Package Leaflet: Information for the Patient
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 20 mg/5 mg/12.5 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/12.5 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/25 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/12.5 mg film-coated tablets EFG
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 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
Olmesartan/Amlodipine/Hydrochlorothiazide Alter contains three active substances called olmesartan medoxomil, amlodipine (as amlodipine besylate), and hydrochlorothiazide. These three substances help 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 Alter
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 Alter:
Consult your doctor if you experience abdominal pain, nausea, vomiting, or diarrhea after taking Olmesartan/Amlodipine/Hydrochlorothiazide Alter. Your doctor will decide whether to continue treatment. Do not stop taking Olmesartan/Amlodipine/Hydrochlorothiazide on your own.
Tell your doctorif you are taking any of the following medications used to treat high blood pressure (hypertension):
Your doctor may need to 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 Alter".
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 medication 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 potential 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 potential 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 heart rate. 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 medication contains a component that may result in a positive doping test result.
You must inform your doctor if you are pregnant (or think you may be). Olmesartan/amlodipine/hydrochlorothiazide is not recommended during pregnancy, and it should 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").
Children and adolescents (under 18 years)
The use of olmesartan/amlodipine/hydrochlorothiazide is not recommended in children and adolescents under 18 years of age.
Taking Olmesartan/Amlodipine/Hydrochlorothiazide Alter with other medications
Tell your doctor or pharmacist if you are taking, have recently taken, or may need to take any of the following medications:
Your doctor may need to adjust your dose and/or take other precautions:
Tell your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medication.
Taking Olmesartan/Amlodipine/Hydrochlorothiazide Alter 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 blood levels of the active ingredient amlodipine, 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 may feel faint or dizzy. If this happens, 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 drop too much.
Pregnancy and breastfeeding
Pregnancy
You must inform your doctor if you are pregnant or think you may 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 medication instead of olmesartan/amlodipine/hydrochlorothiazide. The use of olmesartan/amlodipine/hydrochlorothiazide is not recommended during pregnancy, and it should not be taken if you are pregnant for more than 3 months, as it may cause serious harm to your baby if used from the third month of pregnancy.
If you become pregnant while taking olmesartan/amlodipine/hydrochlorothiazide, inform and consult your doctor immediately.
Breastfeeding
Tell 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 may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medication.
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 medication contains less than 1 mmol of sodium (23 mg) per film-coated tablet; it is essentially "sodium-free".
If you take more Olmesartan/Amlodipine/Hydrochlorothiazide Alter than you should
If you take more tablets than you should, you will likely experience a drop in blood pressure, accompanied by symptoms such as dizziness, and rapid or slow heart rate.
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 bring the medication package or this leaflet with you.
Excess fluid may accumulate in the lungs (pulmonary edema) causing difficulty breathing, which can develop up to 24-48 hours after ingestion.
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 Alter
If you forget to take a dose, take the usual dose the next day. Do not take a double dose to make up for forgotten doses.
If you stop taking Olmesartan/Amlodipine/Hydrochlorothiazide Alter
It is important to continue taking this medication, unless your doctor tells you to stop.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause adverse effects, although not all people suffer from them. If they occur, they are often mild and do not require discontinuation of treatment.
The following adverse effects may be serious:
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 medicine 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 medicine, 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 first describes the adverse effects reported so far with the olmesartan/amlodipine/hydrochlorothiazide combination (in addition to those already mentioned) and, secondly, the known adverse effects of each of the active substances separately, or when two of the substances are taken together.
Unknown frequency: If you experience yellowing of the whites of the eyes, dark urine, skin itching, even if you started treatment with Olmesartan/Amlodipine/Hydrochlorothiazide Alter a long time ago, contact your doctor immediatelywho will evaluate your symptoms and decide how to continue with blood pressure treatment.
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 so far with olmesartan/amlodipine/hydrochlorothiazide:
If these effects occur, they are often mild and do not require discontinuation of 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 easily cause bruising or prolong bleeding time, anaphylactic reactions, abnormal loss of appetite (anorexia), sleep problems, irritability, mood changes including anxiety, feeling of depression, chills, sleep disorders, alteration of taste, loss of consciousness, decreased sense of touch, tingling sensation, worsening of myopia, ringing in the ears (tinnitus), angina (pain or unpleasant sensation in the chest, 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 needing 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, yellowing 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 with 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, severe breathing difficulties (signs include severe breathing difficulties, fever, weakness, and confusion).
Adverse effects of unknown frequency(cannot be estimated from available data)
Decreased vision or eye pain (possible signs of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma). Tremors, rigid posture, mask-like face, slow movements, and unsteady gait. Skin and lip cancer (non-melanoma skin cancer).
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 Pharmacovigilance System for Human Use Medicines: www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.
Do not use this medicine after the expiration date shown on the packaging and blister after "EXP". The expiration date is the last day of the month indicated.
No special storage conditions are required for Olmesartan/Amlodipine/Hydrochlorothiazide Alter 20 mg/5 mg/12.5 mg, Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/12.5 mg, and Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/25 mg.
Do not store above 30°C for Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/12.5 mg and Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/25 mg.
Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and medicines 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 medicines you no longer need. This way, you will help protect the environment.
Composition of Olmesartan/Amlodipine/Hydrochlorothiazide Alter
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 20 mg/5 mg/12.5 mg: Each film-coated tablet contains 20 mg of olmesartan medoxomil, 5 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/12.5 mg: Each film-coated tablet contains 40 mg of olmesartan medoxomil, 5 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/12.5 mg: Each film-coated tablet contains 40 mg of olmesartan medoxomil, 10 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/25 mg: Each film-coated tablet contains 40 mg of olmesartan medoxomil, 5 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/25 mg: Each film-coated tablet contains 40 mg of olmesartan medoxomil, 10 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide.
Tablet core: Pregelatinized corn starch, microcrystalline cellulose, sodium croscarmellose, and magnesium stearate.
Tablet coating: Polyvinyl alcohol, macrogol, talc, titanium dioxide (E171), yellow iron oxide (E172) (40 mg/5 mg/12.5 mg and 40 mg/5 mg/25 mg tablets), and red iron oxide (E172) (40 mg/10 mg/12.5 mg and 40 mg/10 mg/25 mg tablets).
Appearance of the product and package contents
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 20 mg/5 mg/12.5 mg: Film-coated tablets, white, round, biconvex, with the inscription "t5" on one side.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/12.5 mg: Film-coated tablets, light yellow, round, biconvex, with the inscription "t4" on one side.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/12.5 mg: Film-coated tablets, pink, round, biconvex, with the inscription "t3" on one side.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/5 mg/25 mg: Film-coated tablets, light yellow, oblong, biconvex, with the inscription "t2" on one side and scored on the other side. The score line is only for breaking and facilitating swallowing but not for dividing into equal doses.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter 40 mg/10 mg/25 mg: Film-coated tablets, pink, oblong, biconvex, with the inscription "t1" on one side and scored on the other. The score line is only for breaking and facilitating swallowing but not for dividing into equal doses.
Olmesartan/Amlodipine/Hydrochlorothiazide Alter is available in blister packs containing 28 film-coated tablets.
Marketing authorization holder
Laboratorios Alter, S.A.
C/ Mateo Inurria 30
28036 Madrid
Spain
Manufacturer
Laboratorios Cinfa, S.A.
Olaz-Chipi 10, Polígono Industrial Areta
31620 Huarte, Navarra
Spain
Date of the last revision of this leaflet:February 2025
Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/
The average price of OLMESARTAN/AMLODIPINE/HYDROCHLOROTHIAZIDE ALTER 20 mg/5 mg/12.5 mg FILM-COATED TABLETS in October, 2025 is around 15.52 EUR. Prices may vary depending on the region, pharmacy, and whether a prescription is required. Always check with a local pharmacy or online source for the most accurate information.