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Safety Advices
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UNSAFE
Plus 40 may cause excessive drowsiness with alcohol.
CONSULT YOUR DOCTOR
Plus 40 is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
SAFE IF PRESCRIBED
Plus 40 is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
UNSAFE
Plus 40 may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
Plus 40 should be used with caution in patients with severe kidney disease. Dose adjustment of Plus 40 may be needed. Please consult your doctor.
Regular monitoring of blood pressure is advisable for dose adjustment.
CAUTION
Plus 40 should be used with caution in patients with liver disease. Dose adjustment of Plus 40 may be needed. Please consult your doctor.
Medicine Overview of Plus 40mg+12.5mg Tablet
Introduction
Plus 40 is a combination of two medicines. It helps to control high blood pressure in different ways. If high blood pressure is not treated it can lead to heart attacks, strokes and kidney failure. Plus 40 is a medicine used to treat hypertension (high blood pressure). It is a combination of some medicines that helps to control blood pressure when a single medication is not effective. It helps to reduce high blood pressure, thus lowering the chances of any future heart attack and stroke. It is taken with or without food, preferably in the morning to avoid frequent urination...
... Show moreUses of Plus 40
- Hypertension (high blood pressure)
Side effects of Plus 40
Common
- Nausea
- Taste change
- Upset stomach
- Diarrhea
- Headache
- Dizziness
- Weakness
- Electrolyte imbalance
- Glucose intolerance
- Increased blood lipid level
- Increased blood uric acid
- Decreased blood pressure
How to use Plus 40
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Plus 40 may be taken with or without food, but it is better to take it at a fixed time.
How Plus 40 works
Plus 40 is a combination of two medicines: Hydrochlorothiazide and olmesartan which lower blood pressure effectively. Hydrochlorothiazide is a diuretic that removes extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow. Olmesartan is an angiotensin receptor blocker (ARB). It works by blocking the hormone angiotensin thereby relaxing blood vessels. This allows the blood to flow more smoothly and the heart to pump more efficiently.
Quick Tips
- You have been prescribed Plus 40 for the treatment of high blood pressure.
- It can be taken with or without food.
- Plus 40 may cause dehydration. Drink plenty of fluids and inform your doctor if you develop extreme thirst, very dry mouth or muscle weakness.
- It may cause dizziness. Get up slowly when rising from a sitting or lying position.
- Use of Plus 40 during pregnancy or breastfeeding is unsafe.
- It may also decrease the risk of stroke and heart attacks.
Brief Description
Indication
Hypertension, Diabetic nephropathy
Administration
May be taken with or without food.
Adult Dose
Hypertension
Initial: 20 mg/12.5 mg PO qDay
May increase to 40 mg/25 mg after 2 weeks
Hepatic Impairment
Dose adjustment not necessary
Child Dose
Safety and efficacy not established
Renal Dose
Renal Impairment
CrCl <30 mL/min: Not recommended
Contraindication
Hypersensitivity to olmesartan medoxomil, hydrochlorothiazide or to other sulfonamide-derived drugs. Severe hepatic & renal impairment (CrCl <30 mL/min); cholestasis & biliary obstructive disorders; refractory hypokalemia; hypercalcemia; hyponatraemia, symptomatic hyperuricaemia; anuria. Concomitant use w/ aliskiren in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m2). Pregnancy (2nd & 3rd trimester) & lactation.
Mode of Action
Hydrochlorothiazide inhibits the reabsorption of Na and chloride in the distal tubules causing increased excretion of Na and water K and hydrogen ions.
Olmesartan is a selective and competitive angiotensin II Type 1 (AT1) receptor antagonist that blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II. As a result, olmesartan relaxes blood vessels, hence lowering BP and increases blood supply and oxygen to the heart.
Precaution
Drugs that act on renin-angiotensin system can cause fetal injury and death when used in 2nd and 3rd trimesters of pregnancy. Olmesartan medoxomil should be discontinued as soon as possible once pregnancy is detected. Symptomatic hypotension may occur in patients who are volume- and/or salt-depleted. May be associated with oliguria, progressive azotaemia, and acute renal failure (rare). Patients with bilateral or unilateral renal artery stenosis may have increased risk of severe hypotension and renal insufficiency. Caution in renal impairment; monitor serum creatinine and potassium levels periodically. Avoid use in severe renal impairment (CrCl< 20 mL/min) and severe hepatic impairment. Caution...
... Show moreSide Effect
1-10%
Olmesartan
Dizziness (3%),Headache (1%),Fatigue,Diarrhea (1%),Hyperglycemia (1%),Hypertriglyceridemia (1%),Back pain (1%),Bronchitis (1%),Flu-like symptoms (1%),Pharyngitis (1%),Rhinitis (1%),Sinusitis (1%),URI (1%)
Frequency Not Defined
Chest pain,Peripheral edema,Rash,Hyperuricemia,Dizziness,Hyperlipidemia,Diarrhea,Hyperuricemia,Hematuria,Hyperglycemia,Upper respiratory infections,Increased transaminases,Gastroenteritis,Dyspepsia,Arthralgia,Arthritis,Myalgia,Back pain,Increased CPK,Hydrochlorothiazide,Anorexia,Epigastric distress,Hypotension,Orthostatic hypotension,Photosensitivity,Anaphylaxis,Anemia,Confusion,Erythema multiforme,Stevens-Johnson syndrome,Exfoliative dermatitis including toxic epidermal necrolysis,Dizziness,Hypokalemia and/or hypomagnesemia,Hyperuricemia,Headache
Potentially Fatal: Acute renal failure.
Pregnancy Category Note
Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters)
Interaction
Olmesartan medoxomil: Increased risk of hypotension, hyperkalemia & changes in renal function w/ aliskiren. May result in deterioration of renal function w/ NSAIDs. May attenuate the antihypertensive effect of angiotensin II receptor antagonists. Reduces systemic exposure & peak plasma conc w/ colosevelam HCl.
Hydrochlorothiazide: Potentiation of orthostatic hypotension w/ alcohol, barbiturates or narcotics. Antidiabetic drugs. Potentiation effect w/ other antihypertensives. Reduced absorption w/ cholestyramine & colestipol resins. Intensified electrolyte depletion w/ corticosteroid, ACTH. Decreased response to pressor amines (eg norepinephrine). Increased responsiveness to skeletal muscle relaxants (eg tubocurarine). Reduce the renal clearance of lithium.
