Hydrochlorothiazide and olmesartan

What is the most important information I should know about hydrochlorothiazide and olmesartan?

Do not take this medication if you are pregnant. Hydrochlorothiazide and olmesartan is in the FDA pregnancy category D. This means that it is known to be harmful to an unborn baby. When used during the second and third trimesters of pregnancy, olmesartan can cause injury and even death of the developing baby. Notify your doctor immediately if you think you might be pregnant.

Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and olmesartan may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position.

Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness and dizziness while taking hydrochlorothiazide and olmesartan.

Stop taking hydrochlorothiazide and olmesartan and contact your doctor if fainting occurs.

What is hydrochlorothiazide and olmesartan?

Olmesartan is in a class of drugs called angiotensin II receptor antagonists. Olmesartan prevents the constriction (narrowing) of blood vessels (veins and arteries).

Hydrochlorothiazide is a thiazide diuretic (water pill). It increases the amount of water and salt you lost in the urine. Hydrochlorothiazide is used to lower blood pressure and to decrease edema (swelling).

Hydrochlorothiazide and olmesartan is used to reduce hypertension (high blood pressure).

Hydrochlorothiazide and olmesartan may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and olmesartan?

Do not take hydrochlorothiazide and olmesartan without first talking to your doctor if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to hydrochlorothiazide.

Before taking hydrochlorothiazide and olmesartan, tell your doctor if you

• have diabetes;
• have gout;
• have a collagen vascular disease such as systemic lupus erythematosus;
• have a history of allergies or asthma;
• have pancreatitis;
• have kidney disease;
• have liver disease;
• have any type of heart disease or have had a stroke;
• are on a salt-restricted diet or have high levels of potassium in your blood; or
• are taking a potassium supplement (e.g., K-Dur, Klor-Con, others), or a potassium-sparing diuretic such as amiloride (Midamor), triamterene (Dyrenium, Dyazide, Maxzide), or spironolactone (Aldactone).

You may not be able to take hydrochlorothiazide and olmesartan, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Do not take this medication if you are pregnant. Hydrochlorothiazide and olmesartan is in the FDA pregnancy category D. This means that it is known to be harmful to an unborn baby. When used during the second and third trimesters of pregnancy, olmesartan can cause injury and even death of the developing baby. Notify your doctor immediately if you think you might be pregnant.

It is not known whether this drug passes into breast milk. Do not take hydrochlorothiazide and olmesartan without first talking to your doctor if you are breast-feeding a baby.

How should I take hydrochlorothiazide and olmesartan?

Take hydrochlorothiazide and olmesartan exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass (8 ounces) of water.

Hydrochlorothiazide and olmesartan can be taken with or without food.

Do not stop taking this medication without first talking to your doctor, even if you feel well. If you stop taking this medication, your condition could become worse.

Store hydrochlorothiazide and olmesartan at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of the medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a hydrochlorothiazide and olmesartan overdose are not well known but may include dizziness, weakness, fainting, fatigue, and changes in heart rhythm.

What should I avoid while taking hydrochlorothiazide and olmesartan?

Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and olmesartan may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position.

Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness and dizziness while taking hydrochlorothiazide and olmesartan.

Stop taking hydrochlorothiazide and olmesartan and contact your doctor if fainting occurs.

Avoid a diet high in salt. Too much salt may cause the body to retain water and may decrease the effects of hydrochlorothiazide.

Do not use salt substitutes or take potassium supplements without first talking to your doctor. Candesartan can affect potassium levels in the body.

Avoid prolonged exposure to sunlight. Hydrochlorothiazide and olmesartan may increase the sensitivity of the skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Decreased fluid intake, increased sweating, diarrhea, or vomiting may cause dehydration and possibly dizziness or fainting. Maintain adequate fluid intake to decrease the risk of dehydration.

What are the possible side effects of hydrochlorothiazide and olmesartan?

If you experience any of the following serious side effects, stop taking hydrochlorothiazide and olmesartan and call your doctor immediately or seek emergency medical treatment.

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
• little or no urine;
• unusual fatigue, abnormal bleeding or bruising;
• yellowing of the skin or eyes or confusion; or
• fainting.

Other, less serious side effects may be more likely to occur. Continue to take hydrochlorothiazide and olmesartan and talk to your doctor if you experience

• dizziness;
• headache;
• nausea or upset stomach;
• diarrhea;
• insomnia;
• congestion or cough;
• increased urination; or
• increased sweating.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect hydrochlorothiazide and olmesartan?

Before taking hydrochlorothiazide and olmesartan, tell your doctor if you are taking

• a potassium supplement such as K-Dur, Klor-Con, and others;
• a potassium-sparing diuretic (water pill) such as amiloride (Midamor), spironolactone (Aldactone), or triamterene (Dyrenium, Dyazide, Maxzide);
• a barbiturate such as phenobarbital (Luminal, Solfoton), pentobarbital (Nembutal), secobarbital (Seconal), mephobarbital (Mebaral), and others;
• a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin), ketoprofen (Orudis, Orudis KT, Oruvail), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), nabumetone (Relafen), oxaprozin (Daypro), naproxen (Naprosyn, Anaprox, Aleve), and others;
• an oral diabetes medication such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), or tolbutamide (Orinase);
• cholestyramine (Questran) or colestipol (Colestid); or
• lithium (Lithobid, Eskalith, others).

You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Tell your doctor about any other medicines you take to treat high blood pressure or other heart conditions. Hydrochlorothiazide and olmesartan may cause very low blood pressure if it is taken with other heart medications.

Drugs other than those listed here may also interact with hydrochlorothiazide and olmesartan or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, incuding vitamins, minerals, and herbal products.

Where can I get more information?

Your pharmacist has additional information about hydrochlorothiazide and olmesartan written for health professionals that you may read.

What does my medication look like?

Hydrochlorothiazide and olmesartan is available with a prescription under the brand name Benicar HCT. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Benicar HCT 20-12.5 (20 mg of olmesartan and 12.5 mg of hydrochlorothiazide)--reddish-yellow, round, film-coated tablets
• Benicar HCT 40-12.5 (40 mg of olmesartan and 12.5 mg of hydrochlorothiazide)--reddish-yellow, oval, film-coated tablets
• Benicar HCT 40-25 (40 mg of olmesartan and 25 mg of hydrochlorothiazide)--pink, oval, film-coated tablets

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 1.02. Revision date: 2/13/04.