ed renin-angiotensin system, such as
volume- and/or salt-depleted patients (eg, those being treated with
high doses of diuretics), symptomatic hypotension may occur after
initiation of treatment with BENICAR. Treatment should start under
close medical supervision. If hypotension does occur, the patient
should be placed in the supine position and, if necessary, given an
intravenous infusion of normal saline. A transient hypotensive
response is not a contraindication to further treatment, which
usually can be continued without difficulty once the blood pressure
has stabilized.
Impaired Renal Function
In studies of ACE inhibitors in patients with unilateral or
bilateral renal artery stenosis, increases in serum creatinine or
blood urea nitrogen (BUN) have been reported. There has been no
long-term use of olmesartan medoxomil in patients with unilateral
or bilateral renal artery stenosis, but similar results may be
expected.
The prescribing information for BENICAR HCT also includes the
following warnings regarding its hydrochlorothiazide component:
BENICAR HCT is not recommended in patients with severe renal
impairment and is contraindicated in patients with anuria or
hypersensitivity to other sulfonamide-derived drugs.
Fetal/Neonatal Morbidity and Mortality
Thiazides cross the placental barrier and appear in cord blood.
There is a risk of fetal or neonatal jaundice, thrombocytopenia,
and possibly other adverse reactions that have occurred in
adults.
Hepatic Impairment
Thiazides should be used with caution in patients with impaired
hepatic function or progressive liver disease, since minor
alterations of fluid and electrolyte balance may precipitate
hepatic coma.
Hypersensitivity Reaction
Hypersensitivity reactions to hydrochlorothiazide may occur in
patients with or without a history of allergy or bronchial asthma,
but are more likely in patients with such a history.
Systemic Lupus Erythematos
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