Olmesartan Medoxomilo + Hidroclorotiazida Krka (Olmesartan Medoxomil, Hydrochlorothiazide)

Olmesartan medoxomil/hydrochlorothiazide is used to manage high blood pressure, a key factor in cardiovascular disease.

• Hypertension: lowers systolic and diastolic pressure, reducing the risk of stroke and heart attack.
• Essential hypertension: provides sustained blood‑pressure control when monotherapy is insufficient.
• Secondary hypertension: assists in blood‑pressure reduction when caused by renal or endocrine disorders.

• Olmesartan medoxomil selectively blocks angiotensin II type 1 (AT1) receptors, preventing vasoconstriction and aldosterone release, while hydrochlorothiazide inhibits NaCl reabsorption in the distal convoluted tubule, promoting natriuresis and diuresis. The combined effect reduces intravascular volume and systemic vascular resistance, leading to lower arterial pressure.

Common Side Effects

• Dizziness: transient light‑headedness, especially after the first doses.
• Headache: mild to moderate intensity, often resolves with continued therapy.
• Fatigue: general tiredness without specific cause.
• Increased urination: due to the diuretic component.
• Electrolyte imbalance: mild changes in potassium or sodium levels.
• Mild gastrointestinal discomfort: nausea or abdominal cramps.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure causing fainting.
• Acute kidney injury: sudden reduction in renal function.
• Hyperkalemia: elevated potassium that may affect heart rhythm.
• Hyponatremia: low sodium concentration, especially in elderly.
• Allergic reactions: rash, itching, or angioedema.
• Pancreatitis: rare inflammation of the pancreas.

Before initiating therapy, consider the following precautions:

• Blood pressure monitoring: ensure target levels are achieved and maintained.
• Renal function assessment: evaluate serum creatinine and eGFR regularly.
• Electrolyte surveillance: check potassium and sodium levels, especially with concomitant diuretics.
• Hepatic impairment: use with caution in patients with severe liver disease.
• Pregnancy and lactation: avoid use unless clearly indicated, as safety data are limited.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Olmesartan medoxomil/hydrochlorothiazide may interact with several medicines.

Major Interactions (Avoid)

• Aliskiren (in diabetic patients): risk of renal impairment and hyperkalemia.
• Potassium‑sparing diuretics or supplements: may cause dangerous hyperkalemia.
• Lithium: increased lithium levels leading to toxicity.

Moderate Interactions (Monitor Closely)

• NSAIDs: can blunt antihypertensive effect and affect renal function.
• Antidiabetic agents: may require dose adjustment due to enhanced glucose‑lowering effect.
• CYP450 inhibitors (e.g., fluconazole): may increase olmesartan plasma concentrations.