Regulatory Information
PFIZER PRIVATE LIMITED
PFIZER PRIVATE LIMITED
Therapeutic
Prescription Only
Formulation Information
TABLET, FILM COATED
**4.2 Posology and method of administration** _Adults_ The recommended dosage of Azoren is 1 tablet per day. Azoren 20 mg/5 mg may be administered in patients whose blood pressure is not adequately controlled by 20 mg olmesartan medoxomil or 5 mg amlodipine alone. Azoren 40 mg/5 mg may be administered in patients whose blood pressure is not adequately controlled by Azoren 20 mg/5 mg. Azoren 40 mg/10 mg may be administered in patients whose blood pressure is not adequately controlled by Azoren 40 mg/5 mg. A step-wise titration of the dosage of the individual components is recommended before changing to the fixed combination. When clinically appropriate, direct change from monotherapy to the fixed combination may be considered. For convenience, patients receiving olmesartan medoxomil and amlodipine from separate tablets may be switched to Azoren tablets containing the same component doses. Azoren can be taken with or without food. _Elderly (age 65 years or over)_ No adjustment of the recommended dose is generally required for elderly patients but increase of the dosage should take place with care (see sections 4.4 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). If up-titration to the maximum dose of 40 mg olmesartan medoxomil daily is required, blood pressure should be closely monitored. _Renal impairment_ The maximum dose of olmesartan medoxomil in patients with mild to moderate renal impairment (creatinine clearance of 20 – 60 mL/min) is 20 mg olmesartan medoxomil once daily, owing to limited experience of higher dosages in this patient group. The use of Azoren in patients with severe renal impairment (creatinine clearance <20 mL/min) is not recommended (see sections 4.4 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). Monitoring of potassium levels and creatinine is advised in patients with moderate renal impairment. _Hepatic impairment_ Azoren should be used with caution in patients with mild to moderate hepatic impairment (see sections 4.4 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). In patients with moderate hepatic impairment, an initial dose of 10 mg olmesartan medoxomil once daily is recommended and the maximum dose should not exceed 20 mg once daily. Close monitoring of blood pressure and renal function is advised in hepatically impaired patients who are already receiving diuretics and/or other antihypertensive agents. There is no experience of olmesartan medoxomil in patients with severe hepatic impairment. As with all calcium antagonists, amlodipine’s half-life is prolonged in patients with impaired liver function and dosage recommendations have not been established. Azoren should therefore, be administered with caution in these patients. The pharmacokinetics of amlodipine have not been studied in severe hepatic impairment. Amlodipine should be initiated at the lowest dose and titrated slowly in patients with impaired liver function. Use of Azoren in patients with severe hepatic impairment is contraindicated (see section 4.3). _Paediatric population_ The safety and efficacy of Azoren in children and adolescents below 18 years has not been established. No data are available. _Method of administration_ The tablet should be swallowed with a sufficient amount of fluid (e.g. one glass of water). The tablet should not be chewed and should be taken at the same time each day.
ORAL
Medical Information
**4.1 Therapeutic indications** Treatment of essential hypertension. Azoren is indicated in patients whose blood pressure is not adequately controlled on olmesartan medoxomil or amlodipine monotherapy (see sections 4.2 and 5.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
**4.3 Contraindications** Hypersensitivity to the active substances, to dihydropyridine derivatives or to any of the excipients (see section 6.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). Second and third trimester of pregnancy (see sections 4.4 and 4.6 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). Severe hepatic insufficiency and biliary obstruction (see section 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). Due to the component amlodipine, Azoren is also contraindicated in patients with: - severe hypotension - shock (including cardiogenic shock) - obstruction of the outflow tract of the left ventricle (e.g. high-grade aortic stenosis) - haemodynamically unstable heart failure after acute myocardial infarction Do not co-administer aliskiren with Azoren in patients with diabetes (see section 4.5 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). The concomitant use of Azoren with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 m2) (see section 4.5 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
C09DB02
olmesartan medoxomil and amlodipine
Manufacturer Information
PFIZER PRIVATE LIMITED
Daiichi Sankyo Europe GmbH
Pfizer Manufacturing Deutschland GmbH (primary and secondary packager)
Active Ingredients
Documents
Package Inserts
1.4.3 Package Insert (PI) - Proposed Pristine.docx
Approved: March 29, 2021