Olmesartan/Hydrochlorothiazide Aurobindo Pharma (Malta) (Olmesartan Medoxomil, Hydrochlorothiazide)

Olmesartan/Hydrochlorothiazide is indicated for the management of hypertension, acting on the renin‑angiotensin‑aldosterone system and promoting diuresis.

• Hypertension: lowers systolic and diastolic blood pressure when monotherapy is insufficient.
• Resistant hypertension: provides additional blood‑pressure control in patients not achieving targets with a single agent.
• Edema associated with hypertension: reduces fluid retention through its thiazide component.
• Cardiovascular risk reduction: contributes to long‑term risk management in hypertensive patients.

• Olmesartan medoxil selectively blocks the AT1 subtype of angiotensin II receptors, preventing vasoconstriction and aldosterone release. Hydrochlorothiazide inhibits sodium‑chloride reabsorption in the distal convoluted tubule, increasing urinary excretion of sodium and water. The combined actions produce additive reductions in peripheral vascular resistance and plasma volume, resulting in lowered blood pressure.

Common Side Effects

• Dizziness: mild to moderate light‑headedness, especially after the first dose.
• Headache: transient cranial discomfort.
• Fatigue: general tiredness not related to activity level.
• Increased urination: due to the diuretic component.
• Electrolyte imbalance: mild changes in potassium or sodium levels.
• Cough: occasional dry throat irritation.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe electrolyte disturbances: marked hypokalemia or hyponatremia.
• Acute kidney injury: sudden decline in renal function.
• Hepatic dysfunction: elevated liver enzymes.
• Severe hypotension: symptomatic low blood pressure.
• Allergic skin reactions: rash, Stevens‑Johnson syndrome.

Before initiating therapy, evaluate renal function, electrolyte status, and blood pressure response.

• Monitor blood pressure: ensure target levels are achieved without excessive drop.
• Assess renal function: check serum creatinine and eGFR periodically.
• Check electrolytes: especially potassium and sodium levels during treatment.
• Avoid abrupt discontinuation: taper if therapy is stopped to prevent rebound hypertension.
• Pregnancy and lactation: contraindicated in pregnancy; use only if benefits outweigh risks in breastfeeding.

Store at ambient temperature: keep below 25°C, retain original packaging, and protect from moisture.

Olmesartan/Hydrochlorothiazide may interact with several drug classes, requiring clinical awareness.

Major Interactions (Avoid)

• Potassium‑sparing diuretics or supplements: risk of hyperkalaemia.
• Lithium: increased lithium levels, potential toxicity.
• Aliskiren (in diabetics): heightened risk of renal impairment and hypotension.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may blunt antihypertensive effect and affect renal function.
• ACE inhibitors or ARBs: additive potassium rise, monitor serum levels.
• Antidiabetic agents: may enhance glucose‑lowering effect, requiring dose adjustment.