OLMETEC PLUS 40 mg/12.5 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the User

Olmetec Plus 40 mg/12.5 mg film-coated tablets

Olmesartan medoxomil / Hydrochlorothiazide

Read all of this leaflet carefully before you start taking this medicine, because it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack

1. What Olmetec Plus is and what it is used for
2. What you need to know before you take Olmetec Plus
3. How to take Olmetec Plus
4. Possible side effects
5. Storing Olmetec Plus
6. Contents of the pack and other information

1. What Olmetec Plus is and what it is used for

Olmetec Plus contains two active substances, olmesartan medoxomil and hydrochlorothiazide, which are used to treat high blood pressure (hypertension):

• Olmesartan medoxomil belongs to a group of medicines called angiotensin II receptor antagonists. It lowers blood pressure by relaxing blood vessels.

• Hydrochlorothiazide belongs to a group of medicines called thiazide diuretics. It lowers blood pressure by helping the kidneys to remove excess fluid from the body, increasing urine production.

Olmetec Plus will only be given if treatment with Olmetec (olmesartan medoxomil) alone has not controlled your blood pressure sufficiently. The combination of the two active substances in Olmetec Plus has been shown to be more effective at lowering blood pressure than either substance alone.

You may already be taking medicines to treat high blood pressure, but your doctor may consider it necessary for you to take Olmetec Plus to lower it further.

High blood pressure can be treated with medicines such as Olmetec Plus tablets. Your doctor has probably also advised you to make some changes to your lifestyle to help lower your blood pressure (e.g. losing weight, stopping smoking, reducing alcohol intake, and reducing the amount of salt in your diet). Your doctor may also have advised you to take regular exercise, such as walking or swimming. It is important to follow this advice.

2. What you need to know before you take Olmetec Plus

Do not take Olmetec Plus

• If you are allergic to olmesartan medoxomil or hydrochlorothiazide, or any of the other ingredients of this medicine (listed in section 6) or to other sulfonamide-derived medicines.
• If you are more than 3 months pregnant. (It is also better to avoid Olmetec Plus at the start of pregnancy - see section Pregnancy).
• If you have kidney problems.
• If you have diabetes or kidney disease and are treated with a blood pressure medicine containing aliskiren.
• If you have low potassium or sodium levels, high calcium or uric acid levels in your blood, which do not improve with treatment.
• If you have moderate or severe liver problems, or yellowing of the skin and eyes (jaundice), or problems with drainage of bile from the gallbladder (biliary obstruction, e.g. due to gallstones).

If you think any of these apply to you, or if you are not sure, do not take the tablets. Talk to your doctor and follow their advice.

Warnings and precautions

Before taking Olmetec Plus, talk to your doctor:

Tell your doctor if you are taking any of the following medicines used to treat high blood pressure:

• An angiotensin-converting enzyme inhibitor (ACE inhibitor) (e.g. enalapril, lisinopril, ramipril), especially if you have kidney problems associated with diabetes.
• Aliskiren.

Your doctor may check your kidney function, blood pressure, and blood electrolyte levels at regular intervals.

See also the information under the heading “Do not take Olmetec Plus”.

Tell your doctor if you have any of the following health problems:

• Kidney transplant.
• Liver disease.
• Heart failure or problems with your heart valves or heart muscle.
• Vomiting (feeling sick) or diarrhoea, which is severe or lasts for a long time.
• Treatment with high doses of diuretics (medicines that increase urine production) or if you are on a low-salt diet.
• Problems with your adrenal glands (e.g. hyperaldosteronism).
• Diabetes.
• Lupus erythematosus (an autoimmune disease).
• Allergy or asthma.
• If you have had skin cancer or if you develop an unexpected skin lesion during treatment. Treatment with hydrochlorothiazide, particularly long-term use at high doses, may increase the risk of some types of skin and lip cancer (non-melanoma skin cancer). Protect your skin from sun exposure and UV rays while taking Olmetec Plus.
• If you have had respiratory or lung problems (e.g. inflammation or fluid in the lungs) after taking hydrochlorothiazide in the past. If you experience shortness of breath or difficulty breathing after taking Olmetec Plus, seek medical attention immediately.

Tell your doctorif you experience any of the following symptoms:

• Severe, persistent diarrhoea that causes significant weight loss. Your doctor will assess your symptoms and decide how to proceed with your blood pressure treatment.
• Decreased vision or eye pain. These could be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or increased pressure in the eye, and may occur from a few hours to a few weeks after taking Olmetec Plus. This can lead to permanent vision impairment if left untreated.

Your doctor may want to see you more often and perform some tests if you have any of these problems.

Talk to your doctor if you experience abdominal pain, nausea, vomiting, or diarrhoea after taking Olmetec Plus. Your doctor will decide whether to continue treatment. Do not stop taking Olmetec Plus on your own.

Olmetec Plus may cause an increase in blood fat and uric acid levels (which can cause gout - painful swelling of the joints). Your doctor will probably want to perform a blood test from time to time to monitor these possible changes.

A change in blood electrolyte levels may occur. Your doctor will probably want to perform a blood test from time to time to monitor this possible change. Some signs of electrolyte changes are: thirst, dry mouth, muscle pain or cramps, tired muscles, low blood pressure (hypotension), feeling weak, slow, tired, sleepy, or restless, nausea, vomiting, decreased need to urinate, rapid heartbeat. Tell your doctor if you notice any of these symptoms.

As with any other medicine that lowers blood pressure, excessive lowering of blood pressure in patients with impaired blood flow to the heart or brain may cause a heart attack or stroke. Therefore, your doctor will carefully monitor your blood pressure.

If you are going to have parathyroid function tests, you should stop taking Olmetec Plus before these tests are performed.

Athletes should be aware that this medicine contains a component that may result in a positive doping test.

Pregnancy and breast-feeding

Pregnancy

Tell your doctor if you are pregnant, think you might be pregnant, or are planning to become pregnant. Olmetec Plus is not recommended during pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby.

Children and adolescents

Olmetec Plus is not recommended for children and adolescents under 18 years of age.

Using Olmetec Plus with other medicines

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines.

In particular, tell your doctor or pharmacist if you are using any of the following medicines:

• Other blood pressure-lowering medicines (antihypertensives), as they may increase the effect of Olmetec Plus.

Your doctor may need to change your dose and/or take other precautions:

If you are taking an ACE inhibitor or aliskiren (see also the information under the headings “Do not take Olmetec Plus” and “Warnings and precautions”).

• Medicines that may alter potassium levels in the blood when used with Olmetec Plus. These include:

• Potassium supplements (as well as salt substitutes containing potassium).
• Diuretics (medicines that increase urine production).
• Heparin (to thin the blood).
• Laxatives.
• Corticosteroids.
• Adrenocorticotropic hormone (ACTH).
• Carbenoxolone (a medicine for treating mouth and stomach ulcers).
• Sodium penicillin G (an antibiotic also known as benzylpenicillin sodium).
• Certain pain relievers, such as aspirin or salicylates.
• Lithium (a medicine used to treat mood changes and some types of depression) may have its toxicity increased if taken with Olmetec Plus. If you need to take lithium, your doctor will monitor your lithium blood levels.
• Non-steroidal anti-inflammatory drugs (NSAIDs) (medicines used to relieve pain, swelling, and other symptoms of inflammation, including arthritis) may increase the risk of kidney problems and reduce the effect of Olmetec Plus when taken with it.
• Sedatives, hypnotics, and antidepressants used with Olmetec Plus may cause a sudden drop in blood pressure when standing up.
• Certain medicines, such as baclofen and tubocurarine, used as muscle relaxants.
• Amifostine and other medicines used to treat cancer, such as cyclophosphamide or methotrexate.
• Colestyramine and colestipol, medicines used to lower blood fat levels.
• Colesevelam hydrochloride, a medicine that lowers blood cholesterol levels, as it may reduce the effect of Olmetec Plus. Your doctor may advise you to take Olmetec Plus at least 4 hours before colestyramine.
• Anticholinergic medicines, such as atropine and biperiden.
• Medicines such as thioridazine, chlorpromazine, levomepromazine, trifluperazine, cyanemazine, sulpiride, amisulpride, pimozide, sultopride, tiapride, droperidol, or haloperidol, used to treat certain psychiatric disorders.
• Certain medicines, such as quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, or digitalis, used to treat heart problems.
• Medicines such as mizolastine, pentamidine, terfenadine, dofetilide, ibutilide, or erythromycin injections, which may change heart rhythm.

• Oral antidiabetic medicines, such as metformin, or insulin, used to lower blood sugar levels.
• Beta-blockers and diazoxide, medicines used to treat high blood pressure or low blood sugar levels, respectively, as Olmetec Plus may increase the blood sugar-raising effect of these medicines.
• Methyldopa, a medicine used to treat high blood pressure.
• Medicines such as noradrenaline, used to increase blood pressure and reduce heart rate.
• Difemanil, used to treat slow heart rate or reduce sweating.
• Medicines such as probenecid, sulfinpyrazone, and allopurinol, used to treat gout.
• Calcium supplements.
• Amantadine, an antiviral medicine.
• Cyclosporin, a medicine used to prevent organ transplant rejection.
• Antibiotics of the tetracycline group or sparfloxacin.
• Amphotericin, a medicine used to treat fungal infections.
• Certain antacids, used to treat stomach acid excess, such as aluminium and magnesium hydroxide, as they may slightly reduce the effect of Olmetec Plus.
• Cisapride, used to increase food movement in the stomach and intestines.
• Halofantrine, used to treat malaria.

Taking Olmetec Plus with food and drink

Olmetec Plus can be taken with or without food.

Be careful when drinking alcohol while taking Olmetec Plus, as some people may feel weak or dizzy. If this happens, do not drink any alcohol, including wine, beer, or alcoholic drinks.

Black patients

As with other similar medicines, the blood pressure-lowering effect of Olmetec Plus is somewhat less in black patients.

Pregnancy and breast-feeding

Pregnancy

Tell your doctor if you are pregnant, think you might be pregnant, or are planning to become pregnant. Your doctor will advise you to stop taking Olmetec Plus before you become pregnant or as soon as you know you are pregnant, and will advise you to take a different medicine instead of Olmetec Plus.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Olmetec Plus is not recommended for breast-feeding mothers, and your doctor may choose a different treatment if you want to breast-feed.

If you are pregnant or breast-feeding, think you might be pregnant, or are planning to become pregnant, consult your doctor or pharmacist before taking this medicine.

Athletes

Athletes should be aware that this medicine contains a component (hydrochlorothiazide) that may result in a positive doping test.

Driving and using machines

You may feel dizzy or sleepy while being treated for high blood pressure. If this happens, do not drive or use machines until the symptoms have disappeared. Consult your doctor.

Olmetec Plus contains lactose

This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, consult them before taking this medicine.

3. How to take Olmetec Plus

Always take this medicine exactly as your doctor has told you. If you are not sure, check with your doctor or pharmacist.

Recommended dose

The recommended dose is one Olmetec Plus 40 mg/12.5 mg tablet per day. If your blood pressure is not controlled sufficiently, your doctor may change your dose to one Olmetec Plus 40 mg/25 mg tablet per day.

Take the tablets with water. If possible, take your dose at the same time each day, e.g. at breakfast time. It is important to continue taking Olmetec Plus until your doctor tells you to stop.

If you take more Olmetec Plus than you should

If you take more tablets than you should or if a child accidentally takes some, contact your doctor or go to the nearest hospital emergency department immediately and take the medicine pack with you.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately, or call the Toxicology Information Service (tel. 91 562 04 20), stating the medicine and the amount taken.

If you forget to take Olmetec Plus

If you forget to take a dose, take your normal dose the next day. Do nottake a double dose to make up for forgotten doses.

If you stop taking Olmetec Plus

It is important to continue taking Olmetec Plus unless your doctor tells you to stop.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medications, this medication can produce adverse effects, although not all people suffer from them.

However, the following adverse effects can be serious:

• In rare cases, allergic reactions can occur that can affect the entire body, with inflammation of the face, mouth, and/or larynx, along with itching and skin rash. If this happens to you, stop taking Olmetec Plus and consult your doctor immediately.

• Olmetec Plus can cause a pronounced drop in blood pressure, in susceptible patients or as a result of an allergic reaction. Dizziness or fainting can occur infrequently. If this happens to you, stop taking Olmetec Plus, consult your doctor immediately, and remain lying down in a horizontal position.

• Unknown frequency: If you experience yellowing of the whites of the eyes, dark urine, skin itching, even if you started treatment with Olmetec Plus a long time ago, contact your doctor immediatelywho will evaluate your symptoms and decide how to continue with blood pressure treatment.

Olmetec Plus is a combination of two active ingredients. The following information first describes the adverse effects reported so far with the Olmetec Plus combination (in addition to those already mentioned) and, secondly, the known adverse effects of the two active ingredients separately.

These are other known adverse effects so far with Olmetec Plus:

If these effects occur, they are often mild and it is not necessary to interrupt treatment.

Common Adverse Effects (may affect up to 1 in 10 people):

Dizziness, weakness, headache, fatigue, chest pain, swelling of ankles, feet, legs, hands, or arms.

Uncommon Adverse Effects (may affect up to 1 in 100 people):

Rapid and intense heartbeat (palpitations), rash, eczema, vertigo, cough, indigestion, abdominal pain, nausea, vomiting, diarrhea, muscle cramps, and muscle pain, joint pain, arm and leg pain, back pain, erection problems in men, blood in urine.

Also, some changes in blood tests have been observed infrequently, including:

Increased levels of fat in the blood, increased urea or uric acid in the blood, increased creatinine, increased or decreased potassium levels in the blood, increased calcium levels in the blood, increased blood sugar, increased liver function test values. Your doctor will monitor you with a blood test and tell you if you need to take any action.

Rare Adverse Effects (may affect up to 1 in 1,000 people):

Feeling of discomfort, alterations in consciousness, skin swelling (hives), acute kidney failure.

Also, some changes in blood test results have been observed rarely, including:

Increased blood urea nitrogen, decreased hemoglobin and hematocrit values. Your doctor will monitor you with a blood test and tell you if you need to take any action.

Additional Adverse Effects Reported with the Use of Olmesartan Medoxomil or Hydrochlorothiazide Alone, but not with Olmetec Plus or at a Higher Frequency:

Olmesartan Medoxomil:

Common Adverse Effects (may affect up to 1 in 10 people):

Bronchitis, cough, nasal congestion and secretion, sore throat, abdominal pain, indigestion, diarrhea, nausea, gastroenteritis, joint or bone pain, back pain, blood in urine, urinary tract infection, flu-like symptoms, pain.

Also, some changes in blood test results have been observed frequently, including:

Increased levels of fat in the blood, increased urea or uric acid in the blood, increased liver or muscle function.

Uncommon Adverse Effects (may affect up to 1 in 100 people):

Rapid allergic reactions that can affect the whole body and can cause breathing problems, as well as a rapid drop in blood pressure that can lead to fainting (anaphylactic reactions), facial inflammation, angina (chest pain or discomfort known as angina pectoris), feeling of discomfort, allergic skin rash, itching, exanthema (skin rash), skin swelling (hives).

Also, some changes in blood test results have been observed infrequently, including:

Reduction in the number of a type of blood cells called platelets (thrombocytopenia).

Rare Adverse Effects (may affect up to 1 in 1,000 people):

Renal function deterioration, lack of energy, intestinal angioedema: swelling in the intestine that occurs with symptoms such as abdominal pain, nausea, vomiting, and diarrhea.

Also, some changes in blood test results have been observed rarely, including:

Increased potassium in the blood.

Hydrochlorothiazide:

Very Common Adverse Effects (may affect more than 1 in 10 people):

Changes in blood tests, including: increased fat in the blood and uric acid levels.

Common Adverse Effects (may affect up to 1 in 10 people):

Feeling of confusion, abdominal pain, stomach discomfort, feeling of bloating, diarrhea, nausea, vomiting, constipation, glucose excretion in urine.

Also, some changes in blood test results have been observed, including:

Increased creatinine, urea, calcium, and blood sugar levels, decreased chloride, potassium, magnesium, and sodium levels in the blood. Increased serum amylase (hyperamylasemia).

Uncommon Adverse Effects (may affect up to 1 in 100 people):

Decreased or loss of appetite, severe breathing difficulties, anaphylactic skin reactions (hypersensitivity reactions), worsening of pre-existing myopia, erythema, skin reactions due to light sensitivity, itching, purple spots or patches on the skin due to small hemorrhages (purpura), skin swelling (hives).

Rare Adverse Effects (may affect up to 1 in 1,000 people):

Inflammation and pain of the salivary glands, decreased number of white blood cells, decreased number of platelets in the blood, anemia, bone marrow depression, restlessness, depression, sleep problems, feeling of loss of interest (apathy), tingling and numbness, seizures (convulsions), yellowish perception of objects when looking at them, blurred vision, dry eyes, irregular heartbeat, inflammation of blood vessels, blood clots (thrombosis or embolism), lung inflammation, fluid accumulation in the lungs, pancreatitis, jaundice, infection in the gallbladder, symptoms of lupus erythematosus such as skin rash, joint pain, and cold hands and fingers, allergic skin reactions, skin peeling and blisters, non-infectious kidney inflammation (interstitial nephritis), fever, muscle weakness (which can sometimes cause movement disorders).

Very Rare Adverse Effects (may affect up to 1 in 10,000 people):

Electrolyte imbalance that can cause an abnormally reduced level of chloride in the blood (hypochloremic alkalosis), intestinal obstruction (paralytic ileus).

Acute respiratory distress (signs include severe respiratory distress, fever, weakness, and confusion).

Unknown Adverse Effects (frequency cannot be estimated from available data):

Decreased vision or eye pain (possible signs of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma).

Skin and lip cancer (non-melanoma skin cancer).

Reporting Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that does not appear in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medication.

5. Storage of Olmetec Plus

Keep this medication out of sight and reach of children.

No special storage conditions are required.

Do not use this medication after the expiration date that appears on the packaging and on the blister after "CAD". The expiration date is the last day of the month indicated.

Medications should not be thrown down the drain or into the trash. Deposit the packaging and medications you no longer need at the SIGRE Point in the pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. This way, you will help protect the environment.

6. Package Contents and Additional Information

Composition of Olmetec Plus

The active ingredients are:

Olmetec Plus 40 mg/12.5 mg: each film-coated tablet contains 40 mg of olmesartan medoxomil and 12.5 mg of hydrochlorothiazide.

The other components are: microcrystalline cellulose, lactose monohydrate*, low-substitution hypromellose, hypromellose, magnesium stearate, titanium dioxide (E171), talc, hypromellose, and iron (III) oxides (E172).

• See previous section "Olmetec Plus contains lactose"

Appearance of the Product and Package Contents

Olmetec Plus 40 mg/12.5 mg film-coated tablets are yellow-red, oval, 15 x 7 mm, with the inscription "C23" on one side.

Olmetec Plus film-coated tablets are available in packages of 14, 28, 30, 56, 84, 90, 98, 10 x 28, and 10 x 30 tablets, and in packages with precut unit-dose blisters of 10, 50, and 500 tablets.

Not all packages are marketed.

Marketing Authorization Holder

DAIICHI SANKYO ESPAÑA, S.A.

Paseo del Club Deportivo nº1,

Edificio 14, Planta baja izquierda

28223 Pozuelo de Alarcón – Madrid

Spain

Manufacturer

DAIICHI SANKYO EUROPE GmbH

Luitpoldstrasse 1

85276 Pfaffenhofen

Germany

or

BERLIN-CHEMIE AG

Glienicker Weg 125,

12489 Berlin

Germany

This medication is authorized in the Member States of the European Economic Area with the following names:

Austria: Olmetec Plus

Belgium: Olmetec Plus

Denmark: Olmetec Plus

Germany: Olmetec Plus

Greece: Olmetec Plus

Finland: Olmetec Plus

France: CoOlmetec

Iceland: Olmetec Plus

Ireland: Benetor Plus

Italy: Olmegan

Luxembourg: Olmetec Plus

Netherlands: Olmetec HCTZ

Norway: Olmetec Comp

Portugal: Olmetec Plus

Spain: Olmetec Plus

United Kingdom: Olmetec Plus

Date of the last revision of this prospectus: January 2025.

Other Sources of Information

Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/.