Eprosartan/Hydrochlorothiazide

DEA Class; Rx

Common Brand Names; Teveten HCT, Teveten Plus

• ARB/HCTZ Combos

Angiotensin II antagonist and thiazide diuretic used together for management of HTN; additive efficacy; less potassium loss compared to diuretic monotherapy.

Indicated for the treatment of hypertension in patients who do not respond to monotherapy.

Hypersensitivity to eprosartan, hydrochlorothiazide, or sulfonamides

Pregnancy (2nd/3rd trimesters): Significant risk of fetal/neonatal morbidity and mortality

Anuria

Do not coadminister with aliskiren in patients with diabetes mellitus

Adverse reactions with combination products and individual agents

Decreased neutrophil count (1%)

Back pain (3%)

Increased BUN (1%)

Eprosartan

• Upper respiratory infection (8%)
• Cough (4%)
• Abdominal pain (2%)
• Fatigue (2%)
• Hypertriglyceridemia (1%)
• Urinary tract infection (1%)
• Depression (1%)
• Rhinitis (4%)
• Cough (4%)
• Pharyngitis (4%)
• Viral infection (2%)

Hydrochlorothiazide

• Anorexia
• Epigastric distress
• Hypotension
• Orthostatic hypotension
• Photosensitivity
• Anaphylaxis
• Anemia
• Confusion
• Erythema multiforme
• Stevens-Johnson syndrome
• Exfoliative dermatitis including toxic epidermal necrolysis
• Dizziness
• Hypokalemia and/or hypomagnesemia
• Hyperuricemia
• Headache

Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

Not for initial treatment

Electrolyte disturbances may occur

Hyperkalemia, particularly when coadministered with potassium-sparing diuretics, potassium supplements, or salt substitutes; concurrent therapy with hydrochlorothiazide may reduce the frequency of this effect

Photosensitivity may occur

Hypotension may occur in patients who are salt or volume depleted (correct the volume depletion especially in patients receiving high dose diuretics)

Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for renal function changes (including acute renal failure) compared to monotherapy

Caution in aortic mitral stenosis, hepatic impairment, hypercholesterolemia, hypercalcemia, parathyroid disease, pre-existing renal insufficiency, systemic lupus erythematosus, bilateral renal artery stenosis or anuria

Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides

Thiazides may decrease urinary calcium excretion

Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters)

Lactation: excretion in milk unknown/not recommended