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olmesartan, hydrochlorothiazide, amlodipine
This triple-combination antihypertensive reduces blood pressure through three complementary mechanisms: blocking angiotensin II receptors, inhibiting sodium reabsorption in the kidney, and relaxing vascular smooth muscle.
Olmesartan/hydrochlorothiazide/amlodipine is a triple-combination antihypertensive marketed globally, combining an angiotensin II receptor blocker (olmesartan medoxomil), a thiazide diuretic (hydrochlorothiazide), and a calcium channel blocker (amlodipine). The combination targets three distinct pathways in blood pressure regulation: ARB-mediated vasodilation and sodium retention reduction, thiazide-induced natriuresis and vasodilation, and calcium channel blockade-mediated vascular smooth muscle relaxation. Approved for essential hypertension in multiple markets, the triple combination is indicated for patients inadequately controlled on dual therapy or as initial therapy in those requiring aggressive BP reduction. Clinical differentiation centers on complementary mechanisms reducing adverse effects of monotherapy while achieving superior BP control; major Phase 3 trials (N=2,204–2,689) demonstrated efficacy in resistant hypertension. Commercial significance is substantial given the large hypertension patient population globally; the combination is marketed under brands including Sevikar HCT (Daiichi Sankyo). Pipeline development includes formulation optimization and investigation in stroke prevention and resistant hypertension populations.
At a glance
| Generic name | olmesartan, hydrochlorothiazide, amlodipine |
|---|---|
| Also known as | Renin guided selection of treatment |
| Sponsor | The Louis & Rachel Rudin Foundation |
| Drug class | Antihypertensive combination (ARB + thiazide diuretic + calcium channel blocker) |
| Target | Angiotensin II type 1 receptor (AT1R), sodium-chloride cotransporter (NCC), L-type calcium channel |
| Modality | Small molecule |
| Therapeutic area | Cardiovascular |
| Phase | FDA-approved |
Mechanism of action
Olmesartan is an angiotensin II receptor blocker (ARB) that prevents vasoconstriction and aldosterone release. Hydrochlorothiazide is a thiazide diuretic that reduces blood volume and sodium levels. Amlodipine is a calcium channel blocker that directly relaxes vascular smooth muscle. Together, these agents provide synergistic blood pressure reduction through distinct pathways.
Approved indications
- Hypertension (high blood pressure)
Common side effects
- Dizziness
- Fatigue
- Headache
- Peripheral edema
- Hyperkalemia (with ARB component)
- Hypokalemia (with diuretic component)
- Hyperuricemia
Competitive intelligence
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