Tribenzor
Generic name: amlodipine, hydrochlorothiazide, and olmesartan [ am-LOE-di-peen, HYE-droe-KLOR-oh-THYE-a-zide, and-OL-me-SAR-tan ]
Drug class: Miscellaneous antihypertensive combinations
What is Tribenzor
Tribenzor contains a combination of amlodipine, hydrochlorothiazide, and olmesartan. Amlodipine is a calcium channel blocker that relaxes (widens) blood vessels and improves blood flow.
Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.
Olmesartan is an angiotensin II receptor antagonist (sometimes called an ARB) that keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow
Tribenzor is used to treat high blood pressure (hypertension).
Tribenzor is usually given after other blood pressure medicines have been tried without successful treatment.
Warnings
You should not take Tribenzor if you are allergic to sulfa drugs, or if you are unable to urinate.
Do not use Tribenzor if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.
If you have diabetes, do not use Tribenzor together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo).
Side Effects
Get emergency medical help if you have signs of an allergic reaction to Tribenzor: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
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worsening chest pain;
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a light-headed feeling, like you might pass out;
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an unusual skin rash;
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pain or burning when you urinate;
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severe or ongoing diarrhea with weight loss;
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blurred vision, tunnel vision, eye pain, or seeing halos around lights;
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kidney problems - little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
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signs of an electrolyte imbalance - increased thirst or urination, confusion, vomiting, constipation, muscle pain or weakness, leg cramps, lack of energy, irregular heartbeats, numbness or tingling, loss of movement.
Common Tribenzor side effects may include:
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headache, tired feeling;
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swelling in your hands or feet;
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nausea, diarrhea;
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runny or stuffy nose, sore throat;
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muscle spasms;
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swollen joints; or
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painful urination.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Before taking this medicine
You should not use Tribenzor if you are allergic to amlodipine, hydrochlorothiazide, or olmesartan, or:
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if you are allergic to any sulfa drug; or
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if you are unable to urinate.
If you have diabetes, do not use Tribenzor together with any medication that contains aliskiren (a blood pressure medicine).
You may also need to avoid taking Tribenzor with aliskiren if you have kidney disease.
To make sure Tribenzor is safe for you, tell your doctor if you have ever had:
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kidney disease;
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liver disease;
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heart disease;
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an electrolyte imbalance (such as high levels of calcium, or low levels of potassium or magnesium in your blood);
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gout;
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diabetes; or
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a penicillin allergy.
Do not use Tribenzor if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Olmesartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.
You should not breastfeed while using Tribenzor.
How should I take this medicine?
Take Tribenzor exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
You may take Tribenzor with or without food.
Your chest pain may become worse when you first start taking this medicine or when your dose is increased. Call your doctor if your chest pain is severe or ongoing.
You can easily become dehydrated while taking Tribenzor. Drink plenty of water each day.
Your blood pressure will need to be checked often.
Some things can cause your blood pressure to get too low. This includes vomiting, diarrhea, or heavy sweating. Call your doctor if you are sick with vomiting or diarrhea.
If you need surgery or medical tests, tell the surgeon ahead of time that you are using Tribenzor.
It may take up to 2 weeks before your blood pressure improves. Keep using Tribenzor as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.
Store Tribenzor at room temperature away from moisture and heat.
Dosing information
Usual Adult Dose for Hypertension:
Amlodipine 5 to 10 mg/Hydrochlorothiazide 12.5 to 25 mg/Olmesartan 20 to 40 mg orally once a day
Maximum dose: Amlodipine 10 mg/Hydrochlorothiazide 25 mg/Olmesartan 40 mg per day
Comments: Maximum antihypertensive effects are observed within 2 weeks of initial dose or dose change; dosage may be increased after 2 weeks.
Use: Treatment of hypertension as substitution for the individually titrated components or in 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.
Usual Geriatric Dose for Hypertension:
75 Years or Older:
Initial dose: Amlodipine should start at 2.5 mg in these patients, which is not available with this combination product.
Maintenance dose: Amlodipine 5 to 10 mg/Hydrochlorothiazide 12.5 to 25 mg/Olmesartan 20 to 40 mg orally once a day
Maximum dose: Amlodipine 10 mg/Hydrochlorothiazide 25 mg/Olmesartan 40 mg per day
Comments: Full antihypertensive effect is observed within 2 weeks of initial dose or dose change; dosage may be increased after 2 weeks.
Use: Treatment of hypertension as substitution for the individually titrated components or in 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.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking this medicine?
Do not use potassium supplements or salt substitutes, unless your doctor has told you to.
Drinking alcohol with Tribenzor can cause side effects.
Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
What other drugs will affect this medicine?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Tell your doctor about all your current medicines. Many drugs can affect Tribenzor, especially:
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another a diuretic or "water pill";
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any other blood pressure medicines;
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insulin or oral diabetes medicine;
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steroid medicine;
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vitamin or mineral supplements that contain potassium;
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a sedative or opioid medicine;
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cholesterol-lowering medicine;
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an antibiotic, antifungal, or antiviral medicine; or
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NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and others.
This list is not complete and many Other drugs may interact with amlodipine, hydrochlorothiazide, and olmesartan. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
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Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Tribenzor only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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