Generic Name and Formulations:
Olmesartan medoxomil, amlodipine (as besylate), hydrochlorothiazide; 20mg/5mg/12.5mg, 40mg/5mg/12.5mg, 40mg/5mg/25mg, 40mg/10mg/12.5mg, 40mg/10mg/25mg; tabs.
Indications for TRIBENZOR:
Hypertension. Not for initial therapy.
Individualize. 1 tab once daily. May titrate at 2-week intervals; max one 40/10/25mg tab daily. ≥75yrs or severe hepatic impairment: start amlodipine 2.5mg.
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Severe renal impairment (CrCl ≤30mL/min): avoid. Renal artery stenosis. Suspend if renal dysfunction progresses. Correct salt/volume depletion prior to starting therapy. Severe hepatic impairment. Severe CHF or obstructive coronary artery disease. Severe aortic stenosis. Diabetes. Postsympathectomy. SLE. Gout. Acute myopia and secondary angle-closure glaucoma. Monitor electrolytes. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.
Angiotensin II receptor blocker (ARB) + dihydropyridine calcium channel blocker (CCB) + thiazide diuretic.
See Contraindications. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Take 4hrs before colesevelam HCl dose. Concomitant simvastatin: max simvastatin dose 20mg/day. May potentiate cyclosporine, tacrolimus, lithium; monitor levels. Potentiated by CYP3A4 inhibitors; may need dose reduction. Adjust antidiabetic, antigout medications. ACTH, corticosteroids increase hypokalemia risk. Orthostatic hypotension potentiated by alcohol, barbiturates, narcotics. May be antagonized by, and renal toxicity potentiated by NSAIDs, including COX-2 inhibitors; monitor renal function in elderly and/or volume-depleted. Reduced absorption with bile acid resins (eg, cholestyramine, colestipol). Potentiates other antihypertensives. May potentiate nondepolarizing muscle relaxants. May antagonize norepinephrine. Monitor BP with CYP3A4 inducers. May interfere with parathyroid tests.
Dizziness, peripheral edema, headache, fatigue, nasopharyngitis, muscle spasms, nausea, diarrhea, URI, UTI, joint swelling; hyperuricemia, orthostatic hypotension, electrolyte disturbances, possible sprue-like enteropathy.
Clinical Pain Advisor Articles
- History of Migraine May Be Associated With Higher Risk for Cochlear Disorders
- Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain
- Symptom Severity, Sensory Sensitivity May Indicate Pain Centralization in Chronic Overlapping Pain Conditions
- Stat Consult: Chronic Low Back Pain
- Opioid Misuse May Help Predict Alcohol Dependence Treatment Outcomes
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- Methadone Improves Short-Term Outcomes Better Than Morphine in Neonatal Abstinence Syndrome
- Addressing Rare Headache Disorders: Acute Confusional Migraine
- Hospital-Owned Practices Associated With Positive Workplace Perceptions Among Staff
- Optimal Strategies for Opioid Weaning After Ambulatory Surgery
- Chinese Traditional Medicine Showed Effectiveness on Pain, Quality of Life in Advanced Cancer