Abbreviated Prescribing Information: Konverge Plus 20 mg/5 mg/12.5 mg, 40 mg/5 mg/12.5 mg, 40 mg/10 mg/12.5 mg, 40 mg/5 mg/25 mg and 40 mg/10 mg/25 mg film-coated tablets (olmesartan medoxomil /amlodipine [as amlodipine besilate]/hydrochlorothiazide). Prescribing information:Please consult the Summary of Product Characteristics (SmPC) for full prescribing information. Presentation: Film-coated tablets containing: 20 mg olmesartan medoxomil, 5 mg amlodipine, 12.5 mg hydrochlorothiazide or 40 mg olmesartan medoxomil, 5 mg amlodipine, 12.5 mg hydrochlorothiazide or 40 mg olmesartan medoxomil, 10 mg amlodipine, 12.5 mg hydrochlorothiazide or 40 mg olmesartan medoxomil, 5 mg amlodipine, 25 mg hydrochlorothiazide or 40 mg olmesartan medoxomil, 10 mg amlodipine, 25 mg hydrochlorothiazide. Use: Treatment of essential hypertension. Indicated as add-on therapy in adult patients whose blood pressure is not adequately controlled on the combination of olmesartan medoxomil and amlodipine taken as dual-component formulation. Also as substitution therapy in adult patients whose blood pressure is adequately controlled on the combination of olmesartan medoxomil, amlodipine and hydrochlorothiazide, taken as a dual-component (olmesartan medoxomil and amlodipine or olmesartan medoxomil and hydrochlorothiazide) and a single-component formulation (hydrochlorothiazide or amlodipine). Dosage: Oral administration. Adults (18-65 years): Recommended dose is 1 tablet daily. Add –on therapy: administer in patients whose blood pressure is not adequately controlled on olmesartan medoxomil and amlodipine taken as dual-component combination. Step-wise titration of the dosage of the individual components recommended before changing to the triple-component combination. When clinically appropriate, direct change from dual-component combination to triple-component combination may be considered. Substitution therapy: dose to be based on the doses of the individual components of combination at time of switching. Maximum daily dose of 40 mg/10 mg/25 mg. Elderly (65 years or over): Caution, monitor blood pressure frequently especially at maximum dose. Increase dosage with care. Extreme caution, including more frequent monitoring of blood pressure, recommended in patients aged 75 or older. Patients with mild to moderate renal impairment: Maximum dose 20 mg/5 mg/12.5 mg and monitor potassium and creatinine levels. Caution in patients with mild to moderate hepatic impairment; maximum daily dose 20 mg/5 mg/12.5 mg; monitor blood pressure and renal function closely. Use with caution in patients with impaired liver function. Initiate amlodipine at the lowest dose and titrate slowly. Contra-indicated in severe hepatic impairment. Children and adolescents under 18 years: Not recommended. Contraindications: Hypersensitivity to any component, to dihydropyridine derivates or to sulfonamide-derived substances. Severe renal impairment. Refractory hypokalaemia, hypercalcaemia, hyponatraemia and symptomatic hyperuricaemia. Severe hepatic insufficiency, cholestasis or biliary obstruction. Second or third trimesters of pregnancy. Concomitant use with aliskiren-containing products in patients with diabetes mellitus or renal impairment. Severe hypotension, shock (including cardiogenic shock), obstruction of the outflow tract of the left ventricle, haemodynamically unstable heart failure after acute myocardial infarction. Warnings and Precautions: Correct intravascular volume depletion before administering Konverge Plus or maintain close medical supervision. In patients with other conditions associated with stimulation of renin-angiotensin-aldosterone system, possible side effects include acute hypotension, azotaemia, oliguria or, rarely, acute renal failure. Increased risk of severe hypotension and renal insufficiency in patients with bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney. Periodic monitoring of serum and potassium levels is recommended in patients with impaired renal function and kidney transplantation. Combined use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is not recommended. If considered absolutely necessary, use under specialist supervision with frequent close monitoring of renal function, electrolytes and blood pressure. Do not use concomitantly in patients with diabetic nephropathy. Special caution in patients with aortic or mitral stenosis, or obstructive hypertrophic cardiomyopathy. Not recommended in patients with primary aldosteronism. May impair glucose tolerance. In diabetic patients dosage adjustments of insulin or oral hypoglycaemic agents may be required. Increases in cholesterol and triglyceride levels. Thiazides may precipitate hyperuricaemia or frank gout. Periodic determination of serum electrolytes should be performed. Can cause fluid or electrolyte imbalance (including hypokalaemia, hyponatraemia and hypochloraemic alkalosis). Risk of hypokalaemia with cirrhosis of the liver, brisk diuresis, inadequate oral intake of electrolytes, concomitant therapy with corticosteroids or ACTH. Hyperkalaemia, risk factors include renal impairment, and/or heart failure. Close monitoring of serum potassium in patients at risk of hyperkalaemia is recommended. Concomitant use of potassium containing and sparing products should be undertaken with caution and potassium levels monitored frequently. May cause intermittent and slight elevation of serum calcium. Discontinue before carrying out tests for parathyroid function. May increase urinary excretion of magnesium. Dilutional hyponatraemia may occur in oedematous patients in hot weather. Not recommended for combination use with lithium. Changes in renal function in susceptible individuals with heart failure. Amlodipine associated with increased reports of pulmonary oedema. Treat patients with heart failure with caution. Use amlodipine with caution in patients with congestive heart failure. Sprue-like enteropathy reported in very rare cases, in absence of other etiologies immediately discontinue treatment. Intestinal angioedema has been reported in patients treated with angiotensin II receptor antagonists. If intestinal angioedema is diagnosed, olmesartan should be discontinued and appropriate monitoring should be initiated until complete resolution of symptoms has occurred. Hydrochlorothiazide, can cause an idiosyncratic reaction, resulting in choroidal effusion with visual field defect, acute transient myopia and acute angle-closure glaucoma. Do not initiate during pregnancy. Discontinue as soon as possible if pregnancy occurs. Increase dosage with care in the elderly. Photosensitivity reactions have been reported with thiazide diuretics. Increased risk of non-melanoma skin cancer with increasing cumulative dose of HCTZ. Patients should be advised to regularly check skin for any new lesions, limit sun and UV ray exposure and use preventative measure where possible, e.g. sun protection. Suspicious skin lesions should be examined promptly. Reconsider use of HCTZ in patients with previous NMSC. Very rare severe cases of acute respiratory toxicity, including acute respiratory distress syndrome (ARDS) have been reported after taking HCTZ. Pulmonary oedema typically develops within minutes to hours after HCTZ intake. Excessive blood pressure decrease in patients with ischaemic heart disease or ischaemic cerebrovascular disease could result in a myocardial infarction or stroke. Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma. Exacerbation or activation of systemic lupus erythematosus with the use of thiazides. The blood pressure lowering effect of olmesartan medoxomil is somewhat less in black patients than non-black patients.
Interactions: Not recommended for concomitant use with ACE-inhibitors, angiotensin II receptor blockers, aliskiren, lithium, drugs affecting potassium levels. Caution with baclofen, NSAIDs, amifostine, other hypertensive agents, alcohol, barbiturates, narcotics, antidepressants, CYP3A4 inhibitors, CYP3A4 inducers, calcium salts, cholestyramine and colestipol, digitalis glycosides, non-depolarizing skeletal muscle relaxants, anticholinergic agents, antidiabetic medicinal products, beta-blockers and diazoxide, pressor amines, medicinal products used in the treatment of gout, amantadine, cytotoxic agents, salicylates, methyldopa, tetracyclines, grapefruit juice, dantrolene, simvastatin, tacrolimus, mechanistic target of rapamycin (mTOR) inhibitors, cyclosporine. Consider administration at least 4 hours before colesevelam dose to decrease interaction effect.
Pregnancy and Lactation:  Do not use in the first trimester and discontinue as soon as possible if pregnancy occurs. Contraindicated in second and third trimesters of pregnancy. Not recommended during lactation.
Side-effects: Konverge Plus: Common (≥ 1/100 <1/10): upper respiratory tract infection, nasopharyngitis, urinary tract infection, dizziness, headache, palpitations, hypotension, diarrhoea, nausea, constipation, muscle spasm, joint swelling, pollakiuria, asthenia, peripheral oedema, fatigue, blood creatinine increased, blood urea increased, blood uric acid increased. Olmesartan: Common: urinary tract infection, hypertriglyceridaemia, hyperuricaemia, dizziness, headache, cough, bronchitis, pharyngitis, rhinitis, diarrhoea, nausea, abdominal pain, dyspepsia, gastroenteritis, arthritis, back pain, skeletal pain, haematuria, peripheral oedema, fatigue, chest pain, influenza-like symptoms, pain, blood urea increased, hepatic enzymes increased, blood creatine phosphokinase increased. Amlodipine: Very common: oedema. Common: dizziness, headache, somnolence, visual disturbance palpitations, flushing, dyspnoea, nausea, abdominal pain, altered bowel habits, dyspepsia, muscle spasm, ankle swelling, asthenia, fatigue. Hydrochlorothiazide: Very common (≥1/10): hypertriglyceridaemia, hypercolesterinaemia, hyperuricaemia. Common: hypokalaemia, glycosuria, hypercalcaemia, hyperglycaemia, hypomagnesaemia, hyponatriaemia, hypochloraemia, hyperamylasaemia, confusional state, dizziness, diarrhoea, nausea, constipation, abdominal pain, meteorism, gastric irritation, vomiting, blood creatinine increased, blood urea increased. For less frequent side effects see SmPC.
Pack size: Blister containing 28 film-coated tablets.
Legal category: POM.
Product Authorisation Numbers: PA 865/19/1-5
Product Authorisation Holder: Menarini International Operations Luxembourg S.A, 1 Avenue de la Gare, L-1611 Luxembourg.
Marketed by: A. Menarini Pharmaceuticals Ireland Ltd. Further information is available on request from A. Menarini Pharmaceuticals Ireland Ltd., 2nd Floor, Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin A96 T924 or may be found in the SmPC.
Date of Preparation: January 2025