Olmetec Plus Dosage/Direction for Use

Adults: Olmesartan medoxomil-hydrochlorothiazide is administered once daily, with or without food, in patients whose blood pressure is not adequately controlled by olmesartan medoxomil or hydrochlorothiazide alone.
When clinically appropriate, direct change from monotherapy to the fixed combination may be considered. Dose titration of the individual components is recommended:
Olmesartan medoxomil-hydrochlorothiazide 20/12.5 mg may be administered in patients whose blood pressure is not adequately controlled with hydrochlorothiazide 12.5 or 25 mg monotherapy, or olmesartan medoxomil 20 mg alone. If additional blood pressure lowering is required the dose of each monocomponent may be titrated to the strength of olmesartan medoxomil-hydrochlorothiazide 40/12.5 mg and subsequently, if required to 40/25 mg.
Olmesartan medoxomil-hydrochlorothiazide 40/12.5 and 40/25 mg may be administered in patients whose blood pressure is not adequately controlled by olmesartan medoxomil 40 mg alone, hydrochlorothiazide alone or olmesartan medoxomil-hydrochlorothiazide 20/12.5 mg.
Elderly: No initial dosage adjustments recommended for elderly patients (see Pharmacokinetics under Actions).
Renal Impairment: In patients with mild to moderate renal impairment (creatinine clearance of 30-60 mL/min) the dosage of olmesartan medoxomil should not exceed 20 mg daily (ie, olmesartan medoxomil-hydrochlorothiazide 20/12.5 mg), owing to limited experience of higher dosages of olmesartan medoxomil in this patient group (see Pharmacokinetics under Actions). When olmesartan medoxomil-hydrochlorothiazide is used in such patients, periodic monitoring of renal function is advised (see Precautions). Olmesartan medoxomil-hydrochlorothiazide is contraindicated in patients with severe renal impairment (creatinine clearance <30 mL/min) (see Contraindications).
Hepatic Impairment: The use of olmesartan medoxomil-hydrochlorothiazide in patients with hepatic impairment is not recommended since there is currently limited experience of olmesartan medoxomil in this patient group (see Pharmacokinetics under Actions and Precautions).
Children and Adolescents: The safety and efficacy of olmesartan medoxomil-hydrochlorothiazide have not been established in children and adolescents up to 18 years.