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.

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...

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.

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.

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.

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.