高血壓 (ARB) 高血壓 (diuretics) 利尿劑 (thiazide) 高血壓 (CCB) Hypertension
#仿單變更2021

The active ingredients of Sevikar HCT target three separate mechanisms involved in blood pressure regulation. Amlodipine: Dihydropyridine Calcium Channel Blocker
blocks the contractile effects of calcium on cardiac and vascular smooth muscle cells
Olmesartan: Angiotensin II Receptor Blocker
blocks the vasoconstriction and sodium retaining effects of angiotensin II on cardiac, vascular smooth muscle, adrenal and renal cells
Hydrochlorothiazide: Thiazide Diuretic
directly promotes the excretion of sodium and chloride in the kidney leading to reductions in intravascular volume

Refer to individual agents (amlodipine, olmesartan medoxomil, and hydrochlorothiazide). Food does not affect the bioavailability of Sevikar HCT.

(Because of the hydrochlorothiazide component) 1. Patients with anuria
2. Hypersensitivity to olmesartan, amlodipine, hydrochlorothiazide, other sulfonamide-derived drugs

C (first trimester); D (second and third trimesters)
When pregnancy is detected, discontinue as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.<20211217>

Due to the potential for serious adverse reactions in the breastfed infant, breastfeeding is not recommended by the manufacturer.

Common
Edema, headache, fatigue, nasopharyngitis, muscle spasms
Warnings
1. Angioedema:
May involve the head and neck (potentially compromising airway) or the intestine (presenting with abdominal pain); discontinue therapy immediately if angioedema occurs (IM administration of epinephrine may be necessary).
2. Angina/MI:
Reflex tachycardia may occur resulting in angina and/or MI in patients with obstructive coronary disease, especially in the absence of concurrent beta-blockade.
3. Electrolyte disturbances:
Hyperkalemia may occur; risk factors include renal impairment, diabetes mellitus, and concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salts.
4. Gastrointestinal effects:
Symptoms of sprue-like enteropathy (ie, severe, chronic diarrhea with significant weight loss) has been reported; discontinue treatment and consider other antihypertensive treatment if side effect occurs.
5. Ocular effects:
May cause acute transient myopia and acute angle-closure glaucoma; discontinue therapy immediately in patients with acute decreases in visual acuity or ocular pain. Additional treatments may be needed if uncontrolled intraocular pressure persists.
6. Renal function deterioration:
Associated with deterioration of renal function and/or increases in serum creatinine, particularly in patients with low renal blood flow (eg, renal artery stenosis, heart failure)
7. Skin cancer, nonmelanoma:
Prolonged use (≥3 years) may increase the risk for squamous cell carcinoma up to 4 times and increase the risk for basal cell carcinoma up to 1.25 times compared to patients not treated with hydrochlorothiazide<20211217>
8. Sulfonamide allergy:
In cases where prior reactions were severe (Stevens-Johnson syndrome/TEN), some clinicians choose to avoid.

Dose once daily. Dosage may be increased after 2 weeks. The full blood pressure lowering effects are attained within 2 weeks after a change in dose. The maximum recommended dose of Sevikar HCT is 10/40/25 mg. Sevikar HCT may be taken with or without food.
Avoid use in patients with severe renal impairment (ClCr<30 ml/min).