Hydrochlorothiazide Olmesartan

Hydrochlorothiazide Olmesartan Brand Name– Benicar HCT

What is Hydrochlorothiazide Olmesartan

Hydrochlorothiazide Olmesartan are combined in a once daily oral preparation to manage hypertension.

HCTZ is a thiazide diuretic. Compared to other angiotensin II receptor antagonists, olmesartan medoxomil is a prodrug which is administered orally and converted to olmesartan during gastrointestinal absorption.

Olmesartan does not undergo further metabolism by the liver, lacks cytochrome P-450 interactions, and is eliminated via biliary and renal excretion. Because AT receptors are nearly saturated at the starting doses for most angiotensin II receptor antagonists, the antihypertensive dose-response curve for these drugs is nonlinear, with proportionally small decreases in blood pressure attained with increased dosage.

Greater antihypertensive efficacy is generally achieved by adding a small dose of HCTZ to the angiotensin II antagonist.

Like other angiotensin II antagonists, olmesartan tends to reverse the potassium loss associated with HCTZ.

Because olmesartan does not inhibit angiotensin converting enzyme (ACE), it does not result in bradykinin accumulation which is theorized to cause the cough and angioedema associated with ACE inhibitors.

However, angioedema has been rarely associated with angiotensin II antagonists.

Hydrochlorothiazide olmesartan (Benicar HCT®) was FDA-approved on June 5, 2003.

Indications

  • hypertension

For the treatment of hypertension in patients who do not respond to monotherapy

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anaphylactoid reactions
  5. angioedema
  6. aplastic anemia
  7. arthralgia
  8. asthenia
  9. azotemia
  10. back pain
  11. blurred vision
  12. chest pain (unspecified)
  13. cough
  14. diarrhea
  15. dizziness
  16. dyspepsia
  17. elevated hepatic enzymes
  18. erythema multiforme
  19. exfoliative dermatitis
  20. fever
  21. glycosuria
  22. gout
  23. headache
  24. hematuria
  25. hemolytic anemia
  26. hypercalcemia
  27. hypercholesterolemia
  28. hyperglycemia
  29. hyperkalemia
  30. hyperlipidemia
  31. hypertriglyceridemia
  32. hyperuricemia
  33. hypochloremia
  34. hypokalemia
  35. hypomagnesemia
  36. hyponatremia
  37. hypotension
  38. hypovolemia
  39. infection
  40. interstitial nephritis
  41. jaundice
  42. leukopenia
  43. myalgia
  44. myopia
  45. nausea
  46. nephrolithiasis
  47. ocular hypertension
  48. oliguria
  49. orthostatic hypotension
  50. pancreatitis
  51. peripheral edema
  52. photosensitivity
  53. pneumonitis
  54. pruritus
  55. pulmonary edema
  56. rash
  57. renal failure (unspecified)
  58. restlessness
  59. rhabdomyolysis
  60. sialadenitis
  61. sinus tachycardia
  62. Stevens-Johnson syndrome
  63. syncope
  64. teratogenesis
  65. thrombocytopenia
  66. toxic epidermal necrolysis
  67. urticaria
  68. vasculitis
  69. vertigo
  70. vomiting
  71. weakness
  72. weight loss
  73. xanthopsia

Monitoring Parameters

  • blood glucose
  • blood pressure
  • LFTs
  • serum bilirubin (total and direct)
  • serum creatinine/BUN
  • serum electrolytes
  • serum uric acid

Contraindications

  • ACE-inhibitor induced angioedema
  • angioedema
  • anuria
  • asthma
  • breast-feeding
  • children
  • closed-angle glaucoma
  • 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
  • surgery
  • sympathectomy
  • syncope
  • systemic lupus erythematosus (SLE)
  • thiazide diuretic hypersensitivity

Interactions

  • Acarbose
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetohexamide
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
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  • Aliskiren; Amlodipine
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  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
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  • Aspirin, ASA; Oxycodone
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  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
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  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
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  • Esomeprazole; Naproxen
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  • Ethanol
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  • Famotidine; Ibuprofen
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flavoxate
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  • Flurbiprofen
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  • Fosinopril
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  • Gallium Ga 68 Dotatate
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  • Glyburide
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  • Glycopyrrolate
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  • Granisetron
  • Guaifenesin; Hydrocodone
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  • Hydrocodone
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