Trade Names:Benicar HCT- Tablets olmesartan medoxomil 20 mg and hydrochlorothiazide 12.5 mg- Tablets olmesartan medoxomil 40 mg and hydrochlorothiazide 12.5 mg- Tablets olmesartan medoxomil 40 mg and hydrochlorothiazide 25 mg
Treatment of hypertension.
Anuria; hypersensitivity to sulfonamide-derivatives or any component of the product.
PO Titrate the dose based on individual response to each component as monotherapy. The dosage range for olmesartan/hydrochlorothiazide is 10 mg/12.5 mg to 40 mg/25 mg once daily.
Olmesartan: The usual starting dosage of olmesartan is 20 mg once daily as monotherapy. If further reduction of BP is needed after 2 wk of therapy, the dose may be increased to 40 mg. If BP is not controlled by olmesartan alone, hydrochlorothiazide may be added, starting with 12.5 mg and then titrating to 25 mg once daily.
Hydrochlorothiazide: If a patient is taking hydrochlorothiazide, olmesartan may be added, starting with 20 mg once daily and titrating to 40 mg. Consider reducing larger doses of hydrochlorothiazide to 12.5 mg before adding olmesartan.Renal Function ImpairmentAdults
PO If CrCl is over 30 mL/min, the usual regimens of olmesartan/hydrochlorothiazide may be followed. In more severe renal function impairment, olmesartan/hydrochlorothiazide is not recommended.
Store at 68° to 77°F.
Potentiation of orthostatic hypotension may occur.Antidiabetic agents (oral agents and insulin)
Dosage adjustments of the antidiabetic agent may be needed.Antihypertensive agents
Effects may be additive or potentiated.Cholestyramine, colestipol
Hydrochlorothiazide absorption may be reduced up to 85%.Corticosteroids
Increased risk of electrolyte depletion (eg, hypokalemia).Lithium
Increased risk of lithium toxicity caused by reduced clearance. Do not coadminister.Nondepolarizing skeletal muscle relaxants (eg, tubocurarine)
Effect of muscle relaxant may be enhanced.NSAIDs (eg, ibuprofen)
The antihypertensive effect of hydrochlorothiazide may be reduced.Pressor amines (eg, norepinephrine)
Effect of pressor amine may be reduced.
Hydrochlorothiazide may decrease serum protein-bound iodine levels without signs of thyroid disturbance; may cause diagnostic interference of serum electrolyte levels, blood and urine glucose levels, serum bilirubin levels, and serum uric acid levels; may cause intermittent and slight elevations in serum calcium without known disorders of calcium metabolism.
Dizziness (9%); vertigo (greater than 1%); asthenia (postmarketing).
Rash (greater than 1%); alopecia, pruritus, urticaria (postmarketing).
Nausea (3%); abdominal pain, diarrhea, dyspepsia, gastroenteritis (greater than 1%); vomiting (postmarketing).
Hematuria (greater than 1%); acute renal failure, increased blood creatinine levels (postmarketing).
Increased AST, ALT, and glucose tolerance test (greater than 1%).
Increased BUN and serum creatinine (1%).
Hyperuricemia (4%); increased creatine phosphokinase, hyperglycemia, hyperlipidemia (greater than 1%).
Arthralgia, arthritis, back pain, myalgia (greater than 1%); rhabdomyolysis (postmarketing).
Upper respiratory tract infection (7%); coughing (greater than 1%).
Chest pain, peripheral edema (greater than 1%); angioedema (postmarketing).
Can cause injury and death to the developing fetus when used during the second and third trimester of pregnancy.
Perform periodic determinations of serum electrolytes to detect possible electrolyte imbalance.
Category C (first trimester); Category D (second and third trimesters).
Safety and efficacy not established.
Use with caution, usually starting at the low end of the dosage range, because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.
May occur in patients with or without a history of allergy or bronchial asthma.
Not recommended in patients with severe renal function impairment; cumulative effects may develop in patients with impaired renal function.
Use with caution in patients with impaired hepatic function or progressive liver disease.
Hyperglycemia may occur; latent diabetes mellitus may become manifest.
Hyperuricemia or frank gout may be precipitated.
Increases in cholesterol and triglyceride levels may occur.
Activation or exacerbation may occur.
Symptomatic hypotension may occur after initiation of treatment in patients with an activated renin-angiotensin system (eg, volume- or salt-depleted patients).
Bradycardia, dehydration, electrolyte depletion (ie, hypochloremia, hypokalemia, hyponatremia), hypotension, tachycardia.
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