Generic Name and Formulations:
Olmesartan medoxomil, hydrochlorothiazide; 20mg/12.5mg, 40mg/12.5mg, 40mg/25mg; tabs.
Not for initial therapy. May be substituted for titrated components. Individualize. ≥18yrs: BP not controlled on olmesartan or HCTZ alone: one tab once daily; may titrate at 2–4 week intervals; usual max 40mg/25mg once daily. Severe renal impairment (CrCl ≤30mL/min): not recommended. Volume depleted: reduce dose.
<18yrs: not established.
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Correct salt/volume depletion before starting, or monitor closely. Renal impairment: monitor for worsening renal function. Hepatic dysfunction. Renal artery stenosis. Possibly less effective in black patients. Severe CHF. Asthma. Diabetes. Postsympathectomy. SLE. Gout. Monitor electrolytes. Acute myopia. Secondary angle-closure glaucoma. Elderly. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers: not recommended.
Digitalis, lithium toxicity. Adjust antidiabetic, antigout medications. ACTH, corticosteroids increase hypokalemia risk. Orthostatic hypotension potentiated by alcohol, CNS depressants, barbiturates, narcotics. Potentiates other antihypertensives. May potentiate nondepolarizing muscle relaxants. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. May antagonize norepinephrine. May be antagonized by, and renal toxicity potentiated by NSAIDs, including COX-2 inhibitors; monitor renal function periodically in elderly and/or volume depleted. May interfere with parathyroid tests. Reduced absorption with cholestyramine, colestipol. Take 4hrs before colesevelam HCl dose.
Angiotensin II receptor blocker (ARB) + thiazide diuretic.
Dizziness, infection, hyperuricemia, nausea, back pain, weakness, orthostatic hypotension, electrolyte disturbances, rash, adverse lipid values, possible sprue-like enteropathy, rhabdomyolysis (rare).
Tabs—30, 90, 1000
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