Combination Therapy for Hypertension with Amlodipine and Olmesartan

Guideline-Supported Combination

The American College of Cardiology and American Heart Association recommend amlodipine and olmesartan as combination therapy for hypertension, as both are listed as primary antihypertensive agents in the 2017 ACC/AHA hypertension guidelines 1, 2, 3

The American College of Cardiology and American Heart Association suggest monitoring for hyperkalemia, particularly in patients with chronic kidney disease or those taking potassium supplements, as olmesartan can increase potassium levels 1, 2, 3
Monitor renal function and potassium within 2-4 weeks of initiating olmesartan, according to clinical guidelines 4

The American College of Cardiology and American Heart Association advise against using olmesartan in combination with ACE inhibitors or direct renin inhibitors, due to increased risks of hyperkalemia, hypotension, and renal dysfunction 1, 2, 3
Avoid using olmesartan and amlodipine in pregnancy, as both carry fetal risks 1, 2, 3
Use amlodipine with caution in patients with heart failure with reduced ejection fraction, though it may be used if required 1, 2, 3
Monitor for acute renal failure in patients with severe bilateral renal artery stenosis when using olmesartan 1, 2, 3

Olmesartan is typically dosed at 20-40 mg once daily, and amlodipine is typically dosed at 2.5-10 mg once daily, according to clinical guidelines 1, 2, 3
Amlodipine-associated pedal edema is dose-related and more common in women than men 1, 2, 3

Both medications are associated with photosensitivity reactions, so advise patients to use sun protection, according to the Nature Reviews Cardiology 5
No significant drug-drug interactions exist between amlodipine and olmesartan themselves, but amlodipine is a CYP3A4 substrate, which may minimize drug interaction concerns 6, 7