Eprosartan + Hydrochlorothiazide

Indications

Eprosartan + Hydrochlorothiazide is used for: Hypertension

Adult Dose

Hypertension 600 mg/12.5 mg to 600 mg/25 mg PO qDay

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity to eprosartan, hydrochlorothiazide, or sulfonamides Pregnancy (2nd/3rd trimesters): Significant risk of fetal/neonatal morbidity and mortality Anuria Do not coadminister with aliskiren in patients with diabetes mellitus

Precautions

Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide) Not for initial treatment Electrolyte disturbances may occur Hyperkalemia, particularly when coadministered with potassium-sparing diuretics, potassium supplements, or salt substitutes; concurrent therapy with hydrochlorothiazide may reduce the frequency of this effect Photosensitivity may occur Hypotension may occur in patients who are salt or volume depleted (correct the volume depletion especially in patients receiving high dose diuretics) Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for renal function changes (including acute renal failure) compared to monotherapy Caution in aortic mitral stenosis, hepatic impairment, hypercholesterolemia, hypercalcemia, parathyroid disease, pre-existing renal insufficiency, systemic lupus erythematosus, bilateral renal artery stenosis or anuria Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides Thiazides may decrease urinary calcium excretion

Pregnancy-Lactation

Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters) Lactation: excretion in milk unknown/not recommended

Interactions

Adverse Effects

Side effects of Eprosartan + Hydrochlorothiazide : Adverse reactions with combination products and individual agents 1-10% Decreased neutrophil count (1%) Back pain (3%) Increased BUN (1%) Eprosartan Upper respiratory infection (8%) Cough (4%) Abdominal pain (2%) Fatigue (2%) Hypertriglyceridemia (1%) Urinary tract infection (1%) Depression (1%) Rhinitis (4%) Cough (4%) Pharyngitis (4%) Viral infection (2%) Frequency Not Defined Hydrochlorothiazide Anorexia Epigastric distress Hypotension Orthostatic hypotension Photosensitivity Anaphylaxis Anemia Confusion Erythema multiforme Stevens-Johnson syndrome Exfoliative dermatitis including toxic epidermal necrolysis Dizziness Hypokalemia and/or hypomagnesemia Hyperuricemia Headache

Mechanism of Action

Eprosartan Angiotensin II blocker; displaces angiotensin II from AT1 receptor and may lower blood pressure by antagonizing AT1-induced vasoconstriction, aldosterone release, catecholamine release, arginine vasopressin release, water absorption, and hypertrophic responses May induce more complete inhibition of renin-angiotensin system compared with ACE inhibitors; does not affect response to bradykinin Inhibits the pressor effects of an angiotensin II infusion in a dose-related manner Hydrochlorothiazide Thiazide diuretic; inhibits sodium reabsorption in distal renal tubules, resulting in increased excretion of water and of sodium, potassium, and hydrogen ions