olmesartan/amlodipine/hydrochlorothiazide

Dual Blockade of the Renin-Angiotensin System (RAS): 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. Do not co-administer aliskiren with Tribenzor in patients with diabetes [See Contraindications ( 4 )] . Avoid use of aliskiren with Tribenzor in patients with renal impairment (GFR <60 ml/min).

Mechanism: Both drugs target the same system that regulates blood pressure, which can lead to dangerously low blood pressure or kidney damage. This combination also makes it harder for the body to get rid of potassium.

What to do: Do not use these drugs together if you have diabetes or kidney disease. Your doctor will likely avoid this combination to protect your kidneys and heart.

7 DRUG INTERACTIONS Olmesartan medoxomil ( 7.1 ): Nonsteroidal anti-inflammatory drugs (NSAIDS): May lead to increased risk of renal impairment and loss of antihypertensive effect. Colesevelam hydrochloride: Consider administering olmesartan at least 4 hours before colesevelam hydrochloride dose. 1 Drug Interactions with Olmesartan Medoxomil 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 NSAID...

Mechanism: Taking two medicines that contain the same active ingredient can cause your blood pressure to drop too low. It can also cause your kidneys to stop working properly or lead to dangerous levels of potassium.

What to do: You should not take both of these medications together. Your doctor will need to choose one or adjust your doses to prevent serious side effects.

Amlodipine ( 7.2 ): Limit simvastatin to 20 mg daily when coadministered. Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. 2 Drug Interactions with Amlodipine Simvastatin: Co-administration of simvastatin with amlodipine increases the systemic exposure of simvastatin.

Mechanism: Taking both medications increases the total amount of amlodipine in your body, which can cause your blood pressure to drop too low.

What to do: Your doctor should check your blood pressure often and may need to adjust your dose to prevent side effects.

Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. 3 Drug Interactions with Hydrochlorothiazide 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. Cholestyramine and Colestipol Resins : Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins.

Mechanism: Using these together increases the total amount of diuretic in your body, which can change your blood sugar or mineral levels.

What to do: Your doctor may need to monitor your blood sugar and kidney function more closely while you are on both medications.

Amlodipine ( 7.2 ): Limit simvastatin to 20 mg daily when coadministered. 2 Drug Interactions with Amlodipine Simvastatin: Co-administration of simvastatin with amlodipine increases the systemic exposure of simvastatin. Limit the dose of simvastatin in patients on amlodipine to 20 mg daily.

Mechanism: Amlodipine can cause simvastatin to build up in your body by slowing down how it is processed.

What to do: You should limit your daily dose of simvastatin to 20 mg while taking this medication.