Indications for BENICAR HCT:
Hypertension (not for initial therapy).
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.
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. 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.
Angiotensin II receptor blocker (ARB) + thiazide diuretic.
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.
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.
Tabs—30, 90, 1000