Amlodipine / olmesartan Side Effects

Not all side effects for amlodipine / olmesartan may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to amlodipine / olmesartan: oral tablet

In addition to its needed effects, some unwanted effects may be caused by amlodipine / olmesartan. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking amlodipine / olmesartan:

More common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • rapid weight gain
Less common
  • Fast, irregular, pounding, or racing heartbeat or pulse
  • unusual tiredness or weakness
Incidence not known
  • Abdominal or stomach pain
  • dark urine
  • decreased urine output
  • diarrhea
  • fever
  • itching skin or rash
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • muscle pain or stiffness
  • upper right abdominal or stomach pain
  • yellow eyes or skin

Some of the side effects that can occur with amlodipine / olmesartan may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Dizziness
  • feeling of warmth
  • redness of the face, neck, arms, and occasionally, upper chest
  • sleepiness or unusual drowsiness
Incidence not known
  • Hives or welts
  • redness of the skin

For Healthcare Professionals

Applies to amlodipine / olmesartan: oral tablet

Cardiovascular

Worsened angina has been rarely associated with the use of amlodipine (as with other calcium channel blockers).[Ref]

Cardiovascular side effects associated with amlodipine are dose-related, are usually the result of vasodilation, and include flushing in less than 1% and peripheral edema in 2% of patients. Peripheral edema may become a chronic problem, and has occurred in up to 10% of patients who are receiving 10 mg doses. Palpitations occur in 1% to 5% of patients. Recent data have shown that the use of amlodipine in patients with NYHA Class III or IV heart failure is not associated with worsened heart failure. Bradycardia, hypotension, and syncope have been reported in less than 1% of patients. Generalized edema has also been reported rarely.

Cardiovascular side effects associated with olmesartan including tachycardia, chest pain, and peripheral edema have been reported in 0.5% to 1% of patients. At least 5 cases of facial edema and at least one case of olmesartan-induced angioedema, which resolved over 7 to 10 days after discontinuing olmesartan, have been reported.[Ref]

Hematologic

A case study reports a 34-year-old woman with a history of chronic renal failure secondary to glomerulonephritis, who was started on amlodipine for uncontrolled hypertension. Three days later the patient developed severe thrombocytopenia. After discontinuation of the drug, the platelet count returned to normal.[Ref]

Hematologic side effects associated with amlodipine have included isolated cases of thrombocytopenia.

Hematologic side effects associated with olmesartan have included decreased hemoglobin and hematocrit.[Ref]

Nervous system

Nervous system side effects associated with amlodipine have included headache (8%), dizziness (3%), and fatigue (5%). Vertigo, tremors, and paresthesias have been reported in less than 1% of patients receiving amlodipine.

Nervous system side effects associated with olmesartan have included dizziness (3% vs. 1% with placebo), vertigo (0.5% to 1% with placebo), and insomnia (0.5% to 1% with placebo). Asthenia has been reported in postmarketing experience.[Ref]

Respiratory

Respiratory side effects associated with olmesartan have included cough (0.9% vs. 0.7% with placebo), bronchitis, rhinitis, pharyngitis, sinusitis, and upper respiratory tract infection.[Ref]

Hepatic

Hepatic side effects including jaundice and hepatic enzyme elevations (mostly consistent with cholestasis or hepatitis) have been reported with amlodipine use. In some instances, these cases were severe enough to require hospitalization.

Hepatic side effects associated with olmesartan have rarely included liver enzyme and serum bilirubin elevations.[Ref]

Metabolic

Metabolic side effects associated with olmesartan have included hyperglycemia and hypertriglyceridemia.[Ref]

Hypersensitivity

Hypersensitivity reactions have rarely been reported, although experience with amlodipine is limited. A single case of erythema multiforme during amlodipine therapy has been reported.

Hypersensitivity side effects including rare cases of angioedema have been reported in patients receiving olmesartan.

Hypersensitivity reactions reported postmarketing have included anaphylactic reactions and peripheral edema.[Ref]

A 62-year-old man with hypertension and psoriasis developed erythema multiforme within three days after starting amlodipine. The rash resolved upon substitution with nifedipine.[Ref]

Other

Calcium channel blockers have been suggested as possibly unsafe in patients with acute porphyria.[Ref]

Other side effects including a single case of acute porphyria exacerbation have been associated with the use of amlodipine, and confirmed upon rechallenge in the same patient.[Ref]

Renal

Renal side effects have been reported rarely with amlodipine use. At least one case of interstitial nephritis has been associated with amlodipine therapy.

Renal side effects associated with ACE inhibitors have included increases in serum creatinine or BUN in patients with renal artery stenosis. Acute renal failure and increased serum creatinine levels have been reported in postmarketing experience.[Ref]

Musculoskeletal

Musculoskeletal side effects including arthralgia, arthritis, myalgia, and skeletal pain have been reported in 0.5% to 1% of patients receiving olmesartan. Rhabdomyolysis has been reported during postmarketing experience in patients receiving angiotensin II receptor blockers.[Ref]

Gastrointestinal

Gastrointestinal side effects including nausea have been associated with amlodipine in 3% of patients.

Gastrointestinal side effects including abdominal pain, dyspepsia, gastroenteritis, and nausea have been reported in 0.5% to 1% of patients receiving olmesartan. Vomiting has been reported in postmarketing experience. Diarrhea has been reported in more than 1% of patients but at the same or greater incidence than placebo.[Ref]

Anorexia, constipation, dyspepsia, vomiting, flatulence, and diarrhea have been reported in less than 1% of patients. As with some other calcium channel blockers, rare cases of gingival hyperplasia have been associated with amlodipine. At least one case of amlodipine-associated dysgeusia has been reported and confirmed upon rechallenge.[Ref]

Dermatologic

Dermatologic side effects including amlodipine-associated lichen planus and telangiectasia have been rarely reported.

Dermatologic side effects associated with olmesartan have included rash (0.5% to 1%), alopecia, pruritus, and urticaria.[Ref]

Endocrine

Endocrine side effects including a single case of gynecomastia have been associated with the use of amlodipine.[Ref]

The patient's gynecomastia resolved upon substitution of amlodipine with an unrelated antihypertensive agent. The use of amlodipine has not been associated with adverse effects on glucose metabolism or serum lipids.[Ref]

Genitourinary

Genitourinary side effects including gynecomastia have been reported in postmarketing experience with amlodipine.

Genitourinary side effects including urinary tract infection have been reported in 0.5% to 1% of patients receiving olmesartan. Hematuria has been reported in more than 1% of patients but at the same or greater incidence than placebo.[Ref]

References

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