Amlodipine/Hydrochlorothiazide/Olmesartan Dosage

Usual Adult Dose for Hypertension

Amlodipine/hydrochlorothiazide/olmesartan is not indicated as initial treatment of hypertension. It is indicated as replacement (substituted for its individually titrated components) or add-on/switch therapy (to provide additional blood pressure lowering for patients not adequately controlled on maximally tolerated, labeled, or usual doses of any two of the following antihypertensive classes: angiotensin receptor blockers {ARBs}, calcium channel blockers {CCBs}, and diuretics).

Initial dose: Dose orally once daily with or without food

Dosage may be increased after 2 weeks. The full blood pressure lowering effects are attained within 2 weeks after a change in dose.

Maximum dose: amlodipine/hydrochlorothiazide/olmesartan 10/25/40 mg orally once daily

Usual Geriatric Dose for Hypertension

Patients greater than or equal to 75 years: Initial dosage of the amlodipine component should be 2.5 mg, which is not available with the amlodipine/hydrochlorothiazide/olmesartan combination product.

Renal Dose Adjustments

The usual regimens of therapy with amlodipine/hydrochlorothiazide/olmesartan may be followed if the patient's creatinine clearance is greater than 30 mL/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides, so use of amlodipine/hydrochlorothiazide/olmesartan should be avoided in such patients.

Liver Dose Adjustments

Patients with severe hepatic impairment should start amlodipine at 2.5 mg, which is not available with amlodipine/hydrochlorothiazide/olmesartan in combination.

Any patient who experiences dose-limiting adverse reactions to an individual component while on any dual combination of the components of amlodipine/hydrochlorothiazide/olmesartan may be switched to amlodipine/hydrochlorothiazide/olmesartan containing a lower dose of that component to achieve similar blood pressure reductions.

Dose Adjustments

Dosage may be increased after 2 weeks. The full blood pressure lowering effects are attained within 2 weeks after a change in dose.

Precautions

Amlodipine/hydrochlorothiazide/olmesartan is not indicated for initial therapy.

Amlodipine/hydrochlorothiazide/olmesartan therapy should be withheld if progressive renal impairment becomes evident.

Amlodipine/hydrochlorothiazide/olmesartan should not be given with lithium due to the hydrochlorothiazide component which causes reduced renal clearance of the lithium causing lithium toxicity.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Amlodipine/hydrochlorothiazide/olmesartan may be taken with or without food.

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