Amlodipine-Olmesartan

Last Reviewed: Oct 24, 2024

Warnings

Amlodipine Olmesartan (Azor) Risks, Warnings, and Complications

Amlodipine olmesartan can cause or worsen health problems in some people. Talk to your doctor or pharmacist about the potential risks and other treatment options for high blood pressure if you are at an increased risk of adverse reactions from this combination of antihypertensive therapy.

FETAL TOXICITY: Amlodipine olmesartan can cause serious harm to an unborn baby when used by pregnant women, especially during the second and third trimesters of pregnancy. These drugs affect the renin-angiotensin system and can lead to oligohydramnios (decreased amniotic fluid volume), which can cause kidney problems such as decreased kidney function, anuria (non-formation of urine), and kidney failure in the baby. Other complications include underdevelopment of the lungs and skeletal deformities. Before starting amlodipine olmesartan, tell your doctor if you are pregnant. Use appropriate birth control while on this medicine. Stop taking the medicine and call your doctor immediately if you become pregnant during treatment with this drug.
HYPOTENSION (LOW BLOOD PRESSURE): Olmesartan medoxomil can cause low blood pressure (hypotension) in patients who are volume- and/or salt-depleted with an activated renin-angiotensin system. For example, patients who are on high doses of diuretics. This is more likely to occur when treatment with olmesartan is first started. Your doctor will monitor you closely when you start this medicine. If you develop signs of low blood pressure, such as dizziness or lightheadedness, lying down in a supine position might help. Sometimes it is necessary to get an intravenous infusion of normal saline. The medicine can usually be continued once your blood pressure stabilizes.
Amlodipine can also cause symptomatic hypotension, especially in people with severe aortic stenosis. However, this drug has a gradual onset of action and is unlikely to cause a sudden drop in blood pressure.
WORSENING CHEST PAIN (ANGINA) AND HEART ATTACK (MYOCARDIAL INFARCTION): Some people, especially those who have severe coronary artery disease, can develop increased severity, frequency, and duration of angina (chest pain) or acute myocardial infarction (heart attack) after starting a calcium channel blocker or after a dose increase. It is unclear why this happens. Seek emergency medical care if you develop worsening chest pain (pressure, tightness, squeezing, aching), cold sweat, tiredness, lightheadedness, and nausea.
IMPAIRED RENAL FUNCTION: Olmesartan medoxomil can cause changes in kidney function in certain high-risk individuals, such as people with severe congestive heart failure. This occurs due to inhibition of the renin-angiotensin-aldosterone system. It can result in oliguria (low urine output) or progressive azotemia (excess nitrogen and creatinine in the blood). Rarely, it can cause acute renal failure and even death. Additionally, olmesartan medoxomil can cause an increase in serum creatinine and blood urea nitrogen (BUN) levels, similar to the effects of ACE inhibitors. Tell your doctor without delay if you develop any urinary symptoms while on this drug.
PATIENTS WITH IMPAIRED HEPATIC FUNCTION: People with impaired liver function can have decreased clearance of amlodipine from their body. Your doctor may start you on a lower dose of amlodipine and increase the dose more slowly if you have liver dysfunction. Because Azor comes in a fixed dose combination and the lowest dose is 5/20 mg, initial treatment with Azor (combination blood pressure medicine) may not be possible if you have hepatic (liver) impairment.
SPRUE-LIKE ENTEROPATHY: People taking olmesartan can develop severe, chronic diarrhea and significant weight loss. This can develop months to years after starting treatment. Tell your doctor immediately if you develop severe, chronic diarrhea. If no other cause for your diarrhea can be found, you may need to discontinue Azor.
ELECTROLYTE IMBALANCES: Olmesartan inhibits the renin-angiotensin system and can cause hyperkalemia (increased blood potassium levels). Your doctor will monitor serum electrolytes periodically while you are on this blood pressure-lowering medication.

Precautions Before Starting Amlodipine Olmesartan (Azor)

Tell your doctor if you have ever had allergic reactions to amlodipine, olmesartan, any of the active or inactive ingredients in amlodipine olmesartan tablets, other calcium channel blockers, other angiotensin II receptor blockers, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal remedies. This can help avoid drug interactions between your medications.

Give your healthcare professional a complete medical history. Amlodipine olmesartan may not be safe for people with certain medical conditions such as heart disease, heart failure, kidney disease, or liver disease.

Tell your doctor if you are pregnant, might be pregnant, plan to get pregnant, or are breast-feeding.

Precautions During Use of Amlodipine Olmesartan (Azor)

Keep all your medical and lab appointments while on amlodipine olmesartan. Your healthcare provider may start you on a low dose and adjust the dose based on blood pressure control and side effects. They may also order blood tests to check kidney function and electrolyte levels periodically.

Keep a log of your blood pressure readings at home and bring it to your healthcare appointments. Your doctor will adjust the dose of amlodipine olmesartan based on your response to the medicine.

Amlodipine olmesartan can cause dizziness and lightheadedness when you get up from a sitting or lying position, especially when you first start treatment and after a dose increase. To prevent falls, get out of bed slowly and keep your feet on the ground for a few minutes before standing up.

Amlodipine olmesartan can cause dizziness, drowsiness, and fatigue. Be careful while driving and doing other potentially hazardous activities like operating heavy machinery until you know how it affects you.

Drink plenty of fluids during treatment with amlodipine olmesartan. Call your doctor if you develop vomiting, diarrhea, excessive sweating, or inability to drink enough fluids (the resultant dehydration can cause a drop in blood pressure). Tell your doctor immediately if you develop dizziness, weakness, or low blood pressure.

Do not stop taking amlodipine olmesartan without talking to your doctor, even if you feel well and your blood pressure is well controlled. This medicine works only as long as you continue taking it. Stopping it suddenly can lead to dangerously high blood pressure and an increased risk of heart attack and stroke.

Tell all your healthcare providers you are on amlodipine olmesartan before any surgery or medical tests, including dental procedures.

Amlodipine Olmesartan (Azor) Drug Interactions

Certain other drugs can affect how the combination of amlodipine and olmesartan works. Possible interactions with other medicines can increase the risk of severe adverse reactions. The following medications can have interactions with amlodipine and/or olmesartan:

Certain types of anti-seizure medicines such as carbamazepine (Tegretol, Carbatrol, Equetro), phenobarbital, and phenytoin (Dilantin, Phenytek)
Antibiotics such as clarithromycin (Biaxin, in Prevpac)
Immunosuppressants such as cyclosporine (Gengraf, Sandimmune, Neoral) and tacrolimus (Astragraf SL, Prograf)
HIV medications such as efavirenz (Sustiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), and ritonavir (Norvir, in Kaletra)
Antifungal agents such as itraconazole (Sporanox, Onmel) and ketoconazole (Nizoral)
Statin drugs such as lovastatin (Altoprev, in Advicor) and simvastatin (Zocor, in Simcor, in Vytorin)
Cholesterol-lowering medications such as colesevelam (Welchol) and gemfibrozil (Lopid)
Antidepressants such as nefazodone
Tuberculosis medications such as rifabutin (Mycobutin) and rifampin (Rifadin, Rimactane, in Rifamate)
Angiotensin-converting enzyme (ACE) inhibitors such as lisinopril (in Prinzide), fosinopril, captopril (Capoten, in Capozide), benazepril (Lotensin, in Lotrel), enalapril (Vasotec), perindopril (Aceon), quinapril (Accupril, in Accuretic, in Quinaretic), moexipril (Univasc), ramipril (Altace), and trandolapril (Mavik, in Tarka)
Diuretics or water pills
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin)
Potassium supplements and potassium-containing salt substitutes

The above list may not describe all the potential interactions of amlodipine olmesartan. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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