Olmesartan and Hydrochlorothiazide

Olmesartan and Hydrochlorothiazide may be found in some form under the following brand names:

• Benicar HCT

Tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you are taking:

• colesevelam (Welchol)
• angiotensin receptor blockers (ARBs) like valsartan (Diovan) , ACE inhibitors (ACE) like enalapril (Vasotec, Vaseretic), or aliskiren (Tekturna)
• alcohol, a class of drugs called barbiturates, or a type of pain medications called narcotics
• diabetic medications
• cholestyramine (Questran) and colestipol (Colestid)
• medicines that provide relief for inflamed areas of the body (corticosteroids) such as methylprednisolone (Medrol) and dexamethasone (Decadron)
• substances that raise blood pressure (pressor amines) such as norepinephrine (Levophed)
• medicines that relax skeletal muscles such as cyclobenzaprine (Flexeril) and carisoprodol (Soma)
• lithium (Lithobid)
• nonsteroidal anti-inflammatory drugs (NSAIDS) such as naproxen (Aleve) and ibuprofen (Advil)

This is not a complete list of olmesartan and hydrochlorothiazide drug interactions. Ask your doctor or pharmacist for more information. 

Olmesartan and hydrochlorothiazide combination is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

Olmesartan is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. As a result, olmesartan relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure.

olmesartan and hydrochlorothiazide is available only with your doctor's prescription.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Bladder pain
• bloating or swelling of the face, arms, hands, lower legs, or feet
• bloody or cloudy urine
• blurred vision
• chest pain
• difficult, burning, or painful urination
• flushed, dry skin
• frequent urge to urinate
• fruit-like breath odor
• increased hunger
• increased urination
• joint pain, stiffness, or swelling
• lower back, side, or stomach pain
• rapid weight gain
• sweating
• swelling of the feet or lower legs
• tingling of the hands or feet
• troubled breathing
• unexplained weight loss
• unusual weight gain or loss

• Swelling or puffiness of the face

• Convulsions
• decrease in amount of urine
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• rash
• severe diarrhea with weight loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Back pain
• body aches or pain
• chills
• cough
• difficulty with breathing
• ear congestion or pain
• fever
• headache
• head congestion
• hoarseness or other voice changes
• loss of voice
• runny or stuffy nose
• sneezing
• sore throat

• Acid or sour stomach
• belching
• difficulty with moving
• dizziness or lightheadedness
• feeling of constant movement of self or surroundings
• heartburn
• indigestion
• joint pain, stiffness, or swelling
• loss of appetite
• muscle pain or stiffness
• pain, swelling, or redness in the joints
• sensation of spinning
• stomach discomfort or upset
• weakness

• Diarrhea
• muscle pain or stiffness
• nervousness
• weakness or heaviness of the legs

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dizziness.
• Nose and throat irritation.
• Stuffy nose.
• Runny nose.
• Cough.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Hypertension: Oral:

Replacement therapy: Combination product may be substituted for individual titrated agents.

Initiation of combination therapy when monotherapy has failed to achieve desired effects:

Patients currently on olmesartan monotherapy: Initial: Olmesartan 40 mg/hydrochlorothiazide 12.5 mg once daily; may titrate dose after 2 to 4 weeks (maximum: olmesartan 40 mg/hydrochlorothiazide 25 mg per day).

Patients currently on hydrochlorothiazide monotherapy: Initial: Olmesartan 20 mg/hydrochlorothiazide 12.5 mg once daily; may titrate dose after 2 to 4 weeks (maximum: olmesartan 40 mg/hydrochlorothiazide 25 mg per day).

Refer to adult dosing.

When pregnancy is detected, discontinue olmesartan/hydrochlorothiazide as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience dizziness, rhinitis, pharyngitis, or rhinorrhea. Have patient report immediately to prescriber signs of hyperglycemia, signs of renal impairment, signs of fluid and electrolyte imbalance, angina, edema of extremities, significant diarrhea, excessive weight loss, vision changes, or ophthalmalgia (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.