Mareb (Olmesartan Medoxomil, Amlodipine)

Mareb is an antihypertensive combination that targets high blood pressure through dual mechanisms.

• Hypertension: lowers systolic and diastolic blood pressure in patients with essential hypertension.
• Stage 2 hypertension: provides additional blood‑pressure reduction when monotherapy is insufficient.
• Uncontrolled hypertension on monotherapy: offers combined action to achieve target blood pressure.

• Olmesartan medoxomil selectively blocks AT1 receptors, preventing angiotensin II from causing vasoconstriction and aldosterone release. Amlodipine inhibits L‑type calcium channels in vascular smooth muscle, leading to arterial dilation. The combined effect reduces peripheral resistance and lowers blood pressure more effectively than either component alone.

Adverse reactions may occur with any antihypertensive therapy.

Common Side Effects

• Headache: mild to moderate intensity.
• Peripheral edema: swelling of ankles or feet.
• Dizziness: especially after the first dose.
• Flushing: transient warmth and redness.
• Fatigue: general tiredness.
• Nausea: occasional upset stomach.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, or throat requiring urgent care.
• Severe hypotension: markedly low blood pressure causing faintness.
• Hepatic dysfunction: abnormal liver enzymes.
• Renal impairment: worsening kidney function.
• Cardiac arrhythmia: irregular heartbeat.
• Allergic rash: widespread skin reaction.

Before initiating therapy, consider patient‑specific factors and monitor appropriately.

• Renal function: assess creatinine clearance in patients with kidney disease.
• Hepatic disease: use caution in moderate to severe liver impairment.
• Electrolyte balance: monitor potassium and sodium levels.
• Pregnancy: avoid use unless clearly needed; discuss risks with a healthcare professional.
• Elderly patients: start at lower dose and titrate slowly.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Mareb may interact with other medicines that affect blood pressure or electrolyte balance.

Major Interactions (Avoid)

• Dual renin‑angiotensin system blockers (e.g., ACE inhibitors, other ARBs): risk of hyperkalaemia and renal dysfunction.
• Strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole): may increase amlodipine levels.

Moderate Interactions (Monitor Closely)

• Diuretics: may potentiate hypotensive effect.
• NSAIDs: can reduce antihypertensive efficacy and affect renal function.
• Lithium: may increase lithium concentrations.
• St. John's wort: may reduce amlodipine exposure.
• Antacids containing aluminum/magnesium: may affect absorption of olmesartan.