Skip to main content Skip to main navigation menu Skip to site footer

The efficacy of olmesartan/amlodipine combination in hypertension treatment – a systematic review


Introduction: Hypertension is the most common non-communicable disease, which persists as a major risk factor of cardiovascular diseases such as stroke, myocardial infection, and heart failure. Another major problem in clinical practice was the patients' adherence to treatment, directly related to the number of hypertension pills to be taken. Thus, determining the appropriate time duration and action of a hypertensive drug to maintain the blood pressure is needed. Olmesartan is one of the drug compounds frequently used for long-acting anti-hypertensive treatment. It is often combined with amlodipine; however, their combination remains unclear to provide equal efficacy and safety. Thus, in this article, we systematically summarize the combination of Olmesartan with amlodipine.

Methods: This systematic literature review was extracted from Science Direct and Pubmed to identify randomized clinical trials (RCT) of the outcome of the Olmesartan/amlodipine effect compared with other hypertension regimens by using PRISMA guideline 2009. The methodological quality of the included studies was assessed independently by two reviewers using The Cochrane Collaboration's RoB 2 tool.

Results: We evaluated twelve studies in the last ten years, and there were four studies with an intention-to-treat protocol (25% of articles had some concern, and 75% had a low risk of bias.) and eight studies with per-protocol analysis (37,5% of articles were concerned, and the rest had a low risk of overall bias). We also presented the efficacy and safety outcomes of the study reviewed.

Conclusion: Hypertension is a common non-communicable disease, and treatment approaches for hypertension vary widely. Administration of combination drugs is a good approach in reducing the dose of drug administration and reducing the incidence of side effects in monotherapy. Inhibiting the RAA system by olmesartan and reducing vascular smooth muscle tone by amlodipine gives better results and can be a safe and effective option for lowering blood pressure in hypertensive patients. The side effects observed were not severe and only observed in a few cases, making it an option to treat hypertension.


  1. Nesbitt SD, Shojaee A, Maa J. Efficacy of an amlodipine / olmesartan treatment algorithm in patients with or without type 2 diabetes and hypertension ( a secondary analysis of the BP-CRUSH study ). 2012;27(7):445–52. Available from:
  2. Peltzer K, Pengpid S. The Prevalence and Social Determinants of Hypertension among Adults in Indonesia: A Cross-Sectional Population-Based National Survey. Borghi C, editor. Int J Hypertens. 2018;2018:5610725. Available from:
  3. Hussain MA, Mamun A Al, Reid C, Huxley RR. Prevalence, Awareness, Treatment and Control of Hypertension in Indonesian Adults Aged ?40 Years: Findings from the Indonesia Family Life Survey (IFLS). PLoS One. 2016;11(8):e0160922.
  4. Kurnianto A, Kurniadi Sunjaya D, Ruluwedrata Rinawan F, Hilmanto D. Prevalence of Hypertension and Its Associated Factors among Indonesian Adolescents. Int J Hypertens. 2020;2020:4262034. Available from:
  5. Redon J, Pichler G. Comparative study of the efficacy of olmesartan/amlodipine vs. perindopril/amlodipine in peripheral blood pressure after missed dose in type 2 diabetes. J Hypertens. 2016;34(2):359–67.
  6. Ardhany SD. Tingkat Kepatuhan Minum Obat Pasien Hipertensi JKN di Poli Penyakit Dalam RSUD Dr. Doris Sylvanus Palangka Raya. J Surya Med. 2016;1(2 SE-Articles). Available from:
  7. Boratas S, Kilic HF. Evaluation of medication adherence in hypertensive patients and influential factors. Pakistan J Med Sci. 2018;34(4):959–63. Available from:
  8. Zhuo JL, Li XC. Angiotensin III/AT(2) Receptor/NHE3 Signaling Pathway in the Proximal Tubules of the Kidney: A Novel Natriuretic and Antihypertensive Mechanism in Hypertension. J Am Heart Assoc. 2019;8(9):e012644–e012644. Available from:
  9. Derosa G, Cicero AFG, Carbone A, Querci F, Fogari E, D'Angelo A, et al. Evaluation of safety and efficacy of a fixed olmesartan/amlodipine combination therapy compared to single monotherapies. Expert Opin Drug Saf. 2013;12(5):621–9.
  10. Ram CV, Sachson R, Littlejohn T, Qian C, Shojaee A, Stoakes KA, et al. Management of Hypertension in Patients With Diabetes Using an Based Titration Regimen. AJC. 2011;107(9):1346–52. Available from:
  11. Bramlage P, Zemmrich C, Gansz A, Sturm C-D, Fimmers R, Nadal J, et al. Daytime systolic ambulatory blood pressure with a two-step switch from candesartan to olmesartan monotherapy and the fixed-dose combination of olmesartan/amlodipine in patients with uncontrolled essential hypertension (SEVICONTROL-2). J Clin Hypertens (Greenwich). 2014;16(1):41–6.
  12. Mire DE, Silfani TN, Pugsley MK. A Review of the Structural and Functional Features of Olmesartan Medoxomil, An Angiotensin Receptor Blocker. 2005;46(5):585–93.
  13. Bell AM, Nykamp D. Hypertension: Focus on Olmesartan Medoxomil. Clin Med Ther. 2009;1:CMT.S2206.
  14. Zhang X, Zhang H, Ma Y, Che W, Hamblin MR. Management of Hypertension Using Olmesartan Alone or in Combination. Cardiol Ther. 2017;6(1):13–32.
  15. Fares H, DiNicolantonio JJ, O'Keefe JH, Lavie CJ. Amlodipine in hypertension: A first-line agent with efficacy for improving blood pressure and patient outcomes. Open Hear. 2016;3(2).
  16. Tang L, El-Din TMG, Swanson TM, Pryde DC, Scheuer T, Zheng N, et al. Structural basis for inhibition of a voltage-gated Ca2+ channel by Ca2+ antagonist drugs. Physiol Behav. 2017;176(3):139–48.
  17. Chrysant SG, Izzo JL, Kereiakes DJ, Littlejohn T, Oparil S, Melino M, et al. Efficacy and safety of triple-combination therapy with olmesartan, amlodipine, and hydrochlorothiazide in study participants with hypertension and diabetes: a subpopulation analysis of the TRINITY study. J Am Soc Hypertens. 2012;6(2):132–41.
  18. Ding S, Liu J, Fu Q, Zheng Y. Clinical effects of combined olmesartan medoxomil and amlodipine on clinic and ambulatory blood pressure in elderly patients with resistant hypertension. Arch Gerontol Geriatr. 2013;57(3):423–7.
  19. Hsueh WA, Shojaee A, Maa J, Neutel JM, Hsueh WA, Shojaee A, et al. medoxomil ± HCTZ in obese patients uncontrolled on anti-hypertensive monotherapy Original article Efficacy of amlodipine / olmesartan medoxomil [ HCTZ in obese patients uncontrolled on anti-hypertensive monotherapy No op Un t yr au fo ig th r ht di or S sp ize a la d le © vi e o ew p r o nf d p ibi m t rin ed m or t a . Au e m si th rc a U ng or i le is al py us is Lim fo ers tr ite r p c i a d so d ut na ow io. 2012;7995(November 2015).
  20. Jung H, Kim K, Park CG, Kang D, Ahn Y, Bae JH, et al. A multicenter , non-comparative study to evaluate the efficacy and safety of fixed-dose olmesartan / amlodipine in Korean patients with hypertension who are na? ¨ ve or non-responders to anti-hypertensive monotherapy ( ACE-HY study ). Clin Exp Hypertens. 2015;00(00):1–8.
  21. Gao JZSZP. Efficacy and safety of olmesartan medoxomil / amlodipine fixed-dose combination for hypertensive patients uncontrolled with monotherapy. 2014;
  22. Ram CV, Sachson R, Littlejohn T, Qian C, Shojaee A, Stoakes KA, et al. Management of Hypertension in Patients With Diabetes Using an Amlodipine-, Olmesartan Medoxomil-, and Hydrochlorothiazide- Based Titration Regimen. AJC. 2011;107(9):1346–52.
  23. Makani H, Bangalore S, Romero J, Htyte N, Berrios RS, Makwana H, et al. Peripheral edema associated with calcium channel blockers: incidence and withdrawal rate – a meta-analysis of randomized trials. J Hypertens. 2011;29(7).
  24. Makani H, Bangalore S, Romero J, Wever-Pinzon O, Messerli FH. Effect of Renin-Angiotensin System Blockade on Calcium Channel Blocker-Associated Peripheral Edema. Am J Med. 2011;124(2):128–35.
  25. Sanford ML, Nagel AK. A Review of Current Evidence of Olmesartan Medoxomil Mimicking Symptoms of Celiac Disease. J Pharm Pract. 2014;28(2):189–92.

How to Cite

Praptika, N. L. P., Ryantama, A. A. W., & Bhuwana, N. N. A. T. (2022). The efficacy of olmesartan/amlodipine combination in hypertension treatment – a systematic review. Intisari Sains Medis, 13(1), 50–58.




Search Panel

Ni Luh Parameswari Praptika
Google Scholar
ISM Journal

Anak Agung Wira Ryantama
Google Scholar
ISM Journal

Ni Nyoman Astrid Tri Bhuwana
Google Scholar
ISM Journal