olmesartan/hydrochlorothiazide (Rx)Brand and Other Names:Benicar HCT

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

olmesartan/hydrochlorothiazide

tablet

  • 20mg/12.5mg
  • 40mg/12.5mg
  • 40mg/25mg
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Hypertension

Initial: 20 mg/12.5 mg PO qDay

May increase to 40 mg/25 mg after 2 weeks

Renal Impairment

CrCl <30 mL/min: Not recommended

Hepatic Impairment

Dose adjustment not necessary

Safety and efficacy not established

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Interactions

Interaction Checker

olmesartan/hydrochlorothiazide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Adverse reactions with combination products and individual agents

            1-10%

            Olmesartan

            • Dizziness (3%)
            • Headache (1%)
            • Fatigue
            • Diarrhea (1%)
            • Hyperglycemia (1%)
            • Hypertriglyceridemia (1%)
            • Back pain (1%)
            • Bronchitis (1%)
            • Flu-like symptoms (1%)
            • Pharyngitis (1%)
            • Rhinitis (1%)
            • Sinusitis (1%)
            • URI (1%)

            Frequency Not Defined

            Chest pain

            Peripheral edema

            Rash

            Hyperuricemia

            Dizziness

            Hyperlipidemia

            Diarrhea

            Hyperuricemia

            Hematuria

            Hyperglycemia

            Upper respiratory infections

            Increased transaminases

            Gastroenteritis

            Dyspepsia

            Arthralgia

            Arthritis

            Myalgia

            Back pain

            Increased CPK

            Hydrochlorothiazide

            • Anorexia
            • Epigastric distress
            • Hypotension
            • Orthostatic hypotension
            • Photosensitivity
            • Anaphylaxis
            • Anemia
            • Confusion
            • Erythema multiforme
            • Stevens-Johnson syndrome
            • Exfoliative dermatitis including toxic epidermal necrolysis
            • Dizziness
            • Hypokalemia and/or hypomagnesemia
            • Hyperuricemia
            • Headache
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            Warnings

            Black Box Warnings

            Discontinue as soon as possible when pregnancy is detected; affects renin-angiotensin system causing oligohydramnios, which may result in fetal injury and/or death

            Contraindications

            Hypersensitivity to olmesartan, hydrochlorothiazide or sulfonamides

            Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

            Pregnancy (2nd/3rd trimesters): Significant risk of fetal and neonatal morbidity & mortality

            Anuria

            Do not coadminister with aliskiren in patients with diabetes mellitus

            Not for initial treatment

            Cautions

            Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

            Hyperkalemia, particularly when coadministered with potassium-sparing diuretics, potassium supplements, or salt substitutes; concurrent therapy with hydrochlorothiazide may reduce the frequency of this effect

            Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for renal function changes (including acute renal failure) compared to monotherapy; closely monitor blood pressure

            Hypotension may occur in patients who are salt or volume depleted (correct the volume depletion especially in patients receiving high dose diuretics)

            Intestinal problems (ie, sprue-like enteropathy) reported with olmesartan; symptoms may include severe, chronic diarrhea with substantial weight loss

            Hydrochlorothiazide can cause hypokalemia and hyponatremia; hypomagnesemia can result in hypokalemia which appears difficult to treat despite potassium repletion

            Drugs that inhibit the renin-angiotensin system can cause hyperkalemia; monitor serum electrolytes periodically

            Electrolyte disturbances may occur

            Photosensitivity may occur

            Hyperuricemia may occur or gout may be precipitated in certain patients receiving thiazide therapy

            Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides

            Thiazides may decrease urinary calcium excretion

            Caution in aortic mitral stenosis, hepatic impairment, hypercholesterolemia, hypercalcemia, parathyroid disease, pre-existing renal insufficiency, systemic lupus erythematosus, bilateral renal artery stenosis or anuria

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            Pregnancy & Lactation

            Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters)

            Lactation: discontinue drug or do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
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            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
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            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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