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Amlodipine and Olmesartan Medoxomil

Prescription ANDA TE AB Official labelling
Informational index, not medical advice. Content is reproduced from public FDA and NLM data. Always confirm against the manufacturer's current prescribing information. Report adverse events to FDA MedWatch.

Overview

Brand name
AMLODIPINE AND OLMESARTAN MEDOXOMIL
Generic name
Amlodipine and Olmesartan Medoxomil
Dosage form
Tablet
Route
Oral
Marketing category
ANDA · ANDA
Labeler
Ascend Laboratories, LLC
Product type
Human Prescription Drug
DEA schedule
Not scheduled
Active ingredients
4
NDC product codes
9
Packages
26
Data completeness
83% of corroborating sources present

Active ingredients

Source: NDC Directory
Active ingredients and strengths as listed in the NDC Directory.
Ingredient Strength RxCUI Monograph
Amlodipine Besylate 10 mg/1 999967 View
Amlodipine Besylate 5 mg/1 999967 View
Olmesartan Medoxomil 20 mg/1 999967 View
Olmesartan Medoxomil 40 mg/1 999967 View

Forms, strengths and routes

Source: NDC Directory
Dosage form
Tablet
Route of administration
Oral
Presentations
35

Pharmacologic classes are listed in the class section below.

Pharmacologic class

Source: NDC Directory
Established pharmacologic classes (EPC), mechanisms of action (MoA), chemical structures (CS) and physiologic effects (PE).
Class Type Browse
Angiotensin 2 Receptor Antagonists [MoA] MoA All 63 members
Angiotensin 2 Receptor Blocker [EPC] EPC All 67 members
Calcium Channel Antagonists [MoA] MoA All 75 members
Calcium Channel Blocker [EPC] EPC All 55 members
Cytochrome P450 3A Inhibitors [MoA] MoA All 89 members
Dihydropyridine Calcium Channel Blocker [EPC] EPC All 49 members
Dihydropyridines [CS] CS All 49 members

Regulatory status

Source: Drugs@FDANDC Directory
Application number
207435
Application type
ANDA · Abbreviated New Drug Application
Approval date
November 2, 2017
Sponsor
MICRO LABS
Products on application
4
Submissions recorded
2
Products approved under application 207435.
Product Trade name Form Strength Ingredient Status TE Flags
207435-001 AMLODIPINE AND OLMESARTAN MEDOXOMIL TABLET AMLODIPINE BESYLATE; OLMESARTAN MEDOXOMIL Prescription AB
207435-002 AMLODIPINE AND OLMESARTAN MEDOXOMIL TABLET AMLODIPINE BESYLATE; OLMESARTAN MEDOXOMIL Prescription AB
207435-003 AMLODIPINE AND OLMESARTAN MEDOXOMIL TABLET AMLODIPINE BESYLATE; OLMESARTAN MEDOXOMIL Prescription AB
207435-004 AMLODIPINE AND OLMESARTAN MEDOXOMIL TABLET AMLODIPINE BESYLATE; OLMESARTAN MEDOXOMIL Prescription AB

Therapeutic equivalence

Source: Orange Book
TE code
AB
Reference Listed Drug
No
Reference Standard
No

What this rating means: Therapeutically equivalent — bioequivalence demonstrated by in vivo or in vitro testing

Codes beginning with “A” indicate products the FDA considers therapeutically equivalent. Codes beginning with “B” indicate bioequivalence has not been established. See methodology.

Approval history

Source: Drugs@FDA
Most recent submissions on application 207435.
Type No. Action Status Date Review
Supplement 3 Labeling Approved December 28, 2020 Standard
Original application 1 Approved November 2, 2017 Standard

Prescribing information

Source: openFDA Drug Labeling

Reproduced verbatim from the Structured Product Labeling submitted to the FDA (effective 20250530). This is the manufacturer's labelling text, not a summary and not advice.

HUMAN PRESCRIPTION DRUG · 20250530 HUMAN PRESCRIPTION DRUG · 20250109 HUMAN PRESCRIPTION DRUG · 20240815

Boxed Warning

openFDA Drug Labeling

WARNING: FETAL TOXICITY When pregnancy is detected, discontinue Amlodipine and Olmesartan Medoxomil Tablets as soon as possible ( 5.1 , 8.1 ). Drugs that act directly on the renin-angiotensin system (RAS) can cause injury and death to the developing fetus ( 5.1 , 8.1 ). WARNING: FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue Amlodipine and Olmesartan Medoxomil Tablets as soon as possible ( 5.1 , 8.1 ). Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus ( 5.1 , 8.1 ).

Indications and Usage

openFDA Drug Labeling

1 INDICATIONS AND USAGE Amlodipine and Olmesartan Medoxomil Tablets is indicated for the treatment of hypertension, alone or with other antihypertensive agents, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular (CV) events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. There are no controlled trials demonstrating risk reduction with Amlodipine and Olmesartan Medoxomil Tablets. Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC). Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly. Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal. Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy. Amlodipine and Olmesartan Medoxomil Tablets may also be used as initial therapy in patients who are likely to need multiple antihypertensive agents to achieve their blood pressure goals. Patients with moderate or severe hypertension are at relatively high risk for cardiovascular events (such as strokes, heart attacks, and heart failure), kidney failure, and vision problems, so prompt treatment is clinically relevant. The decision to use a combination as initial therapy should be individualized and should be shaped by considerations such as baseline blood pressure, the target goal, and the incremental likelihood of achieving goal with a combination compared to monotherapy. Individual blood pressure goals may vary based upon the patient’s risk. Data from an 8-week, placebo-controlled, parallel-group factorial study [ see Clinical Studies ( 14.1 ) ] provide estimates of the probability of reaching a blood pressure goal with Amlodipine and Olmesartan Medoxomil Tablets compared to amlodipine or olmesartan medoxomil monotherapy. The figures below provide estimates of the likelihood of achieving the targeted systolic or diastolic blood pressure goals with Amlodipine and Olmesartan Medoxomil Tablets 10/40 mg compared with amlodipine or olmesartan medoxomil monotherapy, based upon baseline systolic or …

Dosage and Administration

openFDA Drug Labeling

2 DOSAGE AND ADMINISTRATION The usual starting dose of Amlodipine and Olmesartan Medoxomil Tablets is 5/20 mg once daily. The dosage can be increased after 1 to 2 weeks of therapy to a maximum dose of one 10/40 mg tablet once daily as needed to control blood pressure [see Clinical Studies ( 14.1 )]. Recommended starting dose: 5/20 mg once daily ( 2 ). Titrate as needed in two-week intervals up to a maximum of 10/40 mg once daily ( 2 ).

Dosage Forms and Strengths

openFDA Drug Labeling

3 DOSAGE FORMS AND STRENGTHS Amlodipine and olmesartan medoxomil tablets are formulated for oral administration in the following strength combinations: 5/20 5/40 10/20 10/40 Amlodipine equivalent (mg) 5 5 10 10 Olmesartan medoxomil (mg) 20 40 20 40 Tablets: (amlodipine/olmesartan medoxomil content) 5/20 mg, 10/20 mg, 5/40 mg, and 10/40 mg ( 3 ).

Contraindications

openFDA Drug Labeling

4 CONTRAINDICATIONS Do not co-administer aliskiren with Amlodipine and Olmesartan Medoxomil Tablets in patients with diabetes [S ee Drug Interactions (7.2 )]. • Do not co-administer aliskiren with Amlodipine and Olmesartan Medoxomil Tablets in patients with diabetes (4 ).

Warnings and Cautions

openFDA Drug Labeling

5 WARNINGS AND PRECAUTIONS • Anticipate hypotension in volume- or salt-depleted patients with treatment initiation. Start treatment under close supervision ( 5.2 ). • Increased angina or myocardial infarction may occur upon dosage initiation or increase ( 5.3 ). • Impaired renal function: changes in renal function may occur. ( 5.4 ) • Sprue-like enteropathy has been reported. Consider discontinuation of Amlodipine and Olmesartan Medoxomil Tablets in cases where no other etiology is found ( 5.6 ). 5.1 Fetal Toxicity Amlodipine and Olmesartan Medoxomil Tablets can cause fetal harm when administered to a pregnant woman. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue Amlodipine and Olmesartan Medoxomil Tablets as soon as possible [see Use in Specific Populations ( 8.1 )]. 5.2 Hypotension in Volume-or Salt-Depleted Patients Olmesartan medoxomil. In patients with an activated renin-angiotensin system, such as volume and/or salt-depleted patients (e.g., those being treated with high doses of diuretics) symptomatic hypotension may be anticipated after initiation of treatment with olmesartan medoxomil. Initiate treatment with Amlodipine and Olmesartan Medoxomil Tablets under close medical supervision. If hypotension does occur, place the patient in the supine position and, if necessary, give an intravenous infusion of normal saline. A transient hypotensive response is not a contraindication to further treatment, which usually can be continued without difficulty once the blood pressure has stabilized. Amlodipine. Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. Because of the gradual onset of action, acute hypotension is unlikely. 5.3 Increased Angina or Myocardial Infarction Patients, particularly those with severe obstructive coronary artery disease, may develop increased frequency, duration, or severity of angina or acute myocardial infarction on starting calcium channel blocker therapy or at the time of dosage increase. The mechanism of this effect has not been elucidated. 5.4 Impaired Renal Function Changes in renal function may be anticipated in susceptible individuals treated with olmesartan medoxomil as a consequence of inhibiting the renin-angiotensin-aldosterone system. In patients whose renal function may depend upon the activity of the renin-angiotensin-aldosterone system (e.g., patients with severe congestive heart failure), treatment with angiotensin converting enzyme inhibitors and angiotensin receptor antagonists has been associated with oliguria or progressive azotemia and (rarely) with acute renal failure and/or death. Similar effects may occur in patients treated with Amlodipine and Olmesartan Medoxomil Tablets because of the olmesartan medoxomil component [See Drug Interactions ( 7 ) and Clinical Pharmacology ( 12.3 )]. In studies of ACE inhibitors in patients with unilateral or bilateral renal artery stenosis, increases in serum creatinine or blood urea nitrogen (BUN) have been reported. There has been no long-term use of olmesartan medoxomil in patients with unilateral or bilateral renal artery stenosis, but similar effects would be expected with olmesartan medoxomil and Amlodipine and Olmesartan Medoxomil Tablets. 5.5 Patients with Hepatic Impairment Patients with hepatic impairment have decreased clearance of amlodipine. Starting amlodipine or adding amlodipine at 2.5 mg in hepatically impaired patients is recommended. The lowest dose of Amlodipine and Olmesartan Medoxomil Tablets is 5/20 mg; therefore, initial therapy with Amlodipine and Olmesartan Medoxomil Tablets is not recommended in he …

Adverse Reactions

openFDA Drug Labeling

6 ADVERSE REACTIONS Most common adverse reaction (incidence ≥3%) is edema ( 6.1 ). To report SUSPECTED ADVERSE REACTIONS, contact Ascend Laboratories, LLC at 1-877-272-7901 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. Amlodipine and Olmesartan Medoxomil Tablets The data described below reflect exposure to Amlodipine and Olmesartan Medoxomil Tablets in more than 1600 patients including more than 1000 exposed for at least 6 months and more than 700 exposed for 1 year. Amlodipine and Olmesartan Medoxomil Tablets was studied in one placebo-controlled factorial trial [see Clinical Trials ( 14.1 )]. The population had a mean age of 54 years and included approximately 55% males. Seventy-one percent were Caucasian and 25% were Black. Patients received doses ranging from 5/20 mg to 10/40 mg orally once daily. The overall incidence of adverse reactions on therapy with Amlodipine and Olmesartan Medoxomil Tablets was similar to that seen with corresponding doses of the individual components of Amlodipine and Olmesartan Medoxomil Tablets, and to placebo. The reported adverse reactions were generally mild and seldom led to discontinuation of treatment (2.6% for Amlodipine and Olmesartan Medoxomil Tablets and 6.8% for placebo). Edema Edema is a known, dose-dependent adverse effect of amlodipine but not of olmesartan medoxomil. The placebo-subtracted incidence of edema during the 8-week, randomized, double-blind treatment period was highest with amlodipine 10 mg monotherapy. The incidence was significantly reduced when 20 mg or 40 mg of olmesartan medoxomil was added to the 10 mg amlodipine dose. Placebo-Subtracted Incidence of Edema During the Double-Blind Treatment Period Olmesartan Medoxomil Placebo 20 mg 40 mg Amlodipine Placebo - * - 2.4% 6.2% 5 mg 0.7% 5.7% 6.2% 10 mg 24.5% 13.3% 11.2% * 12.3% = actual placebo incidence Across all treatment groups, the frequency of edema was generally higher in women than men, as has been observed in previous studies of amlodipine. There was a greater decrease in hemoglobin and hematocrit in patients treated with Amlodipine and Olmesartan Medoxomil Tablets as compared to patients receiving either component. Adverse reactions seen at lower rates during the double-blind period also occurred in the patients treated with Amlodipine and Olmesartan Medoxomil Tablets at about the same or greater incidence as in patients receiving placebo. These included hypotension, orthostatic hypotension, rash, pruritus, palpitation, urinary frequency, and nocturia. The adverse event profile obtained from 44 weeks of open-label combination therapy with amlodipine plus olmesartan medoxomil was similar to that observed during the 8-week, double-blind, placebo-controlled period. Initial Therapy Analyzing the data described above specifically for initial therapy, it was observed that higher doses of Amlodipine and Olmesartan Medoxomil Tablets caused slightly more hypotension and orthostatic symptoms, but not at the recommended starting dose of Amlodipine and Olmesartan Medoxomil Tablets 5/20 mg. No increase in the incidence of syncope or near syncope was observed. The incidences of discontinuation because of any treatment emergent adverse events in the double-blind phase are summarized in the table below. Discontinuation for any Treatment Emergent Adverse Event 1 Olmesartan Medoxomil Placebo 10 mg 20 mg 40 mg Amlodipine Placebo 4.9% 4.3% 5.6% 3.1% 5 mg 3.7% 0.0% 1.2% 3.7% 10 mg 5.5% 6.8% 2.5% 5.6% 1 Hypertension is counted as treatment failure and not as treatment emergent adverse event. N=160-163 subjects per treatment group. Amlodipine. Amlodipine has been evaluated for safety in more than 11,000 patients in U.S. and foreign clin …

Drug Interactions

openFDA Drug Labeling

7 DRUG INTERACTIONS Amlodipine ( 7.1 ): If simvastatin is co-administered with amlodipine, do not exceed 20 mg daily of simvastatin. Increased exposure of cyclosporine and tacrolimus. Increased exposure of amlodipine when coadministered with CYP3A inhibitors. Olmesartan medoxomil ( 7.2 ): Nonsteroidal anti-inflammatory drugs (NSAIDS) may lead to increased risk of renal impairment and loss of antihypertensive effect. Dual inhibition of the renin-angiotensin system: Increased risk of renal impairment, hypotension, and hyperkalemia. Colesevelam hydrochloride: Consider administering olmesartan at least 4 hours before colesevelam hydrochloride dose. Lithium: Increases in serum lithium concentrations and lithium toxicity. 7.1 Drug Interactions with Amlodipine Simvastatin: Co-administration of simvastatin with amlodipine increases the systemic exposure of simvastatin. Limit the dose of simvastatin in patients on amlodipine to 20 mg daily. [see Clinical Pharmacology ( 12.3 )]. Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. Frequent monitoring of trough blood levels of cyclosporine and tacrolimus is recommended and adjust the dose when appropriate [see Clinical Pharmacology ( 12.3 )]. CYP3A Inhibitors: Co-administration of amlodipine with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is co-administered with CYP3A inhibitors to determine the need for dose adjustment. CYP3A Inducers: No information is available on the quantitative effects of CYP3A inducers on amlodipine. Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. 7.2 Drug Interactions with Olmesartan Medoxomil Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including olmesartan medoxomil, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving olmesartan medoxomil and NSAID therapy. The antihypertensive effect of angiotensin II receptor antagonists, including olmesartan medoxomil may be attenuated by NSAIDs including selective COX-2 inhibitors. Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Most patients receiving the combination of two RAS inhibitors do not obtain any additional benefit compared to monotherapy. In general, avoid combined use of RAS inhibitors. Closely monitor blood pressure, renal function and electrolytes in patients on Amlodipine and Olmesartan Medoxomil Tablets and other agents that affect the RAS. Do not co-administer aliskiren with Amlodipine and Olmesartan Medoxomil Tablets in patients with diabetes [See Contraindications (4)] . Avoid use of aliskiren with Amlodipine and Olmesartan Medoxomil Tablets in patients with renal impairment (GFR <60 ml/min). Use with Colesevelam Hydrochloride: Concurrent administration of bile acid sequestering agent colesevelam hydrochloride reduces the systemic exposure and peak plasma concentration of olmesartan. Administration of olmesartan at least 4 hours prior to colesevelam hydrochloride decreased the drug interaction effect. Consider administering olmesartan at least 4 hours before the colesevelam hydrochloride dose [see Clinical Pharmacology (12.3)]. Lithium: Increases in serum lithium concentrations and lithium toxi …

Use in Specific Populations

openFDA Drug Labeling

8 USE IN SPECIFIC POPULATIONS Lactation: Breastfeeding is not recommended ( 8.2 ). Geriatric: Not recommended for initial therapy in patients ≥75 years old ( 8.5 ) Hepatic Impairment: Not recommended for initial therapy ( 8.6 ). 8.1 Pregnancy Risk Summary Amlodipine and olmesartan medoxomil can cause fetal harm when administered to a pregnant woman. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death [see Clinical Considerations]. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. When pregnancy is detected, discontinue amlodipine and olmesartan medoxomil as soon as possible. Consider alternative antihypertensive therapy during pregnancy. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Disease-Associated Maternal and/or Embryo/Fetal Risk Hypertension in pregnancy increases the maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage). Hypertension increases the fetal risk for intrauterine growth restriction and intrauterine death. Pregnant women with hypertension should be carefully monitored and managed accordingly. Fetal/Neonatal Adverse Reactions Olmesartan medoxomil Oligohydramnios in pregnant women who use drugs affecting the renin-angiotensin system in the second and third trimesters of pregnancy can result in the following: reduced fetal renal function leading to anuria and renal failure, fetal lung hypoplasia, skeletal deformations, including skull hypoplasia, hypotension, and death. Perform serial ultrasound examinations to assess the intra-amniotic environment. Fetal testing may be appropriate, based on the week of gestation. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Closely observe infants with histories of in utero exposure to olmesartan for hypotension, oliguria, and hyperkalemia. In neonates with a history of in utero exposure to olmesartan, if oliguria or hypotension occur, utilize measures to maintain adequate blood pressure and renal perfusion. Exchange transfusions or dialysis may be required as a means of reversing hypotension and supporting renal function [see Use in Specific Populations (8.4) ]. Data Animal Data No reproductive studies have been conducted with the combination of olmesartan medoxomil, and amlodipine. However, these studies have been conducted for olmesartan medoxomil and amlodipine alone. Olmesartan medoxomil No teratogenic effects were observed when olmesartan medoxomil was administered to pregnant rats at oral doses up to 1000 mg/kg/day (240 times the maximum recommended human dose [MRHD] on a mg/m 2 basis) or pregnant rabbits at oral doses up to 1 mg/kg/day (half the MRHD on a mg/m 2 basis; higher doses could not be evaluated for effects on fetal development as they were lethal to the does). In rats, significant decreases in pup birth weight and weight gain were observed at doses ≥1.6 mg/kg/day, and delays in developmental milestones (delayed separation of ear auricular, eruption of lower incisors, appearance of abdominal hair, descent of testes, and separation of eyelids) and dose-dependent increases in the incidence of dilation of the renal pelvis were observed at doses ≥ 8 mg/kg/day. The no observed effect dose for developmental toxi …

Mechanism of Action

openFDA Drug Labeling

12.1 Mechanism of Action Amlodipine and Olmesartan Medoxomil Tablets. Amlodipine and Olmesartan Medoxomil Tablets is a combination of two antihypertensive drugs: a dihydropyridine calcium antagonist (calcium ion antagonist or slow-channel blocker), amlodipine besylate, and an angiotensin II receptor blocker, olmesartan medoxomil. The amlodipine component of Amlodipine and Olmesartan Medoxomil Tablets inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle, and the olmesartan medoxomil component of Amlodipine and Olmesartan Medoxomil Tablets blocks the vasoconstrictor effects of angiotensin II. Amlodipine. Experimental data suggests that amlodipine binds to both dihydropyridine and nonhydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Negative inotropic effects can be detected in vitro but such effects have not been seen in intact animals at therapeutic doses. Serum calcium concentration is not affected by amlodipine. Within the physiologic pH range, amlodipine is an ionized compound (pKa=8.6), and its kinetic interaction with the calcium channel receptor is characterized by a gradual rate of association and dissociation with the receptor binding site, resulting in a gradual onset of effect. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure. Olmesartan medoxomil. Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation and renal reabsorption of sodium. Olmesartan blocks the vasoconstrictor effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT 1 receptor in vascular smooth muscle. Its action is, therefore, independent of the pathways for angiotensin II synthesis. An AT 2 receptor is found also in many tissues, but this receptor is not known to be associated with cardiovascular homeostasis. Olmesartan has more than a 12,500-fold greater affinity for the AT 1 receptor than for the AT 2 receptor. Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is a mechanism of many drugs used to treat hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction also catalyzed by ACE. Because olmesartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Whether this difference has clinical relevance is not yet known. Blockade of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity and circulating angiotensin II levels do not overcome the effect of olmesartan on blood pressure.

Description

openFDA Drug Labeling

11 DESCRIPTION Amlodipine and olmesartan medoxomil provided as a tablet for oral administration, is a combination of the calcium channel blocker (CCB) amlodipine besylate and the angiotensin II receptor blocker (ARB) olmesartan medoxomil. The amlodipine besylate component of amlodipine and olmesartan medoxomil tablets is chemically described as 3-ethyl-5­ methyl (±)-2-[(2-aminoethoxy)methyl]-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5­-pyridinedicarboxylate, monobenzenesulphonate. Its molecular formula is C 20 H 25 ClN 2 O 5 •C 6 H 6 O 3 S. Olmesartan medoxomil, a prodrug, is hydrolyzed to olmesartan during absorption from the gastrointestinal tract. The olmesartan medoxomil component of amlodipine and olmesartan medoxomil tablets is chemically described as 2,3­ dihydroxy-2-butenyl 4-(1-hydroxy-1-methylethyl)-2-propyl-1-[ p-(o -1H-tetrazol-5­-ylphenyl)benzyl]imidazole-5-carboxylate, cyclic 2,3-carbonate. Its molecular formula is C 29 H 30 N 6 O 6 . The structural formula for amlodipine besylate is: The structural formula for olmesartan medoxomil is: Amlodipine and olmesartan medoxomil tablets contain amlodipine besylate USP, a white or almost white powder, and olmesartan medoxomil USP, a white to off white, crystalline powder. The molecular weights of amlodipine besylate and olmesartan medoxomil are 567.1 and 558.59, respectively. Amlodipine besylate is freely soluble in methanol, sparingly soluble in ethanol and slightly soluble in 2-propanol and in water. Olmesartan medoxomil is sparingly soluble in methanol and practically insoluble in water. Tablet Strength 5/20 mg Each tablet of amlodipine and olmesartan medoxomil tablets also contains the following inactive ingredients: croscarmellose sodium, magnesium stearate, pregelatinized starch, silicified microcrystalline cellulose and the color coatings contain polyvinyl alcohol, titanium dioxide, macrogol and talc (opadry II white). Tablet Strength 5/40 mg Each tablet of amlodipine and olmesartan medoxomil tablets also contains the following inactive ingredients: croscarmellose sodium, magnesium stearate, pregelatinized starch, silicified microcrystalline cellulose and the color coatings contain polyvinyl alcohol, titanium dioxide, macrogol, talc and iron oxide yellow (opadry II yellow). Tablet Strength 10/20 mg Each tablet of amlodipine and olmesartan medoxomil tablets also contains the following inactive ingredients: croscarmellose sodium, magnesium stearate, pregelatinized starch, silicified microcrystalline cellulose and the color coatings contain polyvinyl alcohol, titanium dioxide, macrogol, talc, iron oxide yellow and iron oxide red (opadry II beige). Tablet Strength 10/40 mg Each tablet of amlodipine and olmesartan medoxomil tablets also contains the following inactive ingredients: croscarmellose sodium, magnesium stearate, pregelatinized starch, silicified microcrystalline cellulose and the color coatings contain polyvinyl alcohol, titanium dioxide, macrogol, talc, iron oxide yellow, iron oxide red and ferrosoferric oxide/ iron oxide black (opadry II brown). amlodipine structure olmesartan structure

10 OVERDOSAGE There is no information on overdosage with Amlodipine and Olmesartan Medoxomil Tablets in humans. Amlodipine. Single oral doses of amlodipine maleate equivalent to 40 mg amlodipine/kg and 100 mg amlodipine/kg in mice and rats, respectively, caused deaths. Single oral amlodipine maleate doses equivalent to 4 or more mg amlodipine/kg or higher in dogs (11 or more times the maximum recommended human dose on a mg/m 2 basis) caused a marked peripheral vasodilation and hypotension. Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of amlodipine is limited. If massive overdose should occur, active cardiac and respiratory monitoring should be instituted. Frequent blood pressure measurements are essential. Should hypotension occur, cardiovascular support including elevation of the extremities and the judicious administration of fluids should be initiated. If hypotension remains unresponsive to these conservative measures, administration of vasopressors (such as phenylephrine) should be considered with attention to circulating volume and urine output. Intravenous calcium gluconate may help to reverse the effects of calcium entry blockade. As amlodipine is highly protein bound, hemodialysis is not likely to be of benefit. Olmesartan medoxomil. Limited data are available related to overdosage in humans. The most likely manifestations of overdosage would be hypotension and tachycardia; bradycardia could be encountered if parasympathetic (vagal) stimulation occurs. If symptomatic hypotension should occur, supportive treatment should be initiated. The dialyzability of olmesartan is unknown.

How Supplied / Storage and Handling

openFDA Drug Labeling

16 HOW SUPPLIED/STORAGE AND HANDLING Amlodipine and olmesartan medoxomil tablets contain amlodipine besylate at a dose equivalent to 5 or 10 mg amlodipine and olmesartan medoxomil in the strengths described below. Amlodipine and olmesartan medoxomil tablets are differentiated by tablet color/size and are debossed with an individual product tablet code on one side. Amlodipine and olmesartan medoxomil tablets are supplied for oral administration in the following strength and package configurations: Tablet Strength 5/20 mg Amlodipine and Olmesartan medoxomil tablets are white colored, round shaped, biconvex, film-coated tablet debossed with ‘81’ on one side and ‘I’ on other side and contain 5 mg Amlodipine and 20 mg Olmesartan medoxomil. They are supplied in Bottles of 30 NDC 42571-235-30 Bottles of 90 NDC 42571-235-90 Bottles of 500 NDC 42571-235-05 Bottles of 1000 NDC 42571-235-10 Tablet Strength 10/20 mg Amlodipine and Olmesartan medoxomil tablets are grayish orange colored, round shaped, biconvex, film-coated tablet debossed with ‘83’ on one side and ‘I’ on other side and contain 10 mg Amlodipine and 20 mg Olmesartan medoxomil. They are supplied in Bottles of 30 NDC 42571-236-30 Bottles of 90 NDC 42571-236-90 Bottles of 500 NDC 42571-236-05 Bottles of 1000 NDC 42571-236-10 Tablet Strength 5/40 mg Amlodipine and Olmesartan medoxomil tablets are cream colored, round shaped, biconvex, film-coated tablet debossed with ‘82’ on one side and ‘I’ on other side and contain 5 mg Amlodipine and 40 mg Olmesartan medoxomil. They are supplied in Bottles of 30 NDC 42571-237-30 Bottles of 90 NDC 42571-237-90 Bottles of 500 NDC 42571-237-05 Bottles of 1000 NDC 42571-237-10 Tablet Strength 10/40 mg Amlodipine and Olmesartan medoxomil tablets are Brownish red colored, round shaped, biconvex, film-coated tablet debossed with ‘84’ on one side and ‘I’ on other side and contain 10 mg Amlodipine and 40 mg Olmesartan medoxomil. They are supplied in Bottles of 30 NDC 42571-238-30 Bottles of 90 NDC 42571-238-90 Bottles of 500 NDC 42571-238-05 Bottles of 1000 NDC 42571-238-10 Store at 25° C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature].

Adverse event reports

Source: openFDA FAERS
168,883
FAERS reports mentioning this drug
as of 2026-09-25T03:42:24+00:00
A report count is not a risk measure. FAERS accepts voluntary and mandatory reports without establishing causation, and reporting is influenced by how widely a drug is used, how long it has been marketed, and media attention. FDA states that reports “do not prove that the drug caused the event”. Compare rates, not totals.

Attributed to this product's most-reported active ingredient: AMLODIPINE BESYLATE. Combination products with more than six active ingredients are not attributed, because a report count summed across a long ingredient list measures the list, not the medicine.

Recalls

Source: FDA Enforcement
Drug recall enforcement reports associated with this product.
Classification Reported Firm Reason Status
Class II July 29, 2026 Ascend Laboratories, LLC Failed Dissolution Specifications; Olmesartan Medoxomil content below specifications Ongoing
Class II June 10, 2026 Ascend Laboratories, LLC Failed Dissolution Specifications: Olmesartan Medoxomil content below specifications Ongoing
Class II August 20, 2025 Ascend Laboratories, LLC Failed Dissolution Specifications: low dissolution results Ongoing

Packaging and NDCs

Source: NDC Directory
Every National Drug Code package associated with this medication. The NDC is the identifier used for dispensing, billing and pharmacovigilance in the United States.
Package NDC Product NDC Labeler Description Marketing start
67877-499-30 67877-499 Ascend Laboratories, LLC 30 TABLET in 1 BOTTLE (67877-499-30) August 14, 2017
67877-499-90 67877-499 Ascend Laboratories, LLC 90 TABLET in 1 BOTTLE (67877-499-90) August 14, 2017
67877-500-30 67877-500 Ascend Laboratories, LLC 30 TABLET in 1 BOTTLE (67877-500-30) August 14, 2017
67877-500-90 67877-500 Ascend Laboratories, LLC 90 TABLET in 1 BOTTLE (67877-500-90) August 14, 2017
67877-501-30 67877-501 Ascend Laboratories, LLC 30 TABLET in 1 BOTTLE (67877-501-30) August 14, 2017
67877-501-90 67877-501 Ascend Laboratories, LLC 90 TABLET in 1 BOTTLE (67877-501-90) August 14, 2017
67877-502-30 67877-502 Ascend Laboratories, LLC 30 TABLET in 1 BOTTLE (67877-502-30) August 14, 2017
67877-502-90 67877-502 Ascend Laboratories, LLC 90 TABLET in 1 BOTTLE (67877-502-90) August 14, 2017
72162-2379-3 72162-2379 Bryant Ranch Prepack 30 TABLET in 1 BOTTLE (72162-2379-3) August 15, 2024
72162-2379-9 72162-2379 Bryant Ranch Prepack 90 TABLET in 1 BOTTLE (72162-2379-9) August 15, 2024
42571-235-05 42571-235 Micro Labs Limited 500 TABLET in 1 BOTTLE (42571-235-05) January 1, 2018
42571-235-10 42571-235 Micro Labs Limited 1000 TABLET in 1 BOTTLE (42571-235-10) January 1, 2018
42571-235-30 42571-235 Micro Labs Limited 30 TABLET in 1 BOTTLE (42571-235-30) January 1, 2018
42571-235-90 42571-235 Micro Labs Limited 90 TABLET in 1 BOTTLE (42571-235-90) January 1, 2018
42571-236-05 42571-236 Micro Labs Limited 500 TABLET in 1 BOTTLE (42571-236-05) January 1, 2018
42571-236-10 42571-236 Micro Labs Limited 1000 TABLET in 1 BOTTLE (42571-236-10) January 1, 2018
42571-236-30 42571-236 Micro Labs Limited 30 TABLET in 1 BOTTLE (42571-236-30) January 1, 2018
42571-236-90 42571-236 Micro Labs Limited 90 TABLET in 1 BOTTLE (42571-236-90) January 1, 2018
42571-237-05 42571-237 Micro Labs Limited 500 TABLET in 1 BOTTLE (42571-237-05) January 1, 2018
42571-237-10 42571-237 Micro Labs Limited 1000 TABLET in 1 BOTTLE (42571-237-10) January 1, 2018
42571-237-30 42571-237 Micro Labs Limited 30 TABLET in 1 BOTTLE (42571-237-30) January 1, 2018
42571-237-90 42571-237 Micro Labs Limited 90 TABLET in 1 BOTTLE (42571-237-90) January 1, 2018
42571-238-05 42571-238 Micro Labs Limited 500 TABLET in 1 BOTTLE (42571-238-05) January 1, 2018
42571-238-10 42571-238 Micro Labs Limited 1000 TABLET in 1 BOTTLE (42571-238-10) January 1, 2018
42571-238-30 42571-238 Micro Labs Limited 30 TABLET in 1 BOTTLE (42571-238-30) January 1, 2018
42571-238-90 42571-238 Micro Labs Limited 90 TABLET in 1 BOTTLE (42571-238-90) January 1, 2018
67877-499 67877-499 Ascend Laboratories, LLC — August 14, 2017
67877-500 67877-500 Ascend Laboratories, LLC — August 14, 2017
67877-501 67877-501 Ascend Laboratories, LLC — August 14, 2017
67877-502 67877-502 Ascend Laboratories, LLC — August 14, 2017
72162-2379 72162-2379 Bryant Ranch Prepack — January 1, 2018
42571-235 42571-235 Micro Labs Limited — January 1, 2018
42571-236 42571-236 Micro Labs Limited — January 1, 2018
42571-237 42571-237 Micro Labs Limited — January 1, 2018
42571-238 42571-238 Micro Labs Limited — January 1, 2018

Sources for this page

Every dataset that contributed a fact to this page.
Dataset Agency Used for
NDC Directory FDA Identity, ingredients, strengths, forms, routes, labelers, packages
Drugs@FDA FDA Application, sponsor, submissions, review documents, marketing status
Orange Book FDA Therapeutic equivalence codes, reference drug flags, patents, exclusivity
Drug Labeling FDA / NLM Prescribing information reproduced above
FAERS FDA Adverse event report counts
Enforcement FDA Recall records

Generated September 25, 2026 · 13 sections on this page.