Amlodipine Hydrochlorothiazide Olmesartan

Amlodipine Hydrochlorothiazide Olmesartan Brand Name– Tribenzor

What is Amlodipine Hydrochlorothiazide Olmesartan

Amlodipine Hydrochlorothiazide Olmesartan is a triple combination product for the maintenance treatment of hypertension after titration of the individual components.

Amlodipine is a dihydropyridine calcium channel blocker; hydrochlorothiazide is a thiazide diuretic; and olmesartan is an angiotensin II receptor antagonist, also known as an angiotensin 2 receptor blocker (ARB).

The combination of an ARB with either a diuretic or a calcium-channel blocker results in additive blood pressure reduction. Combining drugs from complimentary classes is significantly more effective in lowering blood pressure than increasing the dose of one drug.

In the TRINITY study (Triple Therapy With Olmesartan medoxomil, Amlodipine, and Hydrochlorothiazide in Hypertensive Patients), there was a significantly greater reduction from baseline in both seated systolic and diastolic blood pressures at week 12 in the triple therapy group (-37.1 mmHg/-21.8 mmHg for amlodipine 10 mg; hydrochlorothiazide 25 mg; olmesartan 40 mg group) compared to dual combinations of amlodipine + olmesartan, hydrochlorothiazide + olmesartan, or amlodipine + hydrochlorothiazide (p < 0.001 for triple therapy compared to all dual treatment groups).

Patients with severe hypertension had a greater therapeutic response than those with moderate hypertension.

Additionally, significantly more patients in the triple therapy group vs. the other groups reached blood pressure targets of less than 140/90 mmHg, less than 120/80 mmHg, seated SBP less than 140 mmHg, and seated DBP less than 90 mmHg (p < 0.001).

Amlodipine Hydrochlorothiazide Olmesartan (Tribenzor) was initially approved by the FDA in July 2010.

Indications

  • hypertension

Side Effects

  1. agranulocytosis
  2. alopecia
  3. angina
  4. angioedema
  5. aplastic anemia
  6. arthropathy
  7. atrial fibrillation
  8. azotemia
  9. blurred vision
  10. bradycardia
  11. cholestasis
  12. cough
  13. diarrhea
  14. dizziness
  15. dysphagia
  16. elevated hepatic enzymes
  17. erythema multiforme
  18. exfoliative dermatitis
  19. fatigue
  20. flatulence
  21. gingival hyperplasia
  22. gout
  23. gynecomastia
  24. headache
  25. hemolytic anemia
  26. hepatitis
  27. hyperbilirubinemia
  28. hypercalcemia
  29. hypercholesterolemia
  30. hyperglycemia
  31. hyperkalemia
  32. hypertriglyceridemia
  33. hyperuricemia
  34. hypomagnesemia
  35. hypotension
  36. infection
  37. jaundice
  38. leukopenia
  39. muscle cramps
  40. myopia
  41. nausea
  42. nephrolithiasis
  43. ocular hypertension
  44. orthostatic hypotension
  45. pancreatitis
  46. pancytopenia
  47. peripheral edema
  48. peripheral neuropathy
  49. pharyngitis
  50. photosensitivity
  51. purpura
  52. renal failure (unspecified)
  53. rhabdomyolysis
  54. Stevens-Johnson syndrome
  55. syncope
  56. teratogenesis
  57. thrombocytopenia
  58. toxic epidermal necrolysis
  59. urticaria
  60. vasculitis
  61. ventricular tachycardia
  62. vomiting
  63. weight loss
  64. xanthopsia

Monitoring Parameters

  • blood glucose
  • blood pressure
  • heart rate
  • LFTs
  • serum bilirubin
  • serum creatinine/BUN
  • serum electrolytes
  • serum uric acid

Contraindications

  • ACE-inhibitor induced angioedema
  • angina
  • angioedema
  • anuria
  • aortic stenosis
  • asthma
  • breast-feeding
  • closed-angle glaucoma
  • coronary artery disease
  • diabetes mellitus
  • electrolyte imbalance
  • geriatric
  • gout
  • heart failure
  • hepatic disease
  • hypercalcemia
  • hyperglycemia
  • hyperkalemia
  • hyperuricemia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • myopia
  • orthostatic hypotension
  • pancreatitis
  • penicillin hypersensitivity
  • pregnancy
  • renal artery stenosis
  • renal disease
  • renal failure
  • renal impairment
  • sulfonamide hypersensitivity
  • sunlight (UV) exposure
  • systemic lupus erythematosus (SLE)
  • thiazide diuretic hypersensitivity

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  • Sitagliptin
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Solifenacin
  • Sotalol
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Streptozocin
  • Succinylcholine
  • Sufentanil
  • Sulfacetamide
  • Sulfacetamide; Sulfur
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfinpyrazone
  • Sulfonylureas
  • Sulindac
  • Tacrolimus
  • Tamsulosin
  • Tapentadol
  • Tazarotene
  • Tegaserod
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temsirolimus
  • Terbutaline
  • Tetrabenazine
  • Tetracaine
  • Thalidomide
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Timolol
  • Tiotropium; Olodaterol
  • Tipranavir
  • Tizanidine
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Tolterodine
  • Tolvaptan
  • Topiramate
  • Toremifene
  • Tramadol
  • Trandolapril
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Treprostinil
  • Tretinoin, ATRA
  • Triamterene
  • Trihexyphenidyl
  • Trimethoprim
  • Trospium
  • Tubocurarine
  • Tucatinib
  • Umeclidinium; Vilanterol
  • Valdecoxib
  • Valproic Acid, Divalproex Sodium
  • Vecuronium
  • Vemurafenib
  • Venlafaxine
  • Verapamil
  • Verteporfin
  • Vilazodone
  • Vinorelbine
  • Vitamin D
  • Vitamin D analogs
  • Voriconazole
  • Vorinostat
  • Vortioxetine
  • Yohimbine
  • Zafirlukast
  • Ziconotide
  • Ziprasidone
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