Hypertension

1.Hydrochlorothiazide:Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions.
2.Amlodipine:directly acts on vascular smooth muscle to produce peripheral arterial vasodilation reducing peripheral vascular resistance and blood pressure.
3.Olmesartan(angiotensin II receptor antagonist): blocks the vasoconstriction and sodium retaining effects of angiotensin II on cardiac, vascular smooth muscle, adrenal and renal cells.

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

Patients with anuria (lack of urine production), hypersensitivity to any component or allergies to other sulfonamide drugs.

1.Once pregnancy is confirmed, it is imperative to immediately discontinue the use of Sevikar HCT. 2.The use of drugs may cause fetal renal dysfunction and increase the risk of fetal and neonatal morbidity and mortality.

Due to the potential adverse effects on infants, it is advised that breastfeeding is not recommended during treatment with Sevikar HCT.

Common: Edema , Dizziness, headache , fatigue ,nausea, Muscle spasm, joint swelling.
Warnings:
1.Angioedema: Angioedema has been reported rarely with some angiotensin II receptor antagonists. It may involve the head and neckor the intestine.
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 with angiotensin II receptor antagonists.
4.Gastrointestinal effects: Symptoms of sprue-like enteropathy (ie, severe, chronic diarrhea with significant weight loss) has been reported.
5.Ocular effects: Hydrochlorothiazide may cause acute transient myopia and acute angle-closure glaucoma; discontinue therapy immediately in patients with acute decreases in visual acuity or ocular pain.
6.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.

Dosage:once daily. May be increased at intervals of 2 weeks as needed. The maximum recommended dose of Sevikar HCT is 40/10/25 mg.

Avoid using in patients with severe renal impairment (creatinine clearance <30 mL/min).