What is Benicar HCT?
Benicar HCT (olmesartan medoxomil-hydrochlorothiazide) tablets, for oral use, is a combination of an angiotensin II receptor blocker (ARB) and a thiazide diuretic used to treat high blood pressure (hypertension).
Common side effects of Benicar HCT include nausea, hyperuricemia, dizziness, upper respiratory tract infection, chest pain, back pain, swelling in extremities, spinning sensation (vertigo), abdominal pain, indigestion, upset stomach, diarrhea, SGOT increased, GGT increased, SGPT increased, hyperlipemia, creatine phosphokinase increased, high blood sugar (hyperglycemia), joint pain, muscle pain, cough, rash, and blood in urine.
- Combining Benicar HCT with alcohol, barbiturates, or narcotics may cause dizziness on standing.
- Dosage adjustment of antidiabetic drugs (oral and insulin) may be required when taken with Benicar HCT.
- Benicar HCT combined with other antihypertensive drugs may have an additive effect and can increase side effects.
- Cholestyramine and colestipol resins impair the absorption of hydrochlorothiazide.
- Corticosteroids taken with Benicar HCT can cause ACTH-intensified electrolyte depletion, particularly low blood potassium (hypokalemia).
- Taking Benicar HCT with skeletal muscle relaxants may cause increased responsiveness to the muscle relaxant.
- Lithium should not generally be given with diuretics because diuretics reduce the renal clearance of lithium and add a high risk of lithium toxicity.
It is unknown if olmesartan passes into breast milk. Hydrochlorothiazide passes into breast milk. Because of the potential for adverse effects on the nursing infant, breastfeeding is not recommended while using Benicar HCT.
What are the side effects of Benicar HCT?
When pregnancy is detected, discontinue Benicar HCT as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
What are the serious side effects of Benicar HCT?
Benicar HCT may cause serious side effects including:
- muscle pain,
- tenderness or weakness,
- unusual tiredness,
- dark colored urine,
- eye pain,
- vision problems,
- yellowing of the skin or eyes (jaundice),
- easy bruising,
- unusual bleeding,
- little or no urination,
- painful or difficult urination,
- swelling in your feet or ankles,
- shortness of breath,
- slurred speech,
- severe weakness,
- loss of coordination,
- feeling unsteady,
- slow or unusual heart rate,
- loss of movement,
- leg cramps,
- irregular heartbeats,
- fluttering in your chest,
- increased thirst or urination, and
- numbness or tingling
Get medical help right away, if you have any of the symptoms listed above.
What are the common side effects of Benicar HCT?
The most common side effects of Benicar HCT include:
Tell the doctor if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Benicar HCT. For more information, ask your doctor or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What drugs interact with Benicar HCT?
Agents Increasing Serum Potassium
- Coadministration of Benicar HCT with other drugs that raise serum potassium levels may result in hyperkalemia. Monitor serum potassium in such patients.
- Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration of lithium with angiotensin II receptor antagonists or hydrochlorothiazide. Monitor serum lithium levels during concomitant use.
Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors )
- In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists (including olmesartan medoxomil) may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving olmesartan medoxomil and NSAID therapy.
- The antihypertensive effect of angiotensin II receptor antagonists, including olmesartan medoxomil may be attenuated by NSAIDs including selective COX-2 inhibitors.
- In some patients the administration of a NSAID can reduce the diuretic, natriuretic, and antihypertensive effects of thiazide diuretics. Therefore, monitor blood pressure closely.
Dual Blockade Of The Renin Angiotens In System
- Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Most patients receiving the combination of two RAS inhibitors do not obtain any additional benefit compared to monotherapy. In general, avoid combined use of RAS inhibitors. Closely monitor blood pressure, renal function and electrolytes in patients on Benicar HCT and other agents that affect the RAS.
- Do not co-administer aliskiren with Benicar HCT in patients with diabetes. Avoid use of aliskiren with Benicar HCT in patients with renal impairment (GFR < 60 ml/min).
- Concurrent administration of bile acid sequestering agent colesevelam hydrochloride reduces the systemic exposure and peak plasma concentration of olmesartan. Administration of olmesartan at least 4 hours prior to colesevelam hydrochloride decreased the drug interaction effect. Consider administering olmesartan at least 4 hours before the colesevelam hydrochloride dose.
Use Of Hydrochlorothiazide With Other Drugs
When administered concurrently the following drugs may interact with thiazide diuretics:
- Antidiabetic drugs (oral agents and insulin): Dosage adjustment of the antidiabetic drug may be required.
- Ion exchange resins: Staggering the dosage of hydrochlorothiazide and ion exchange resins (e.g., cholestyramine, colestipol) such that hydrochlorothiazide is administered at least 4 hours before or 4 – 6 hours after the administration of resins would potentially minimize the interaction.
- Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia.
Side effects of Benicar HCT list for healthcare professionals
The following adverse reactions with Benicar HCT are described elsewhere:
- Hypotension in Volume- or Salt-Depleted Patients
- Impaired Renal Function
- Hypersensitivity Reactions
- Electrolyte and Metabolic Imbalances
- Acute Myopia and Secondary Angle-Closure Glaucoma
- Systemic Lupus Erythematosus
- Sprue-Like Enteropathy
Clinical Trials Experience
In a placebo-controlled, factorial clinical trial of olmesartan medoxomil (2.5 mg to 40 mg) and hydrochlorothiazide (12.5 mg to 25 mg), the following adverse reactions reported in Table 1 occurred in > 2% of patients, and more often on the olmesartan medoxomil and hydrochlorothiazide combination than on placebo.
Table 1: Adverse Reactions in a Factorial Trial of Patients with Hypertension
|Upper Respiratory Infection||7||6||7||0|
Other adverse reactions that have been reported with an incidence of greater than 1.0%, whether or not attributed to treatment, in the more than 1200 hypertensive patients treated with olmesartan medoxomil and hydrochlorothiazide in controlled or open-label trials are listed below.
- Body as a Whole: chest pain, back pain, peripheral edema
- Central and Peripheral Nervous System: vertigo
- Gastrointestinal: abdominal pain, dyspepsia, gastroenteritis, diarrhea
- Liver and Biliary System: SGOT increased, GGT increased, ALT increased
- Metabolic and Nutritional: creatine phosphokinase increased
- Musculoskeletal: arthritis, arthralgia, myalgia
- Respiratory System: coughing
- Skin and Appendages Disorders: rash
- Urinary System: hematuria
- Facial edema was reported in 2/1243 patients receiving olmesartan medoxomil and hydrochlorothiazide. Angioedema has been reported with angiotensin II receptor antagonists, including Benicar HCT.
Other adverse reactions that have been reported with hydrochlorothiazide are listed below:
- Body as a Whole: weakness
- Digestive: pancreatitis, jaundice (intrahepatic cholestatic jaundice), sialadenitis, cramping, gastric irritation
- Hematologic: aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia
- Hypersensitivity: purpura, photosensitivity, urticaria, necrotizing angiitis (vasculitis and cutaneous vasculitis), fever, respiratory distress including pneumonitis and pulmonary edema, anaphylactic reactions
- Metabolic: glycosuria, hyperuricemia
- Musculoskeletal: muscle spasm
- Nervous System/Psychiatric: restlessness
- Renal: renal dysfunction, interstitial nephritis
- Skin: erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis
- Special Senses: transient blurred vision, xanthopsia
Clinical Laboratory Test Findings
- Creatinine/blood urea nitrogen (BUN): Minor elevations in creatinine and BUN occurred in 1.7% and 2.5% respectively, of patients taking Benicar HCT and 0% and 0% respectively, given placebo in controlled clinical trials.
The following adverse reactions have been identified during post-approval use of BENICAR HCT. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure:
- Body as a Whole: Asthenia
- Gastrointestinal: Vomiting
- Metabolic: Hyperkalemia
- Musculoskeletal: Rhabdomyolysis
- Skin and Appendages: Alopecia, pruritus
Data from one controlled trial and an epidemiologic study have suggested that high-dose olmesartan may increase cardiovascular (CV) risk in diabetic patients, but the overall data are not conclusive.
Benicar HCT (olmesartan medoxomil-hydrochlorothiazide) tablets, for oral use, is a combination of an angiotensin II receptor blocker (ARB) and a thiazide diuretic used to treat high blood pressure (hypertension). Common side effects of Benicar HCT include nausea, hyperuricemia, dizziness, upper respiratory tract infection, chest pain, back pain, swelling in extremities, spinning sensation (vertigo), abdominal pain, indigestion, upset stomach, diarrhea, and others.
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Blood Pressure Readings: Chart, Normal, High, Low
Blood pressure is the force applied by the blood over the inner walls of the arteries. Although the average blood pressure for a person remains constant, it shows minor fluctuations throughout the day—declining while relaxing and momentarily increasing while being excited or under stress. An increase in resting blood pressure can scar, stiffen, or harden the arteries.
Why Is My Bottom Blood Pressure Number High?
Isolated diastolic hypertension (IDH) occurs when your systolic blood pressure is normal, and only your diastolic blood pressure is high (over 80 mm Hg). Causes of high diastolic blood pressure include a high-sodium diet, obesity, lack of physical activity, excessive alcohol consumption, stress and anxiety.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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What Does it Mean When the Bottom Number of Your Blood Pressure is Over 100?
Diastolic blood pressure (DBP) is the pressure exerted on the walls of the arteries when the heart muscle relaxes between beats. When the bottom number of blood pressure (diastole) is over 100 mmHg, it may be called diastolic hypertension (DHT). Diastolic blood pressure means the blood pressure reading during the phase when your heart relaxes (diastole). Force of the blood against the walls of the arteries (the blood vessels carrying blood from the heart to other sites) in the body is called blood pressure. The heart pumps the blood into the arteries as it contracts (systole).
Low Blood Pressure (Hypotension)
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, and fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
How to Lower My Blood Pressure Immediately
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What Is Considered Stroke-Level High Blood Pressure?
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How Do You Check Your Blood Pressure With Fingers?
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Is 120 Over 60 a Good Blood Pressure Reading?
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What Is the Blood Pressure of a Very Fit Person?
Studies show that a very fit person who exercises regularly will have a lower resting blood pressure (usually below 120/80 mm Hg) than someone who leads a sedentary lifestyle.
What Causes Low Diastolic Blood Pressure?
A diastolic blood pressure (DBP) of somewhere between 60 and 90 mm Hg is good in older people. Causes of low DBP include bed rest, dehydration, loss of water, alcohol use, hormone deficiencies, allergic reactions, nutritional deficiencies and prolonged standing leading to blood pooling in the legs.
Hypertension-Related Kidney Disease
Second Source WebMD Medical Reference
How Is Diastolic Hypertension Treated?
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Is A Manual Blood Pressure More Accurate?
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Which Is More Important: Systolic or Diastolic Blood Pressure?
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Things to Know About High Blood Pressure Treatment
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Can Drinking Water Lower Your Blood Pressure?
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Low Blood Pressure (Hypotension) Causes
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Which Blood Pressure Number Is the Most Important?
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Pulmonary hypertension is elevated pressure in the pulmonary arteries that carry blood from the lungs to the heart. The most common symptoms are fatigue and difficulty breathing. If the condition goes undiagnosed, more severe symptoms may occur. As pulmonary hypertension worsens, some people with the condition have difficulty performing any activities that require physical exertion. While there is no cure for pulmonary hypertension, it can be managed and treated with medications and supplemental oxygen to increase blood oxygen levels.
Portal hypertension is most commonly caused by cirrhosis, a disease that results from scarring of the liver. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from the liver to the heart, and a parasitic infection called schistosomiasis. Symptoms of portal hypertension include varices (enlarged veins), vomiting blood, blood in the stool, black and tarry stool, ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity), confusion and lethargy, splenomegaly or enlargement of the spleen, and decreased white blood cell counts.
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What Is High Blood Pressure (Hypertension)?
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