Package Leaflet: Information for the User
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 20 mg/5 mg/12.5 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/5 mg/12.5 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/10 mg/12.5 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/5 mg/25 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/10 mg/25 mg film-coated tablets EFG
Olmesartan medoxomil / Amlodipine / Hydrochlorothiazide
Read the entire package leaflet carefully before you start taking this medicine, because it contains important information for you.
Contents of the package leaflet
This medicinal product contains three active substances called olmesartan medoxomil, amlodipine (as amlodipine besylate) and hydrochlorothiazide. The three substances help to control high blood pressure.
The action of these substances contributes to lowering your blood pressure. Olmesartan/hydrochlorothiazide/amlodipine is used to treat high blood pressure:
Do not take Olmesartan/Amlodipine/Hydrochlorothiazide Alembic
Do not take olmesartan/amlodipine/hydrochlorothiazide if any of these cases apply to you.
Warnings and precautions
Consult your doctor or pharmacist before starting to take Olmesartan/Amlodipine/Hydrochlorothiazide Alembic:
Tell your doctorif you are taking any of the following medicines used to treat high blood pressure (hypertension):
Your doctor may monitor your kidney function, blood pressure, and blood electrolyte levels (e.g., potassium) at regular intervals.
See also the information under the heading "Do not take Olmesartan/Amlodipine/Hydrochlorothiazide Alembic".
Tell your doctorif you have any of the following health problems:
Contact your doctor if you experience any of the following symptoms:
As with any other medicine that lowers blood pressure, an excessive decrease in blood pressure in patients with altered blood flow in the heart or brain may cause a heart attack or stroke. Therefore, your doctor will carefully monitor your blood pressure.
Olmesartan/amlodipine/hydrochlorothiazide may cause an increase in lipid and uric acid levels in the blood. Your doctor will likely want to perform a blood test from time to time to monitor these possible changes.
A change in blood levels of certain chemicals called electrolytes may occur. Your doctor will likely want to perform a blood test from time to time to monitor this possible change. Some signs of electrolyte changes are: thirst, dry mouth, muscle pain or cramps, tired muscles, low blood pressure (hypotension), feeling of weakness, slowness, fatigue, drowsiness or restlessness, nausea, vomiting, decreased need to urinate, rapid heartbeat. Tell your doctor if you notice any of these symptoms.
If you are going to have parathyroid function tests, you should stop taking olmesartan/amlodipine/hydrochlorothiazide before these tests are performed.
Athletes are informed that this medicine contains a component that may result in a positive doping test.
You must inform your doctor if you are pregnant (or think you might be). Olmesartan/amlodipine/hydrochlorothiazide is not recommended during pregnancy, and it must not be taken if you are pregnant for more than 3 months, as it may cause serious harm to your baby if taken at this stage (see section "Pregnancy and breastfeeding").
Consult your doctor if you experience abdominal pain, nausea, vomiting, or diarrhea after taking olmesartan/amlodipine/hydrochlorothiazide. Your doctor will decide whether to continue treatment. Do not stop taking olmesartan/amlodipine/hydrochlorothiazide on your own.
Children and adolescents (under 18 years)
The use of olmesartan/amlodipine/hydrochlorothiazide is not recommended in children and adolescents under 18 years of age.
Other medicines and Olmesartan/Amlodipine/Hydrochlorothiazide Alembic
Inform your doctor or pharmacist if you are taking, have recently taken, or might take any of the following medicines:
Other blood pressure-lowering medicines, as they may increase the effect of olmesartan/amlodipine/hydrochlorothiazide. Your doctor may need to adjust your dose and/or take other precautions:
If you are taking a converting enzyme inhibitor (ACE inhibitor) or aliskiren (see also the information under the headings "Do not take Olmesartan/Amlodipine/Hydrochlorothiazide Alembic" and "Warnings and precautions").
Inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicine.
Taking Olmesartan/Amlodipine/Hydrochlorothiazide Alembic with food and drinks
Olmesartan/amlodipine/hydrochlorothiazide can be taken with or without food.
People taking olmesartan/amlodipine/hydrochlorothiazide should not consume grapefruit or grapefruit juice. This is because grapefruit and grapefruit juice can lead to an increase in the levels of the active ingredient amlodipine in the blood, which can cause an unpredictable increase in the blood pressure-lowering effect of olmesartan/amlodipine/hydrochlorothiazide.
Be careful when drinking alcohol while taking olmesartan/amlodipine/hydrochlorothiazide, as some people feel faint or dizzy. If this happens to you, do not drink any alcohol.
Elderly patients
If you are over 65 years old, your doctor will regularly monitor your blood pressure each time your dose is increased, to ensure that your blood pressure does not decrease too much.
Pregnancy and breastfeeding
Pregnancy
You must inform your doctor if you are pregnant, or if you think you might be. Your doctor will advise you to stop taking olmesartan/amlodipine/hydrochlorothiazide before becoming pregnant or as soon as you know you are pregnant, and will advise you to take another medicine instead of olmesartan/amlodipine/hydrochlorothiazide. Olmesartan/amlodipine/hydrochlorothiazide is not recommended during pregnancy, and it must not be taken when pregnant for more than 3 months, as it may cause serious harm to your baby if taken from the third month of pregnancy.
If you become pregnant while taking olmesartan/amlodipine/hydrochlorothiazide, inform and consult your doctor immediately.
Breastfeeding
Inform your doctor if you are breastfeeding or about to start breastfeeding. It has been shown that amlodipine and hydrochlorothiazide pass into breast milk in small amounts. Olmesartan/amlodipine/hydrochlorothiazide is not recommended in breastfeeding mothers, and your doctor may choose another treatment if you wish to breastfeed.
If you are pregnant or breastfeeding, think you might be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.
Driving and using machines
You may feel drowsy, sick, or dizzy, or have a headache while being treated for high blood pressure. If this happens, do not drive or use machines until the symptoms have disappeared. Consult your doctor.
This medicine contains lactose. If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medicine.
This medicine contains less than 1 mmol of sodium (23 mg) per film-coated tablet; this is essentially "sodium-free".
If you take more Olmesartan/Amlodipine/Hydrochlorothiazide Alembic than you should
If you take more tablets than you should, you will probably experience a drop in blood pressure, accompanied by symptoms such as dizziness, and rapid or slow heartbeat.
Excess fluid may accumulate in the lungs (pulmonary edema) causing difficulty breathing, which can develop up to 24-48 hours after ingestion.
If you take more tablets than you should, or if a child accidentally ingests some tablets, contact your doctor or go to the nearest emergency center immediately and take the medicine package or this leaflet with you.
In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone 91 562 04 20.
If you forget to take Olmesartan/Amlodipine/Hydrochlorothiazide Alembic
If you forget to take a dose, take your usual dose the next day. Do not take a double dose to make up for forgotten doses.
If you stop taking Olmesartan/Amlodipine/Hydrochlorothiazide Alembic
It is important to continue taking this medicine, unless your doctor tells you to stop the treatment.
If you have any other questions about the use of this medicine, ask your doctor or pharmacist.
Like all medications, this medication can cause adverse effects, although not all people suffer from them. If they occur, they are often mild and do not require interrupting treatment.
The following adverse effects may be serious, although they affect only a small group of people:
During treatment with olmesartan/amlodipine/hydrochlorothiazide, allergic reactions with inflammation of the face, mouth, and/or larynx (vocal cords), along with itching and skin rash, may occur. If this happens to you, stop taking this medication and consult your doctor immediately.
Olmesartan/amlodipine/hydrochlorothiazide may cause a pronounced decrease in blood pressure, in susceptible patients. This can cause fainting or severe dizziness. If this happens to you, stop taking this medication, consult your doctor immediately, and remain lying down in a horizontal position.
Olmesartan/amlodipine/hydrochlorothiazide is a combination of three active substances. The following information describes the adverse effects reported so far with the combination olmesartan/amlodipine/hydrochlorothiazide (in addition to those already mentioned) and the adverse effects known for each of the active substances separately, or when two of the substances are taken together.
To give you an idea of the number of patients who may have adverse effects, they have been classified as frequent, infrequent, rare, and very rare.
These are other known adverse effects of olmesartan/amlodipine/hydrochlorothiazide:
If these effects occur, they are often mild and do not require interrupting treatment.
Frequent(may affect up to 1 in 10 people)
Upper respiratory tract infection, sore throat and nose, urinary tract infection, dizziness, headache, perception of heartbeats, low blood pressure, nausea, diarrhea, constipation, cramps, joint swelling, urge to urinate, weakness, ankle swelling, fatigue, abnormal laboratory test values.
Infrequent(may affect up to 1 in 100 people)
Dizziness when standing up, vertigo, rapid heartbeat, feeling of fainting, flushing and feeling of heat in the face, cough, dry mouth, muscle weakness, inability to have or maintain an erection.
These are the known adverse effects for each of the active substances separately or when two of the substances are taken together:
They may be adverse effects due to olmesartan/amlodipine/hydrochlorothiazide, even if they have not been observed so far with olmesartan/amlodipine/hydrochlorothiazide.
Very frequent(may affect more than 1 in 10 people)
Edema (fluid retention).
Frequent(may affect up to 1 in 10 people)
Bronchitis, stomach and intestine infection, vomiting, increased blood sugar, sugar in urine, confusion, drowsiness, visual disturbances (including double vision and blurred vision), nasal secretion or congestion, sore throat, difficulty breathing, cough, abdominal pain, heartburn, stomach discomfort, flatulence, joint or bone pain, back pain, bone pain, blood in urine, flu-like symptoms, chest pain, pain.
Infrequent(may affect up to 1 in 100 people)
Reduction in the number of a type of blood cells called platelets, which can cause easy bruising or prolonged bleeding, anaphylactic reactions, abnormally decreased appetite (anorexia), sleep problems, irritability, mood changes including anxiety, feeling of depression, chills, sleep disorders, alteration of the sense of taste, loss of consciousness, decreased sense of touch, tingling sensation, worsening of myopia, ringing in the ears (tinnitus), angina (chest pain or discomfort known as angina pectoris), irregular heartbeats, rash, hair loss, allergic skin inflammation, skin redness, purple spots or patches on the skin due to small hemorrhages (purpura), skin discoloration, red itchy patches (urticaria), increased sweating, itching, skin rash, skin reactions to light, such as sunburn or skin rash, muscle pain, urination problems, feeling of need to urinate at night, increased breast size in men, decreased sexual desire, facial swelling, feeling of discomfort, weight gain or loss, exhaustion.
Rare(may affect up to 1 in 1,000 people)
Inflammation and pain of the salivary glands, decrease in the number of white blood cells in the blood, which could increase the risk of infections, decrease in the number of red blood cells (anemia), bone marrow damage, restlessness, feeling of loss of interest (apathy), seizures (convulsions), yellowish perception of objects when looking at them, dry eyes, blood clots (thrombosis, embolism), fluid accumulation in the lungs, pneumonia, inflammation of blood vessels and small blood vessels in the skin, pancreatitis, yellowish discoloration of the skin and eyes, acute inflammation of the gallbladder, symptoms of lupus erythematosus such as skin rash, joint pain, and cold hands and fingers, severe skin reactions including intense skin rash, urticaria, skin redness of the body, severe itching, blisters, peeling, and skin inflammation, inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis), sometimes very severe, movement impairment, acute kidney failure, non-infectious kidney inflammation, decreased kidney function, fever.
Intestinal angioedema: swelling in the intestine that presents symptoms such as abdominal pain, nausea, vomiting, and diarrhea.
Very rare(may affect up to 1 in 10,000 people)
High muscle tension, numbness of hands or feet, heart attack, stomach inflammation, gum thickening, intestinal obstruction, liver inflammation.
Acute respiratory difficulty (signs include severe respiratory difficulty, fever, weakness, and confusion).
Adverse effects of unknown frequency(cannot be estimated from available data)
Decreased vision or eye pain (possible signs of acute angle-closure glaucoma). Tremors, rigid posture, mask-like face, slow movements, and unsteady gait. Skin and lip cancer (non-melanoma skin cancer).
If you experience yellowing of the whites of your eyes, dark urine, itching of the skin, even if you started treatment with X a long time ago, contact your doctor immediatelywho will evaluate your symptoms and decide how to continue treatment for high blood pressure.
Reporting of adverse effects
If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that does not appear in this leaflet. You can also report them directly through the Spanish Medicines Monitoring System for Human Use: www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medication.
Keep this medication out of sight and reach of children.
Do not use this medication after the expiration date that appears on the packaging and blister after "EXP". The expiration date is the last day of the month indicated.
Medications should not be thrown away through the sewers or in the trash. Deposit the packaging and medications you no longer need in the SIGRE collection point at the pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. This way, you will help protect the environment.
Composition of Olmesartan/Amlodipine/Hydrochlorothiazide Alembic
The active ingredients are olmesartan medoxomil, amlodipine (as amlodipine besylate), and hydrochlorothiazide.
Each film-coated tablet contains 20 mg of olmesartan medoxomil, 5 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide.
Each film-coated tablet contains 40 mg of olmesartan medoxomil, 5 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide.
Each film-coated tablet contains 40 mg of olmesartan medoxomil, 10 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide.
Each film-coated tablet contains 40 mg of olmesartan medoxomil, 5 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide.
Each film-coated tablet contains 40 mg of olmesartan medoxomil, 10 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide.
The other components are:
Tablet core:Microcrystalline cellulose (Avicel PH 113), pregelatinized corn starch 1500LM, hydroxypropylcellulose (Klucel EXF), colloidal anhydrous silica (Aerosil 200), sodium croscarmellose (Ac-Di-Sol), magnesium stearate, lactose
Coating:Partially hydrolyzed polyvinyl alcohol (E-1203), macrogol (E-1521), titanium dioxide (E-171), talc (E-553b), yellow iron oxide (E-172), red iron oxide (E-172) (20 mg / 5 mg / 12.5 mg, 40 mg / 10 mg / 12.5 mg, 40 mg / 10 mg / 25 mg film-coated tablets only), black iron oxide (E-172) (20 mg / 5 mg / 12.5 mg, 40 mg / 5 mg / 12.5 mg, 40 mg / 5 mg / 25 mg film-coated tablets only)
Appearance of the product and package contents
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 20 mg/5 mg/12.5 mg: film-coated tablets of light cream to cream color, round, biconvex, film-coated tablets engraved with "L18" on one side and smooth on the other, and approximately 8.00 mm in diameter.
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/5 mg/12.5 mg: film-coated tablets of light yellow to yellow color, round, biconvex, film-coated tablets engraved with "L709" on one side and smooth on the other, and approximately 10.50 mm in diameter.
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/10 mg/12.5 mg: film-coated tablets of grayish-red color, round, biconvex, film-coated tablets engraved with "L711" on one side and smooth on the other, and approximately 10.50 mm in diameter.
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/5 mg/25 mg: film-coated tablets of light yellow to yellow color, oval, biconvex, film-coated tablets engraved with "L710" on one side and smooth on the other, and approximately 15.00 mm in length and 7.00 mm in width.
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic 40 mg/10 mg/25 mg: film-coated tablets of grayish-red color, oval, biconvex, film-coated tablets engraved with "L712" on one side and smooth on the other, and approximately 15.00 mm in length and 7.00 mm in width.
Olmesartan/Amlodipine/Hydrochlorothiazide Alembic film-coated tablets EFG are presented in:
Aluminum-aluminum blisters (polyamide/aluminum/polyethylene/aluminum) in a cardboard box containing 7, 14, 28, 30, 56, 84, 90, 98, 10 x 28, and 10 x 30 film-coated tablets or single-dose precut blisters in a cardboard box containing 10, 50, and 500 film-coated tablets.
Aluminum-aluminum blisters (polyvinyl chloride/polyamide/aluminum/polyvinyl chloride/aluminum) in a cardboard box containing 7, 14, 28, 30, 56, 84, 90, 98, 10 x 28, and 10 x 30 film-coated tablets or single-dose precut blisters in a cardboard box containing 10, 50, and 500 film-coated tablets.
Aluminum-aluminum blisters (polyamide/aluminum/polyvinyl chloride/aluminum) integrated with desiccant in a cardboard box containing 7, 10, 14, 28, 30, 50, 56, 84, 90, 98, 10 x 28, 10 x 30, and 10 x 50 film-coated tablets.
Aluminum-aluminum blisters (polyamide/aluminum/polyvinyl chloride/aluminum) integrated with desiccant marked with "DO NOT OPEN OR EAT".
Only some package sizes may be marketed.
Marketing authorization holder
Alembic Pharmaceuticals Europe Ltd
Palazzo Pietro Stiges, 103, Strait Street, Valletta VLT 1436
Malta
Manufacturer
Pharmadox Healthcare Ltd
KW20A, Kordin Industrial Estate, Paola
PLA 3000, Malta
Date of the last revision of this leaflet:November 2020
Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/