Benicar HCT (olmesartan, hydrochlorothiazide) is an antihypertensive medication used to lower high blood pressure. High blood pressure, also called hypertension, is a very common but very serious condition affecting over 1 billion people around the world. It rarely produces symptoms until a major medical event occurs, including kidney damage, heart attack, or stroke.

Hypertension can be managed with medications like Benicar HCT. This product contains two active ingredients, both of which are good at regulating blood pressure on their own:

• Olmesartan medoxomil is an angiotensin receptor blocker (ARB), which works by relaxing blood vessels so blood can flow more freely. This lowers blood pressure and improves oxygen delivery to the heart, in addition to reducing the work the heart has to do to pump blood.
• Hydrochlorothiazide, more commonly called HCTZ or HCT, is a thiazide diuretic that works by blocking salt reuptake in the kidneys, excreting it in urine instead. Salt retains fluid, so by eliminating it overall blood volume is reduced, which lowers blood pressure.

Benicar HCT combines both of these into a single tablet, which most patients find more convenient that taking each medication separately. They can be taken separately, though, with the same benefit, if that is preferred.

Lowering blood pressure prevents damage to blood vessels and the heart, while reducing risk of events like kidney failure, stroke, or heart attack.

Managing Blood Pressure

Benicar HCT is usually prescribed when a patient is already taking either olmesartan or HCT alone but it is not producing significant results. Much less commonly it may be the first high blood pressure medication prescribed, when hypertension is so severe that a single medication is unlikely to be enough. Additional blood pressure treatments may also be given along with Benicar HCT.

Treatment usually consists of:

• Patients taking olmesartan but not HCT should start with 40 mg olmesartan and 12.5 mg HCT.
• Patients taking HCT but not olmesartan should take 20 mg olmesartan and 12.5 mg HCT.
• Patients not taking anything should start with 20 mg olmesartan and 12.5 mg HCT.
• In both cases after several weeks of treatment dosage may be adjusted, usually upward, to a maximum of 40 mg olmesartan and 12.5 mg HCT.

Most patients will register some degree of lower blood pressure in the first few days of use, but it will take several weeks of treatment to see maximum benefit, which is why doctors will usually wait several weeks before adjusting dosage. Exceptions are when unexpected side effects occur, such as blood pressure dropping too low; treatment will be stopped or adjusted immediately in those cases.

Benicar HCT will lower blood pressure more than Benicar or HCT alone. Patients may experience symptoms of low blood pressure, even if it's within healthy ranges. Symptoms include:

• Mild weakness
• Mild fatigue
• Lightheadedness
• Dizziness
• Difficulty concentrating

These should stop occurring in the first few weeks of Benicar HCT use; if not, or if they become severe, discuss with a doctor.

Lifestyle changes are usually also recommended; losing weight, regular exercise, regulating salt intake, and so forth. Patients who are able to make and maintain these changes may eventually stop relying on Benicar HCT for good blood pressure levels; others, unable to make lifestyle changes or for whom lifestyle changes have a limited influence, will need to take Benicar HCT indefinitely, possibly for the remainder of life.

Potential Complications

Side effects from Benicar HCT are rare, other than those described above involving lowered blood pressure. If any side effect becomes concerning for any reason don't be afraid to talk to a doctor about it---no matter how trivial it may seem.

Patients who have kidney problems or diabetes and are taking aliskiren (another antihypertensive medication) should not take Benicar HCT.

Benicar HCT may interact with a number of other medications. Of greatest concern are:

• Other diuretics
• Medications for heart problems
• Pain medicines, including NSAIDs
• Cholesterol-lowering medications
• Other antihypertensive medications

There may be other medications that interact with Benicar HCT as well; check with a doctor or pharmacist before mixing treatments if unsure of effects.

Be aware that this medication can cause severe birth defects and even fetal death if taken while pregnant. Effects on nursing infants are unclear.