strong>Vstupn\u00ed vy\u0161et\u0159en\u00ed:<\/strong> mo\u010dovina, elektrolyty, kreatinin, eGFR. V\u00fdchoz\u00ed hodnoty dom\u00e1c\u00edho m\u011b\u0159en\u00ed TK.<\/li>\n<li><strong>1-2 t\u00fddny:<\/strong> opakujte U&amp;E. O\u010dek\u00e1vejte m\u00edrn\u00fd vzestup kreatininu (a\u017e 30% je p\u0159ijateln\u00e9). Vzestup drasl\u00edku je obvykle minim\u00e1ln\u00ed.<\/li>\n<li><strong>4-6 t\u00fddn\u016f:<\/strong> kontrola TK; vy\u0161et\u0159en\u00ed otok\u016f kotn\u00edk\u016f a gingiv\u00e1ln\u00ed hyperplazie.<\/li>\n<li><strong>Pr\u016fb\u011b\u017en\u00e9:<\/strong> ro\u010dn\u00ed U&amp;E. Dom\u00e1c\u00ed m\u011b\u0159en\u00ed TK dvakr\u00e1t t\u00fddn\u011b.<\/li>\n<li><strong>P\u0159eru\u0161te a vy\u0161et\u0159ete:<\/strong> vzestup kreatininu &gt;30%, drasl\u00edk &gt;5,5, symptomatick\u00e1 hypotenze, t\u011b\u017ek\u00e9 otoky kotn\u00edk\u016f nereaguj\u00edc\u00ed na sn\u00ed\u017een\u00ed d\u00e1vky, chronick\u00fd nevysv\u011btliteln\u00fd pr\u016fjem nebo \u00fabytek hmotnosti (specifick\u00e9 varov\u00e1n\u00ed p\u0159ed enteropati\u00ed podobnou sprue u olmesartanu).<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9 (&gt;1 %):<\/strong><\/p>\n<ul>\n<li><strong>Otok kotn\u00edk\u016f<\/strong> &mdash; amlodipine-related; typically milder on Olmezest AM than on amlodipine monotherapy (roughly halved by the ARB component)<\/li>\n<li>M\u00edrn\u00e9 z\u00e1vrat\u011b, n\u00e1valy horka, bolest hlavy (obvykle prvn\u00ed 1-2 t\u00fddny; ustupuje s rozvojem tolerance na vazodilataci)<\/li>\n<li>Palpitace (souvisej\u00edc\u00ed s amlodipinem; reflexn\u00ed tachykardie je u dlouhodob\u011b p\u016fsob\u00edc\u00edho amlodipinu m\u00edrn\u00e1)<\/li>\n<li>O\u010dek\u00e1van\u00fd m\u00edrn\u00fd vzestup kreatininu (a\u017e 30 %)<\/li>\n<li>M\u00edrn\u00e1 hyperkal\u00e9mie<\/li>\n<li>\u00danava, nevolnost, p\u0159\u00edznaky horn\u00edch cest d\u00fdchac\u00edch<\/li>\n<\/ul>\n<p><strong>Nep\u0159\u00edli\u0161 \u010dast\u00e9, ale klinicky v\u00fdznamn\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Hyperplazie d\u00e1sn\u00ed<\/strong> \u2014 souvisej\u00edc\u00ed s amlodipinem; u 1-3 % dlouhodob\u00fdch u\u017eivatel\u016f. Pozornost k \u00fastn\u00ed hygien\u011b sni\u017euje riziko. P\u0159i z\u00e1va\u017en\u00fdch projevech p\u0159ejd\u011bte na re\u017eim bez DHP nebo pouze s ARB.<\/li>\n<li><strong>Angioed\u00e9m<\/strong> \u2014 ni\u017e\u0161\u00ed v\u00fdskyt ne\u017e u ACE inhibitor\u016f, ale mo\u017en\u00fd. Okam\u017eit\u011b vysa\u010fte.<\/li>\n<li><strong>T\u011b\u017ek\u00e1 hyperkal\u00e9mie<\/strong> \u2014 zejm\u00e9na s dopl\u0148ky drasl\u00edku, \u0161et\u0159\u00edc\u00edmi diuretiky na drasl\u00edk, NSAID nebo CKD<\/li>\n<li><strong>Akutn\u00ed po\u0161kozen\u00ed ledvin p\u0159i oboustrann\u00e9 sten\u00f3ze ren\u00e1ln\u00ed arterie<\/strong> \u2014 stejn\u00fd mechanismus jako u monoterapie ARB<\/li>\n<li><strong>Specifick\u00e1 enteropatie podobn\u00e1 sprue u olmesartanu<\/strong> (varov\u00e1n\u00ed FDA z roku 2013) \u2014 chronick\u00fd pr\u016fjem, \u00fabytek hmotnosti, atrofie klk\u016f napodobuj\u00edc\u00ed celiakii. Vz\u00e1cn\u00e9, ale zn\u00e1m\u00e9; po vysazen\u00ed olmesartanu ustupuje.<\/li>\n<li><strong>Zhorsen\u00ed nebo vyvol\u00e1n\u00ed srde\u010dn\u00edho selh\u00e1n\u00ed u t\u011b\u017ece sn\u00ed\u017een\u00e9 ejek\u010dn\u00ed frakce<\/strong> \u2014 amlodipin je neutr\u00e1ln\u00ed u HF-REF (studie PRAISE), ale neochrann\u00fd; existuj\u00ed lep\u0161\u00ed volby pro HF-REF.<\/li>\n<li><strong>Hypotenze po prvn\u00ed d\u00e1vce<\/strong> u pacient\u016f s deplec\u00ed objemu nebo t\u011bch na vysok\u00fdch d\u00e1vk\u00e1ch diuretik<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed \u2014 ABSOLUTN\u00cd kontraindikace ve v\u0161ech trimestrech.<\/strong> Olmesartan je teratogenn\u00ed (fet\u00e1ln\u00ed ren\u00e1ln\u00ed ageneze, oligohydramnion, plicn\u00ed hypoplazie). P\u0159epnout na <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a>, methyldopu nebo nifedipin.<\/li>\n<li><strong>T\u011b\u017ek\u00e1 symptomatick\u00e1 hypotenze<\/strong> (systolick\u00fd TK &lt;90)<\/li>\n<li><strong>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za<\/strong> \u2014 amlodipinem indukovan\u00e1 vazodilatace m\u016f\u017ee vyvolat synkopu p\u0159i fixovan\u00e9 obstrukci v\u00fdtokov\u00e9ho traktu<\/li>\n<li><strong>Obstruk\u010dn\u00ed hypertrofick\u00e1 kardiomyopatie<\/strong> \u2014 podobn\u00e9 riziko dynamick\u00e9 obstrukce<\/li>\n<li><strong>Kardiogenn\u00ed \u0161ok nebo akutn\u00ed IM v pr\u016fb\u011bhu 1 t\u00fddne<\/strong><\/li>\n<li><strong>Bilater\u00e1ln\u00ed sten\u00f3za ren\u00e1ln\u00edch tepen<\/strong><\/li>\n<li><strong>Anamn\u00e9za angioed\u00e9mu p\u0159i u\u017e\u00edv\u00e1n\u00ed ARB nebo ACE inhibitoru<\/strong> (do 4 t\u00fddn\u016f)<\/li>\n<li><strong>Hyperkal\u00e9mie &gt;5,5 mmol\/l v\u00fdchoz\u00ed<\/strong><\/li>\n<li><strong>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed (Child-Pugh C)<\/strong><\/li>\n<li><strong>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed sacubitrilu\/valsartanu (Entresto)<\/strong>, <strong>aliskiren u diabetu nebo CKD<\/strong>, <strong>ACE inhibitory<\/strong> (ONTARGET po\u0161kozen\u00ed)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Simvastatin<\/strong> \u2014 amlodipin zvy\u0161uje expozici simvastatinu a zvy\u0161uje riziko rabdomyol\u00fdzy. <strong>D\u00e1vka simvastatinu nesm\u00ed p\u0159ekro\u010dit 20 mg denn\u011b<\/strong> p\u0159i u\u017e\u00edv\u00e1n\u00ed s amlodipinem. Pokud jsou pot\u0159eba vy\u0161\u0161\u00ed d\u00e1vky statinu, pou\u017eijte alternativn\u00ed statin (rosuvastatin, atorvastatin a\u017e do 40 mg).<\/li>\n<li><strong>Siln\u00e9 inhibitory CYP3A4<\/strong> (klarithromycin, itrakonazol, ketokonazol, ritonavir, kobicistat, diltiazem, verapamil) \u2014 zvy\u0161uj\u00ed hladiny amlodipinu. Pokud je to mo\u017en\u00e9, vyhn\u011bte se chronick\u00e9 kombinaci; pe\u010dliv\u011b monitorujte TK a sni\u017ete d\u00e1vku amlodipinu, pokud se zhor\u0161\u00ed hypotenze nebo otoky.<\/li>\n<li><strong>Siln\u00e9 induktory CYP3A4<\/strong> (rifampicin, karbamazepin, fenytoin, t\u0159ezalka te\u010dkovan\u00e1) \u2014 sni\u017euj\u00ed hladiny amlodipinu a jeho \u00fa\u010dinek na TK.<\/li>\n<li><strong>Grapefruitov\u00e1 \u0161\u0165\u00e1va<\/strong> \u2014 m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed hladin amlodipinu; pravideln\u00e1 vysok\u00e1 konzumace (&gt;1 l\/den) m\u016f\u017ee zv\u00fd\u0161it \u00fa\u010dinek na TK; ob\u010dasn\u00e1 konzumace je v po\u0159\u00e1dku.<\/li>\n<li><strong>NSAID<\/strong> \u2014 sni\u017euj\u00ed antihypertenzn\u00ed \u00fa\u010dinek obou slo\u017eek; zvy\u0161uj\u00ed riziko AKI s ARB.<\/li>\n<li><strong>Drasl\u00edkov\u00e9 dopl\u0148ky, \u0161et\u0159\u00edc\u00ed diuretika (spironolakton, eplerenon, amilorid)<\/strong> \u2014 aditivn\u00ed hyperkal\u00e9mie; pe\u010dliv\u011b monitorujte.<\/li>\n<li><strong>Lithium<\/strong> \u2014 ARB sni\u017euj\u00ed clearance lithia; monitorujte hladiny, pokud je kombinace nevyhnuteln\u00e1.<\/li>\n<li><strong>Tacrolimus, cyklosporin<\/strong> \u2014 amlodipin zvy\u0161uje jejich hladiny; monitorujte spodn\u00ed hladiny.<\/li>\n<li><strong>Jin\u00e9 ACE inhibitory, jin\u00e9 ARB, aliskiren<\/strong> \u2014 nekombinujte.<\/li>\n<li><strong>Sildenafil, tadalafil, alfa-blok\u00e1tory<\/strong> \u2014 aditivn\u00ed hypotenze. Odd\u011blit d\u00e1vkov\u00e1n\u00ed; za\u010d\u00edt ni\u017e\u0161\u00ed d\u00e1vkou PDE5 inhibitoru (sildenafil 25 mg; tadalafil 5 mg).<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Olmezest AM vs ARB+Thiazide Combinations<\/h2>\n<p>Ob\u011b kombinace ARB+CCB a ARB+thiazid jsou doporu\u010dov\u00e1ny ve sm\u011brnic\u00edch jako druh\u00e1 volba. Kl\u00ed\u010dov\u00e9 rozd\u00edly:<\/p>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Faktor<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">ARB + CCB (Olmezest AM)<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">ARB + HCTZ (nap\u0159. Telma H)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">D\u016fkazy o kardiovaskul\u00e1rn\u00edch v\u00fdsledc\u00edch<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u011bj\u0161\u00ed (ACCOMPLISH)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">St\u0159edn\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Metabolick\u00fd profil<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Neutr\u00e1ln\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zhor\u0161uje gluk\u00f3zu, ur\u00e1ty, lipidy<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vhodn\u00e9 u diabetu, dny, metabolick\u00e9ho syndromu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ano (preferov\u00e1no)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ano, ale zhor\u0161uje gluk\u00f3zu\/ur\u00e1ty<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Otok kotn\u00edk\u016f<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Mo\u017en\u00e9 (m\u00e9n\u011b ne\u017e samotn\u00fd amlodipin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ne<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Porucha elektrolyt\u016f<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Minim\u00e1ln\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Mo\u017en\u00e1 hypokal\u00e9mie, hyponatr\u00e9mie<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">CKD (eGFR 30-60)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u00da\u010dinn\u00e9<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HCTZ ztr\u00e1c\u00ed \u00fa\u010dinnost p\u0159i n\u00edzk\u00e9 GFR<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Preferov\u00e1no p\u0159i<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Diabetes, dna, CKD, metabolick\u00fd syndrom, \u010derno\u0161\u0161t\u00ed pacienti<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Stavy s objemov\u00fdm p\u0159et\u00ed\u017een\u00edm, rezistentn\u00ed hypertenze<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Bottom line: for most younger patients with uncomplicated hypertension who need a two-drug combination, ARB+CCB (Olmezest AM) has a slight edge in CV outcome evidence and metabolic profile. ARB+HCTZ remains first choice in volume-expanded states (salt-sensitive hypertension, obesity, Black patients &mdash; though amlodipine is also strongly effective in Black patients) and in resistant hypertension requiring triple therapy.<\/p>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Store Olmezest AM below 25&deg;C in the original blister pack. Keep out of reach of children.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d kombinovat olmesartan s amlodipinem v jedn\u00e9 tablet\u011b?<\/h3>\n<p>Dva d\u016fvody. Za prv\u00e9, <strong>aditivn\u00ed sn\u00ed\u017een\u00ed krevn\u00edho tlaku<\/strong>: oba l\u00e9ky p\u016fsob\u00ed na komplement\u00e1rn\u00ed dr\u00e1hy (angiotensinov\u00fd receptor a L-typ kalciov\u00e9ho kan\u00e1lu), co\u017e vede k poklesu systolick\u00e9ho tlaku o 10-15 mmHg v\u00edce ne\u017e u ka\u017ed\u00e9ho l\u00e9ku samostatn\u011b. Za druh\u00e9, a m\u00e9n\u011b zjevn\u011b, <strong>p\u0159id\u00e1n\u00ed ARB k amlodipinu zhruba sn\u00ed\u017e\u00ed v\u00fdskyt otok\u016f kotn\u00edk\u016f na polovinu<\/strong> \u2014 venodilata\u010dn\u00ed \u00fa\u010dinek ARB vyva\u017euje arteriol\u00e1rn\u00ed dilataci amlodipinu, \u010d\u00edm\u017e zlep\u0161uje kapil\u00e1rn\u00ed hydrostatick\u00fd tlak. D\u016fkazy z studie ACCOMPLISH ukazuj\u00ed ni\u017e\u0161\u00ed v\u00fdskyt kardiovaskul\u00e1rn\u00edch p\u0159\u00edhod u kombinace ARB+amlodipin ne\u017e u ARB+HCTZ u vysoce rizikov\u00fdch pacient\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Will Olmezest AM cause ankle swelling?<\/h3>\n<p>Mo\u017en\u00e1 \u2014 ale <strong>m\u00e9n\u011b \u010dasto ne\u017e amlodipinov\u00e1 monoterapie<\/strong>. Samotn\u00fd amlodipin zp\u016fsobuje otoky kotn\u00edk\u016f u 10-20 % pacient\u016f. P\u0159id\u00e1n\u00ed olmesartanu tuto m\u00edru sn\u00ed\u017e\u00ed na p\u0159ibli\u017en\u011b 5-10 %. Otoky jsou obvykle m\u00edrn\u00e9, neprogresivn\u00ed a <strong>nereaguj\u00ed na diuretika<\/strong> (jde o kapil\u00e1rn\u011b-hydrostatick\u00fd, nikoli objemov\u00fd p\u0159et\u00ed\u017een\u00fd mechanismus). Pokud jsou otoky obt\u011b\u017euj\u00edc\u00ed, mo\u017enosti jsou: sn\u00ed\u017eit d\u00e1vku amlodipinu na 5 mg (tableta 20\/5), p\u0159ej\u00edt na ne-DHP CCB (diltiazem) nebo p\u0159ej\u00edt na kombinaci ARB+thiazid.<\/p>\n<h3 class=\"wp-block-heading\">When should I take Olmezest AM?<\/h3>\n<p>Jednou denn\u011b ve stejnou dobu ka\u017ed\u00fd den. <strong>\u010cas pod\u00e1n\u00ed nem\u00e1 klinick\u00fd v\u00fdznam.<\/strong> for Olmezest AM &mdash; both olmesartan (13-hour half-life) and amlodipine (30-50-hour half-life) give 24-hour BP coverage. Morning dosing is most convenient for most patients; evening dosing is occasionally used in patients who do not show normal nocturnal BP dipping.<\/p>\n<h3 class=\"wp-block-heading\">I&rsquo;m diabetic &mdash; is Olmezest AM safe?<\/h3>\n<p>Ano \u2014 kombinace ARB+amlodipin je <strong>preferovan\u00e1 kombinace u diabetu<\/strong> proto\u017ee je metabolicky neutr\u00e1ln\u00ed (nezhor\u0161uje gluk\u00f3zovou toleranci, lipidy ani kyselinu mo\u010dovou na rozd\u00edl od thiazid\u016f). Olmesartan m\u00e1 specifick\u00e9 d\u016fkazy pro diabetickou nefropatii (ROADMAP). Sledujte obvykl\u00fdm zp\u016fsobem funkci ledvin a hladinu drasl\u00edku.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Olmezest AM with a statin?<\/h3>\n<p>V\u011bt\u0161inou ano, s jedn\u00edm omezen\u00edm: <strong>d\u00e1vka simvastatinu nesm\u00ed p\u0159ekro\u010dit 20 mg denn\u011b<\/strong> p\u0159i u\u017e\u00edv\u00e1n\u00ed s amlodipinem (amlodipin zvy\u0161uje expozici simvastatinu a zvy\u0161uje riziko rabdomyol\u00fdzy). Rosuvastatin (<a href=\"https:\/\/medsbase.com\/cs\/rosu-hdl\/\">Rozucor<\/a>), atorvastatin do 40 mg a pravastatin nejsou amlodipinem ovlivn\u011bny a lze je u\u017e\u00edvat v jak\u00e9koli d\u00e1vce.<\/p>\n<h3 class=\"wp-block-heading\">Can I eat grapefruit while taking Olmezest AM?<\/h3>\n<p>Ob\u010dasn\u00fd grapefruit je v po\u0159\u00e1dku. Pravideln\u00e1 vysok\u00e1 konzumace (v\u00edce ne\u017e p\u0159ibli\u017en\u011b 1 litr \u0161\u0165\u00e1vy denn\u011b) m\u016f\u017ee m\u00edrn\u011b zv\u00fd\u0161it hladinu amlodipinu inhibic\u00ed CYP3A4, co\u017e m\u016f\u017ee potenci\u00e1ln\u011b zhor\u0161it pokles krevn\u00edho tlaku nebo otoky kotn\u00edk\u016f. Jin\u00e9 dihydropyridiny (zejm\u00e9na felodipin) jsou na grapefruit citliv\u011bj\u0161\u00ed; interakce s amlodipinem je relativn\u011b m\u00edrn\u00e1.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Olmezest AM in pregnancy?<\/h3>\n<p><strong>Ne \u2014 absolutn\u011b kontraindikov\u00e1no.<\/strong> Olmesartan is teratogenic (fetal renal agenesis, oligohydramnios, pulmonary hypoplasia, skull defects). Amlodipine alone has been used in pregnancy (there is modest safety data) but the olmesartan component makes Olmezest AM unsuitable. Switch to <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a>, methyldopa nebo nifedipin (monoterapie).<\/p>\n<h3 class=\"wp-block-heading\">Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Vezm\u011bte si l\u00e9k, jakmile si vzpomenete, pokud nen\u00ed dal\u0161\u00ed d\u00e1vka napl\u00e1nov\u00e1na b\u011bhem n\u011bkolika hodin \u2014 v tom p\u0159\u00edpad\u011b vynechejte vynechanou d\u00e1vku. Ned\u00e1vejte si dvojitou d\u00e1vku. Dlouh\u00fd polo\u010das amlodipinu zaji\u0161\u0165uje, \u017ee kontrola krevn\u00edho tlaku je pom\u011brn\u011b tolerantn\u00ed k jedn\u00e9 vynechan\u00e9 d\u00e1vce; n\u011bkolik po sob\u011b jdouc\u00edch vynechan\u00fdch dn\u016f v\u0161ak m\u016f\u017ee v\u00e9st k op\u011btovn\u00e9mu zv\u00fd\u0161en\u00ed krevn\u00edho tlaku.<\/p>\n<h3 class=\"wp-block-heading\">I developed chronic diarrhoea on Olmezest AM &mdash; what should I do?<\/h3>\n<p>Prove\u010fte vy\u0161et\u0159en\u00ed na <strong>olmesartanem asociovanou enteropatii podobnou sprue<\/strong> \u2014 vz\u00e1cnou, ale zn\u00e1mou komplikaci (varov\u00e1n\u00ed FDA z roku 2013), kter\u00e1 se projevuje chronick\u00fdm pr\u016fjmem, \u00fabytkem hmotnosti a atrofi\u00ed klk\u016f napodobuj\u00edc\u00ed celiakii. Stav se uprav\u00ed po vysazen\u00ed olmesartanu. P\u0159echod na jin\u00fd ARB (telmisartan, valsartan, losartan) nebo na zcela jinou t\u0159\u00eddu l\u00e9k\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Where can I buy Olmezest AM online?<\/h3>\n<p>You can buy Olmezest AM (20\/5 mg olmesartan + amlodipine, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlode \u2014 Amlodipin 5\/10 mg (BKK)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">Aquazide \u2014 Hydrochlorothiazid<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/coversyl\/\">Coversyl &mdash; Perindopril (ACEi alternative)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/losatec-h\/\">Losatec H \u2014 Losartan + HCTZ<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">Telmaheal \u2014 Telmisartan 20\/40\/80 mg (monoterapie)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/valzaar-h\/\">Valzaar H \u2014 Valsartan + HCTZ<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/healmaryl\/\">Healmaryl<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/asthalin\/\">Asthalin<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/pirox-dt\/\">Pirox DT<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/glinil-m\/\">Glinil M<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lispro\/\">Lispro<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Olmezest AM is Mankind Pharma&#8217;s fixed-dose olmesartan 20 mg + amlodipine 5 mg tablets \u2014 metabolically-neutral ARB+CCB combination backed by ACCOMPLISH trial evidence (20% lower CV events vs ARB+thiazide in high-risk hypertension). Uniquely, adding olmesartan to amlodipine roughly halves the amlodipine ankle-oedema rate \u2014 the ARB&#8217;s venous dilation rebalances amlodipine&#8217;s arteriolar dilation. Preferred combination in diabetes, gout, and metabolic syndrome.<\/p>","protected":false},"featured_media":59864,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3342,3260,3356],"product_tag":[3362,3427,4755],"class_list":{"0":"post-59863","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-general-health","9":"product_cat-heart-blood-pressure","10":"product_cat-high-blood-pressure-medication","11":"product_tag-amlodipine","12":"product_tag-olmesartan","13":"product_tag-olmezest-am","15":"first","16":"instock","17":"shipping-taxable","18":"purchasable","19":"product-type-variable","20":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/59863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=59863"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/59864"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=59863"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=59863"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=59863"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=59863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}