Benicar HCT is a medication prescribed for the treatment of hypertension, commonly known as high blood pressure. It is a combination drug composed of two active ingredients: olmesartan medoxomil, an angiotensin II receptor blocker (ARB), and hydrochlorothiazide, a thiazide diuretic.

The two components of Benicar HCT work synergistically to lower blood pressure through different mechanisms. Olmesartan medoxomil blocks the action of angiotensin II, a hormone that causes blood vessels to narrow, while hydrochlorothiazide increases the excretion of sodium and water from the body, reducing the volume of fluid in the bloodstream. By reducing blood pressure, Benicar HCT helps to lower the risk of complications associated with hypertension, such as heart attack, stroke, and kidney problems.

Precautions and Warnings with Benicar HCT


Benicar HCT is contraindicated in patients with a history of hypersensitivity to any component of the medication. It should not be used in patients with severe renal impairment (creatinine clearance <30 mL/min), anuria, or severe hepatic impairment.

Special Populations

  • Pregnancy: Benicar HCT can cause fetal harm when administered to pregnant women. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy can cause fetal and neonatal morbidity and death. If pregnancy is detected, discontinue Benicar HCT as soon as possible.
  • Pediatric Use: Safety and effectiveness of Benicar HCT in pediatric patients have not been established.
  • Geriatric Use: Elderly patients may be more sensitive to the effects of Benicar HCT. Close monitoring of renal function and electrolytes is recommended in this population.

Monitoring Requirements

Patients taking Benicar HCT should have regular monitoring of blood pressure, renal function, and electrolytes. Periodic monitoring of serum potassium and creatinine levels is advised, especially in patients with pre-existing renal impairment or those taking potassium-sparing diuretics or potassium supplements.

Benicar HCT Side Effects

While Benicar HCT is generally well-tolerated, like any medication, it may cause side effects in some individuals. Side effects associated with Benicar HCT may include:

Common Side Effects

  • Dizziness
  • Upper respiratory infection
  • High uric acid levels
  • Nausea
  • Back pain
  • Swelling in arms and legs
  • Stomach pain
  • Diarrhea
  • Joint pain
  • Cough
  • Rash

Serious Side Effects

  • Dangerously Low Blood Pressure: Dizziness, lightheadedness, pale skin, feeling faint
  • Serious Kidney Problems: Urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
  • High Blood Potassium Levels: Nausea, muscle weakness, abnormal heartbeat
  • Severe Allergic Reaction: Swelling of your lips, tongue, throat, or face, trouble breathing, rash
  • Severe Diarrhea

Drug Interactions with Benicar HCT

Benicar HCT may interact with other medications, supplements, or substances, potentially affecting its effectiveness or increasing the risk of adverse effects. Some notable drug interactions with Benicar HCT may include:

  • Potassium-Sparing Diuretics: Concomitant use of potassium-sparing diuretics (e.g., spironolactone) or potassium supplements with Benicar HCT may increase the risk of hyperkalemia (elevated potassium levels).
  • Lithium: Benicar HCT may increase lithium levels, leading to lithium toxicity. Close monitoring of lithium levels and adjustment of dosage may be necessary when used concomitantly.
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Concurrent use of NSAIDs, including selective COX-2 inhibitors, may diminish the antihypertensive effect of Benicar HCT and increase the risk of renal impairment.
  • Dual Renin-Angiotensin System (RAS) Blockade: Concomitant use of Benicar HCT with other agents that affect the RAS (e.g., ACE inhibitors, aliskiren) may increase the risk of hypotension, hyperkalemia, and renal impairment.

Benicar HCT Strengths and Dosages

Available Strengths

Benicar HCT tablets are available in the following strengths:

  • Olmesartan Medoxomil 20 mg/Hydrochlorothiazide 12.5 mg
  • Olmesartan Medoxomil 40 mg/Hydrochlorothiazide 12.5 mg

Recommended Dosages

The recommended starting dose of Benicar HCT is one tablet once daily. The dosage may be titrated based on the individual patient’s response to therapy. Patients requiring additional blood pressure reduction may be prescribed a higher strength tablet or additional antihypertensive medications. Additionally, dosage adjustment may be necessary in patients with renal impairment or hepatic dysfunction.

Cost of Benicar HCT in America

At this time of writing, the cost for Benicar HCT oral tablet (12.5 mg-20 mg) to be approximately $317 for a supply of 30 tablets

Patients are encouraged to check with their local pharmacies, insurance providers, or explore patient assistance programs to determine the most cost-effective option for obtaining Benicar HCT.

Benicar HCT Alternatives

Several alternative medications are available for the treatment of hypertension, including both single-agent antihypertensive drugs and combination therapies. Alternatives to Benicar HCT may include:

  • Other ARB/Thiazide Diuretic Combinations: Similar combination medications containing different angiotensin II receptor blockers (ARBs) and thiazide diuretics may be available. Examples include valsartan/hydrochlorothiazide and irbesartan/hydrochlorothiazide. These medications work through similar mechanisms to Benicar HCT and may be suitable alternatives for patients who do not respond well to or cannot tolerate Benicar HCT.
  • Standalone ARBs: Standalone ARBs, such as losartan, valsartan, and irbesartan, are available for patients who may not tolerate the combination therapy or prefer a different medication regimen. ARBs work by blocking the action of angiotensin II, leading to blood vessel relaxation and blood pressure reduction.
  • Thiazide Diuretics: Thiazide diuretics, such as hydrochlorothiazide (HCTZ), can be used as monotherapy or in combination with other antihypertensive agents. While they may not provide the same level of blood pressure control as combination therapies, they are effective in reducing blood volume and lowering blood pressure.
  • ACE Inhibitors: Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril, enalapril, and ramipril, are another class of antihypertensive medications. They work by inhibiting the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced blood pressure. ACE inhibitors may be used as an alternative for patients who do not tolerate ARBs or have contraindications to them.
  • Calcium Channel Blockers (CCBs): Calcium channel blockers, such as amlodipine, diltiazem, and verapamil, are effective antihypertensive agents that work by blocking calcium channels in blood vessels, leading to vasodilation and reduced blood pressure. They may be used alone or in combination with other medications for blood pressure management.

FAQs of Benicar

What is the primary indication for Benicar HCT?

Benicar HCT is primarily indicated for the treatment of hypertension (high blood pressure) in adults.

How long does it take for Benicar HCT to start working?

Benicar HCT may start lowering blood pressure within a few hours of the first dose, but it may take up to 2 weeks to achieve the full therapeutic effect.

Can Benicar HCT be taken with food?

Benicar HCT can be taken with or without food. However, taking it with food may help reduce the risk of gastrointestinal side effects.

Is Benicar HCT safe during pregnancy?

Benicar HCT is contraindicated during pregnancy due to the potential risk of fetal harm. Women of childbearing age should use effective contraception while taking Benicar HCT.

Can Benicar HCT cause weight gain?

Weight gain is not a common side effect of Benicar HCT. However, individual responses to medication may vary, and some patients may experience changes in weight while taking this medication.

Are there any lifestyle changes recommended while taking Benicar HCT?

Lifestyle modifications such as adopting a healthy diet, regular exercise, limiting alcohol intake, and managing stress can complement the effects of Benicar HCT in controlling blood pressure.

How should Benicar HCT be stored?

Benicar HCT should be stored at room temperature (between 68°F to 77°F or 20°C to 25°C) in a tightly closed container, away from moisture and light. Keep it out of reach of children.

What should I do if I miss a dose of Benicar HCT?

If you miss a dose of Benicar HCT, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Can Benicar HCT be taken by patients with kidney problems?

Benicar HCT should be used with caution in patients with renal impairment. Dosage adjustments may be necessary based on the severity of renal dysfunction. Close monitoring of renal function and electrolyte levels is recommended in these patients.

Are there any precautions I should take before starting Benicar HCT?

Before starting Benicar HCT, inform your healthcare provider about any medical conditions you have, especially kidney or liver disease, electrolyte imbalances, or diabetes. Also, inform them about all medications you are currently taking, including prescription, over the counter, and herbal products, to avoid potential drug interactions.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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