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Benicar Hct Generic Name & Formulations
Legal Class
Rx
General Description
Olmesartan medoxomil, hydrochlorothiazide; 20mg/12.5mg, 40mg/12.5mg, 40mg/25mg; tabs.
Pharmacological Class
Angiotensin II receptor blocker (ARB) + thiazide diuretic.
How Supplied
Tabs—30, 90, 1000
Manufacturer
Generic Availability
YES
Mechanism of Action
Olmesartan blocks the vasoconstrictor effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in vascular smooth muscle. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium.
Benicar Hct Indications
Indications
Hypertension (not for initial therapy).
Benicar Hct Dosage and Administration
Adult
BP not controlled on olmesartan alone: initially 40/12.5mg once daily. Intolerant to or BP not controlled on HCTZ alone: initially 20/12.5mg once daily. Both: may titrate at 2–4 week intervals up to max 40mg/25mg once daily. May substitute for individually titrated components.
Children
Not established.
Nursing Considerations
Patients should be asked to report pregnancies to their physicians as soon as possible. Caution patients that inadequate fluid intake, excessive perspiration, diarrhea or vomiting can lead to excessive fall in BP, with lightheadedness and possible syncope.
Benicar Hct Contraindications
Contraindications
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
Benicar Hct Boxed Warnings
Boxed Warning
Fetal toxicity.
Benicar Hct Warnings/Precautions
Warnings/Precautions
Fetal toxicity may develop; discontinue if pregnancy is detected. Correct salt/volume depletion before starting, or monitor closely. Hepatic impairment. Severe renal impairment (CrCl<30mL/min): not established. Renal artery stenosis. Severe CHF. Asthma. Diabetes. SLE. Gout. Acute myopia. Secondary angle-closure glaucoma. Monitor BP, calcium, potassium, renal function periodically. Possibly less effective in black patients. Elderly. Neonates. Pregnancy (Cat.D). Nursing mothers: not recommended.
Benicar Hct Pharmacokinetics
Elimination
Renal, fecal.
Benicar Hct Interactions
Interactions
See Contraindications. Hyperkalemia with concomitant other drugs that increase serum potassium levels. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). May be antagonized by, and renal toxicity potentiated by NSAIDs, including COX-2 inhibitors; monitor renal function periodically in elderly and/or volume depleted. Lithium toxicity (monitor). Adjust antidiabetics. ACTH, corticosteroids increase hypokalemia risk. Orthostatic hypotension potentiated by alcohol, other CNS depressants. Potentiates other antihypertensives, skeletal muscle relaxants. Give ≥4hrs before colesevelam HCl dose; ≥4hrs before or 4–6hrs after cholestyramine, colestipol resins.
Benicar Hct Adverse Reactions
Adverse Reactions
Nausea, hyperuricemia, dizziness, upper respiratory infection; orthostatic hypotension, renal impairment, hypersensitivity reactions, electrolyte disturbances, possible sprue-like enteropathy; HCTZ: increased risk for non-melanoma skin cancer.
Benicar Hct Clinical Trials
See Literature
Benicar Hct Note
Not Applicable
Benicar Hct Patient Counseling
See Literature
