Benicar HCT is a combination pill of an ARB (angiotensin receptor blocker), Olmesartan, and a thiazide diuretic. It is used in the treatment of hypertension.
Olmesartan and hydrochlorothiazide (Benicar HCT) Uses:
-
Hypertension:
- Hypertension management (not indicated for initial treatment)
Olmesartan and hydrochlorothiazide (Benicar HCT) Dose in Adults
Olmesartan and hydrochlorothiazide (Benicar HCT) Dose in the treatment of Hypertension:
P/O:
-
Replacement therapy:
- For individual titrated agents, combination product may be substituted.
-
Initiation of combination therapy when monotherapy has failed to achieve desired effects:
-
Patients currently on olmesartan monotherapy:
- Initial:
- Daily Olmesartan 40 mg per hydrochlorothiazide 12.5 mg once.
- After 2 to 4 weeks, may titrate dose (max: olmesartan 40 mg per hydrochlorothiazide 25 mg per day).
-
Patients currently on hydrochlorothiazide monotherapy:
- Initial:
- Daily Olmesartan 20 mg/hydrochlorothiazide 12.5 mg once.
- may titrate dose after 2 to 4 weeks (max: olmesartan 40 mg/hydrochlorothiazide 25 mg per day).
-
Use in children:
Not recommended.
Pregnancy Risk Factor D
- [US Boxed Warning]
- Drugs that affect the renin-angiotensin pathway can cause harm and even death for the developing foetus.
- Stop having a baby if you are pregnant.
- You can also contact individual agents.
Use of hydrochlorothiazide and olmesartan during lactation
- It is unknown if breast milk contains olmesartan.
- Thiazide diuretics in breast milk are excreted.
- Manufacturer recommends that a decision is made regarding whether to stop nursing or discontinue using the drug.
- This consideration should be taken in light of the possibility of serious adverse reactions in the infant while nursing.
- Talk to individual agents.
Olmesartan and hydrochlorothiazide (Benicar HCT) Dose in Kidney Disease:
-
CrCl >30 mL/minute:
- No dosage adjustment is necessary.
-
CrCl ≤30 mL/minute:
- In the manufacturer’s labeling, there are no dosage adjustments provided (has not been studied).
Olmesartan and hydrochlorothiazide (Benicar HCT) Dose in Liver Disease:
- In the manufacturer’s labeling, there are no dosage adjustments provided for the combination product.
- A max of olmesartan 20 mg/hydrochlorothiazide 12.5 mg per day has been recommended in patients with moderate hepatic impairment (Olmetec Plus Canadian product labeling).
Side Effects of Olmesartan and hydrochlorothiazide (Benicar HCT):
-
Central Nervous System:
- Dizziness
-
Endocrine & Metabolic:
- Hyperuricemia
-
Gastrointestinal:
- Nausea
-
Respiratory:
- Upper Respiratory Tract Infection
Side effects of Olmesartan and hydrochlorothiazide (Benicar HCT) (frequency not known):
-
Cardiovascular:
- Chest Pain
- Peripheral Edema
-
Central Nervous System:
- Vertigo
-
Dermatologic:
- Skin Rash
-
Endocrine & Metabolic:
- Hyperglycemia
- Hyperlipidemia
-
Gastrointestinal:
- Abdominal Pain
- Diarrhea
- Dyspepsia
- Gastroenteritis
-
Genitourinary:
- Hematuria
-
Hepatic:
- Increased Serum Transaminases
-
Neuromuscular & Skeletal:
- Back Pain
- Arthralgia
- Arthritis
- Increased Creatine Phosphokinase
- Myalgia
-
Respiratory:
- Cough
Contraindications to Olmesartan and hydrochlorothiazide (Benicar HCT):
- Hypersensitivity to hydrochlorothiazide, olmesartan or any other component of the formulation
- Concomitant use of aliskiren is not recommended for patients suffering from diabetes mellitus.
- Anuria
Notice:
- Although some product labeling states this medication is contraindicated with other sulfonamide-containing drug classes, the scientific basis of this statement has been challenged.
- See "Warnings/Precautions" for more detail.
- Limited evidence exists of allergenic cross-reactivity between angiotensin II receptor-blockers and thiazide related diuretics.
- Cross-sensitivity can be possible due to similarities in chemical structure and pharmacologic activities.
Canadian labeling:
-
Additional contraindications not listed in the US labeling:
- Hypersensitivity to other sulfonamide derived drugs
- Concomitant use of aliskiren is recommended for patients with severe or moderate renal impairment. (GFR 60mL/minute/1.73m2)
Warnings and precautions
-
Angioedema
- Angioedema may be caused by some angiotensin II antagonists. It has been reported that it is rare (ARBs), and can occur anytime during treatment, especially after the first dose.
- It could involve the head and neck (potentially compromising the airway), or the intestine (presenting as abdominal pain).
- Patients who have angioedema idiopathic, hereditary or other conditions may be at increased risk.
- Particularly if the tongue, glottis or larynx is involved. They can be associated with obstruction of airways. Therefore, frequent monitoring may become necessary.
- Patients who have had previous airway surgery may be at greater risk for obstruction.
- Stop all therapy immediately if angioedema develops
- It is crucial to be aggressive in early management.
- It may be necessary to administer epinephrine intramuscularly (IM).
- Patients who have angioedema caused by ARBs should not be readministered.
-
Electrolyte disturbances:
- Angiotensin II receptor antagonists may cause hyperkalemia.
- The risk factors are renal dysfunction, diabetes mellitus and concomitant potassium-sparing diuretics or potassium supplements.
- These agents should be used with caution.
- Hypokalemia, hypochloremic acidosis, hypomagnesemia and hyponatremia can be caused by Thiazide diuretics.
-
Gastrointestinal effects:
- With olmesartan, symptoms of sprue-like intestinal disease (i.e. severe, chronic diarrhea with significant weight gain) may be present years after the initial treatment with villous atrophy, which is commonly seen on intestinal biopsy.
- Once other causes have been ruled out, discontinue treatment and look into other antihypertensive treatments.
- In a series of 22 patients, clinical and histologic improvements were observed after treatment was stopped (Rubio-Tapia 2012).
-
Gout
- Gout can be caused by a family history or chronic renal disease.
- Doses greater than 25 mg daily may increase the risk.
-
Hypersensitivity reactions
- Hypersensitivity reactions can occur with hydrochlorothiazide.
- Patients with bronchial asthma or allergy history are at greater risk.
-
Hypotension
- Patients who have been treated with high-dose diuretics may experience symptoms of hypotension upon initiation.
- Correct volume depletion must be done before administration.
- To further treatment with olmesartan/hydrochlorothiazide, his transient hypotensive response is not a contraindication.
-
Ocular effects
- Acute transient myopia or acute angle-closure vision may be caused by hydrochlorothiazide. This usually occurs within hours to weeks of initiation.
- Stop all therapy immediately for patients experiencing severe visual or ocular pain.
- Additional treatments may be required if intraocular pressure continues to rise.
- A history of penicillin allergy or sulfonamide allergy could be a risk factor.
-
Photosensitivity
- Hydrochlorothiazide may be a possible cause.
-
Renal function deterioration:
- This may be associated with decreased renal function and increases in serum creatinine in patients with low renal flow (eg, kidney artery stenosis or heart failure) whose GFR is dependent upon efferent arterial vasoconstriction (angiotensin II).
- A deterioration could lead to oliguria, acute kidney failure and progressive azotemia.
- After initiation, small increases in serum creatinine might occur.
- Patients with significant and progressive impairment of renal function should be considered for discontinuation.
-
Allergy to sulfonamide ("sulfa")
- Patients with an allergy to sulfonamides may have a wide contraindication when using medications that contain a sulfonamide chemical class.
- Cross-reactivity between members of a particular class is possible (eg, between two antibiotic sulfonamides).
- Crossreactivity concerns have been raised for all compounds with the sulfonamide structural.
- Cross-reactivity between antibiotic sulfonamides (and nonantibiotic) sulfonamides is unlikely, if at all. This has been confirmed by a better understanding of allergic mechanisms.
- Nonantibiotic sulfonamides are not likely to cause anaphylaxis (a mechanism of cross-reaction due antibody production).
- T-cell-mediated (type IV), reactions (e.g. maculopapular skin rash) are less understood. It is difficult to exclude this possibility based on current knowledge.
- These classes are sometimes avoided by some clinicians in severe cases of reactions (Stevens Johnson syndrome/TEN).
-
Aortic/mitral stenosis:
- Olmesartan should be used with caution in patients suffering from severe aortic/mitralstenosis.
-
Bariatric surgery
- Dehydration
- Avoid diuretics immediately after bariatric surgery.
- Possible electrolyte disturbances or dehydration.
- Once oral fluid intake goals have been met, diuretics can be resumed if indicated.
-
Diabetes:
- Hydrochlorothiazide should be used with caution in patients with diabetes mellitus or prediabetes.
- May experience a change in glucose control
-
Hepatic impairment
- Be cautious with patients suffering from severe hepatic impairment.
- Avoid electrolyte imbalances and acid/base imbalances in severe or progressive hepatic diseases to avoid hepatic complications.
-
Hypercalcemia:
- Thiazide diuretics may decrease renal calcium excretion.
- Patients with hypercalcemia should be advised to stop using it.
-
Hypercholesterolemia:
- Use caution in patients with high or moderate cholesterol levels.
- Increased cholesterol and triglyceride levels were reported with thiazides.
-
Parathyroid disease
- Thiazide diuretics reduce calcium excretion.
- Long-term use can lead to pathologic changes in parathyroid glands, including hypophosphatemia and hypercalcemia.
- It is important to stop using it before testing for parathyroid function.
-
Renal artery stenosis
- Use olmesartan cautiously in patients with unstented unilateral/bilateral kidney artery stenosis.
- If unstented bilateral renal arterial stenosis exists, it is best to avoid using this device.
-
Renal impairment
- Use caution in patients suffering from renal impairment.
- Patients with impaired renal function may experience azotemia as a result of the cumulative effects hydrochlorothiazide has on their bodies.
- Hydrochlorothiazide is not effective in severe renal disease.
- Patients with anuria are not advised to use this product.
-
Systemic lupus erythematosus (SLE):
- SLE activation or exacerbation can be caused by hydrochlorothiazide.
Olmesartan and hydrochlorothiazide: Drug Interaction
|
Risk Factor C (Monitor therapy) |
|
|
Ajmaline |
Sulfonamides may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. |
|
Alcohol (Ethyl) |
May enhance the orthostatic hypotensive effect of Thiazide and Thiazide-Like Diuretics. |
|
Alfuzosin |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Allopurinol |
Thiazide and Thiazide-Like Diuretics may enhance the potential for allergic or hypersensitivity reactions to Allopurinol. Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Allopurinol. Specifically, Thiazide Diuretics may increase the concentration of Oxypurinol, an active metabolite of Allopurinol. |
|
Aminolevulinic Acid (Topical) |
Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). |
|
Amphetamines |
May diminish the antihypertensive effect of Antihypertensive Agents. |
|
Angiotensin II |
Receptor Blockers may diminish the therapeutic effect of Angiotensin II. |
|
Anticholinergic Agents |
May increase the serum concentration of Thiazide and Thiazide-Like Diuretics. |
|
Antidiabetic Agents |
Thiazide and Thiazide-Like Diuretics may diminish the therapeutic effect of Antidiabetic Agents. |
|
Antidiabetic Agents |
Hyperglycemia-Associated Agents may diminish the therapeutic effect of Antidiabetic Agents. |
|
Antipsychotic Agents (Second Generation [Atypical]) |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). |
|
Barbiturates |
May enhance the orthostatic hypotensive effect of Thiazide and Thiazide-Like Diuretics. |
|
Barbiturates |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Benperidol |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Beta2-Agonists |
May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. |
|
Brigatinib |
May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. |
|
Brimonidine (Topical) |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Calcium Salts |
Thiazide and Thiazide-Like Diuretics may decrease the excretion of Calcium Salts. Continued concomitant use can also result in metabolic alkalosis. |
|
CarBAMazepine |
Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of CarBAMazepine. Specifically, there may be an increased risk for hyponatremia. |
|
Cardiac Glycosides |
Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Cardiac Glycosides. Specifically, cardiac glycoside toxicity may be enhanced by the hypokalemic and hypomagnesemic effect of thiazide diuretics. |
|
Corticosteroids (Orally Inhaled) |
May enhance the hypokalemic effect of Thiazide and ThiazideLike Diuretics. |
|
Corticosteroids (Systemic) |
May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. |
|
Cyclophosphamide |
Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Cyclophosphamide. Specifically, granulocytopenia may be enhanced. |
|
CycloSPORINE (Systemic) |
Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of CycloSPORINE (Systemic). |
|
Dapoxetine |
May enhance the orthostatic hypotensive effect of Angiotensin II Receptor Blockers. |
|
Dexketoprofen |
May enhance the adverse/toxic effect of Sulfonamides. |
|
Dexmethylphenidate |
May diminish the therapeutic effect of Antihypertensive Agents. |
|
Diacerein |
May enhance the therapeutic effect of Diuretics. Specifically, the risk for dehydration or hypokalemia may be increased. |
|
Diazoxide |
Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Diazoxide. |
|
Diazoxide |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Drospirenone |
Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Drospirenone. |
|
DULoxetine |
Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. |
|
Eltrombopag |
May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates. |
|
Eplerenone |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. |
|
Gemfibrozil |
May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates. See separate drug interaction monographs for agents listed as exceptions. |
|
Heparin |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. |
|
Heparins (Low Molecular Weight) |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. |
|
Herbs (Hypertensive Properties) |
May diminish the antihypertensive effect of Antihypertensive Agents. |
|
Herbs (Hypotensive Properties) |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Hypotension-Associated Agents |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. |
|
Ipragliflozin |
May enhance the adverse/toxic effect of Thiazide and Thiazide-Like Diuretics. Specifically, the risk for intravascular volume depletion may be increased. |
|
Ivabradine |
Thiazide and Thiazide-Like Diuretics may enhance the arrhythmogenic effect of Ivabradine. |
|
Levodopa-Containing Products |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Containing Products. |
|
Licorice |
May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. |
|
Lormetazepam |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Methylphenidate |
May diminish the antihypertensive effect of Antihypertensive Agents. |
|
Molsidomine |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Multivitamins/Fluoride (with ADE) |
May enhance the hypercalcemic effect of Thiazide and Thiazide-Like Diuretics. |
|
Multivitamins/Minerals (with ADEK, Folate, Iron) |
Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Multivitamins/Minerals (with ADEK, Folate, Iron). |
|
Multivitamins/Minerals (with AE, No Iron) |
Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Multivitamins/Minerals (with AE, No Iron). Specifically, thiazide diuretics may decrease the excretion of calcium, and continued concomitant use can also result in metabolic alkalosis. |
|
Naftopidil |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Neuromuscular-Blocking Agents (Nondepolarizing) |
Thiazide and Thiazide-Like Diuretics may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). |
|
Nicergoline |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Nicorandil |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. |
|
Nicorandil |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Nitroprusside |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. |
|
Nonsteroidal Anti-Inflammatory Agents |
Thiazide and Thiazide-Like Diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Thiazide and Thiazide-Like Diuretics. |
|
Nonsteroidal Anti-Inflammatory Agents |
Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function. |
|
Opioid Agonists |
May enhance the adverse/toxic effect of Diuretics. Opioid Agonists may diminish the therapeutic effect of Diuretics. |
|
Oxcarbazepine |
Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of OXcarbazepine. Specifically, there may be an increased risk for hyponatremia. |
|
Pentoxifylline |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Pholcodine |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. |
|
Phosphodiesterase 5 Inhibitors |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Porfimer |
Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. |
|
Potassium Salts |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. |
|
Potassium-Sparing Diuretics |
Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Potassium-Sparing Diuretics. |
|
Prostacyclin Analogues |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Quinagolide |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. |
|
Ranolazine |
May enhance the adverse/toxic effect of Angiotensin II Receptor Blockers. |
|
Reboxetine |
May enhance the hypokalemic effect of Thiazide and Thiazide-Like Diuretics. |
|
Selective Serotonin Reuptake Inhibitors |
May enhance the hyponatremic effect of Thiazide and Thiazide-Like Diuretics. |
|
Tacrolimus (Systemic) |
Angiotensin II Receptor Blockers may enhance the hyperkalemic effect of Tacrolimus (Systemic). |
|
Teriflunomide |
May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates. |
|
Toremifene |
Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Toremifene. |
|
Trimethoprim |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. |
|
Valsartan |
HydroCHLOROthiazide may enhance the hypotensive effect of Valsartan. Valsartan may increase the serum concentration of HydroCHLOROthiazide. |
|
Verteporfin |
Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. |
|
Vitamin D Analogs |
Thiazide and Thiazide-Like Diuretics may enhance the hypercalcemic effect of Vitamin D Analogs. |
|
Yohimbine |
May diminish the antihypertensive effect of Antihypertensive Agents. |
|
Risk Factor D (Consider therapy modification) |
|
|
Aliskiren |
May enhance the hyperkalemic effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the hypotensive effect of Angiotensin II Receptor Blockers. Aliskiren may enhance the nephrotoxic effect of Angiotensin II Receptor Blockers. Management: Aliskiren use with ACEIs or ARBs in patients with diabetes is contraindicated. Combined use in other patients should be avoided, particularly when CrCl is less than 60 mL/min. If combined, monitor potassium, creatinine, and blood pressure closely. |
|
Amifostine |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration. If blood pressure lowering therapy cannot be withheld, amifostine should not be administered. |
|
Angiotensin-Converting Enzyme Inhibitors |
Angiotensin II Receptor Blockers may enhance the adverse/toxic effect of Angiotensin-Converting Enzyme Inhibitors. Angiotensin II Receptor Blockers may increase the serum concentration of Angiotensin-Converting Enzyme Inhibitors. Management: In US labeling, use of telmisartan and ramipril is not recommended. It is not clear if any other combination of an ACE inhibitor and an ARB would be any safer. Consider alternatives to the combination when possible. |
|
Bile Acid Sequestrants |
May decrease the absorption of Thiazide and Thiazide-Like Diuretics. The diuretic response is likewise decreased. |
|
Colesevelam |
May decrease the serum concentration of Olmesartan. Management: Administer olmesartan at least 4 hours prior to colesevelam. |
|
Lithium |
Thiazide and Thiazide-Like Diuretics may decrease the excretion of Lithium. |
|
Lithium |
Angiotensin II Receptor Blockers may increase the serum concentration of Lithium. Management: Lithium dosage reductions will likely be needed following the addition of an angiotensin II receptor antagonist. |
|
Obinutuzumab |
May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. |
|
Sodium Phosphates |
Angiotensin II Receptor Blockers may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Management: Consider avoiding this combination by temporarily suspending treatment with ARBs, or seeking alternatives to oral sodium phosphate bowel preparation. If the combination cannot be avoided, maintain adequate hydration and monitor renal function closely. |
|
Sodium Phosphates |
Diuretics may enhance the nephrotoxic effect of Sodium Phosphates. Specifically, the risk of acute phosphate nephropathy may be enhanced. Management: Consider avoiding this combination by temporarily suspending treatment with diuretics, or seeking alternatives to oral sodium phosphate bowel preparation. If the combination cannot be avoided, hydrate adequately and monitor fluid and renal status. |
|
Tolvaptan |
May increase the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates. |
|
Topiramate |
Thiazide and Thiazide-Like Diuretics may enhance the hypokalemic effect of Topiramate. Thiazide and Thiazide-Like Diuretics may increase the serum concentration of Topiramate. Management: Monitor for increased topiramate levels/adverse effects (e.g., hypokalemia) with initiation/dose increase of a thiazide diuretic. Closely monitor serum potassium concentrations with concomitant therapy. Topiramate dose reductions may be necessary. |
|
Risk Factor X (Avoid combination) |
|
|
Aminolevulinic Acid (Systemic) |
Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). |
|
Bromperidol |
Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Bromperidol may diminish the hypotensive effect of Blood Pressure Lowering Agents. |
|
Dofetilide |
HydroCHLOROthiazide may enhance the QTc-prolonging effect of Dofetilide. HydroCHLOROthiazide may increase the serum concentration of Dofetilide. |
|
Levosulpiride |
Thiazide and Thiazide-Like Diuretics may enhance the adverse/toxic effect of Levosulpiride. |
|
Mecamylamine |
Sulfonamides may enhance the adverse/toxic effect of Mecamylamine. |
|
Promazine |
Thiazide and Thiazide-Like Diuretics may enhance the QTc-prolonging effect of Promazine. |
Monitoring Parameters:
- Blood pressure, serum electrolytes, BUN, creatinine
How to administer Olmesartan and hydrochlorothiazide (Benicar HCT)?
P/O:
- Administer with or without food.
Mechanism of action of Olmesartan and hydrochlorothiazide (Benicar HCT):
- Olmesartan blocks the vasoconstrictor & aldosterone-secreting effects of angiotensin II.
- Hydrochlorothiazide reduces sodium reabsorption from the distal tubules, leading to increased excretion sodium, water, and potassium ions.
See individual agents (Olmesartan and Hydrochlorothiazide)
International Brands of Olmesartan and hydrochlorothiazide (Benicar HCT):
- Benicar HCT
- Olmetec Plus
- Abetis Plus
- Almetec CO
- Alteisduo
- Alzor HCT
- Cardosal Plus
- CoOLMETEC
- Fu Ao Tan
- Iltux HCT
- Olme-H
- Olmegan
- Olmesan Plus
- Olmetec Comp
- Olmetec D
- Olmetec HCT
- Olmetec HCTZ
- Olmetec Plus
- Olmetec Plus H
- Olmezar Plus
- Omesar Plus
- Openvas CO
- Orbas Plus
Olmesartan and hydrochlorothiazide Brand Names in Pakistan:
Olmesartan and hydrochlorothiazide Tablets 20 mg |
|
| Co-Baritec | Barrett Hodgson Pakistan (Pvt) Ltd. |
| Co-Olesta | Searle Pakistan (Pvt.) Ltd. |
| Malisartan -Ht | Alied Medical |
| Olmipress -H | Remington Pharmaceutical Industries (Pvt) Ltd. |
| Omsana Diu | Hilton Pharma (Pvt) Limited |
| Orion Diu | Ferozsons Laboratoies Ltd. |
| Oscord Diu | Hilton Pharma (Pvt) Limited |
| Sofvasc-Olm | Wilsons Pharmaceuticals |
Olmesartan and hydrochlorothiazide Tablets 40 mg |
|
| Benicar-H | Himont Pharmaceuticals (Pvt) Ltd. |
| Co-Baritec | Barrett Hodgson Pakistan (Pvt) Ltd. |
| Co-Olesta | Searle Pakistan (Pvt.) Ltd. |
| Malisartan -Ht | Alied Medical |
| Olmipress -H | Remington Pharmaceutical Industries (Pvt) Ltd. |
| Omsana Diu | Hilton Pharma (Pvt) Limited |
| Oscord Diu | Hilton Pharma (Pvt) Limited |
| Sofvasc-Olm | Wilsons Pharmaceuticals |
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