Hydrochlorothiazide + Olmesartan Medoxomil

Hydrochlorothiazide + Olmesartan Medoxomil is a combination medicine that helps control high blood pressure. Olmesartan is an angiotensin receptor blocker (ARB) that relaxes blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. Hydrochlorothiazide is a diuretic that removes extra water and electrolytes from the body. This combination is effective for treating hypertension, which if left untreated can lead to heart attacks, strokes and kidney failure. It can be taken with or without food, preferably in the morning to avoid frequent urination at night.

• Hypertension (high blood pressure)

Adult Dose (Oral):

• Initial: 20 mg/12.5 mg once daily
• May increase to 40 mg/25 mg after 2 weeks if needed
• Hepatic Impairment: No dosage adjustment necessary

Renal Dose: CrCl <30 mL/min: Not recommended

Common Side Effects:

• Nausea
• Taste change
• Upset stomach
• Diarrhea
• Headache
• Dizziness
• Weakness
• Electrolyte imbalance
• Glucose intolerance
• Increased blood uric acid
• Decreased blood pressure

Others: Chest pain, back pain, peripheral edema, abdominal pain, dyspepsia, gastroenteritis

Precautions:

• Hydrochlorothiazide + Olmesartan may decrease alertness, affect vision or make you feel sleepy and dizzy; do not drive if these symptoms occur
• May cause dehydration; drink plenty of fluids; inform doctor if extreme thirst, very dry mouth or muscle weakness develops
• May cause dizziness; get up slowly when rising from a sitting or lying position
• Not safe during pregnancy and breastfeeding
• Periodic determination of serum electrolytes (hypokalemia, hyponatremia, hypochloremic alkalosis)
• Hyperuricemia may occur
• Renal impairment

Contraindications:

• Hypersensitivity
• Severe hepatic & renal impairment (CrCl <30 mL/min)
• Cholestasis & biliary obstructive disorders
• Refractory hypokalemia
• Hypercalcemia, hyponatremia
• Symptomatic hyperuricemia
• Anuria
• Pregnancy (2nd & 3rd trimester) & lactation

Drug Interactions:

• Alcohol, Barbiturates, Narcotics: May potentiate orthostatic hypotension
• Antidiabetic drugs: Dosage adjustment may be required
• Other antihypertensives: Additive effect
• NSAIDs: May cause deterioration of renal function
• Cholestyramine & Colestipol: Reduced absorption
• Lithium: Reduced renal clearance
• Aliskiren: Do not co-administer in patients with diabetes or renal impairment

Food Interactions: Hydrochlorothiazide + Olmesartan may cause excessive drowsiness with alcohol.

Use in Pregnancy: Unsafe during pregnancy; definite evidence of risk to developing baby; doctor may rarely prescribe in life-threatening situations if benefits outweigh risks.

Use in Lactation: Probably safe; limited human data suggests drug does not represent any significant risk to baby.

Renal Impairment: CrCl >30 mL/min: Follow usual regimen; loop diuretics preferred in severe renal impairment; not recommended.

Hepatic Impairment: No dosage adjustment necessary in hepatic impairment; however caution is advised.

Overdose: Olmesartan: Hypotension and tachycardia; supportive treatment. Hydrochlorothiazide: Electrolyte depletion (hypokalemia, hypochloremia) and dehydration; hypokalemia with digitalis may accentuate cardiac arrhythmias; symptomatic treatment.