Aliskiren, Amlodipine, and Hydrochlorothiazide (Oral)

Aliskiren, amlodipine, and hydrochlorothiazide is a compound medication used to treat high blood pressure by relaxing your blood vessels and removing excess water from your body.

Overview

Aliskiren, amlodipine, and hydrochlorothiazide are three medications that are often prescribed together to treat hypertension, or high blood pressure. This combination is usually prescribed in a single compound medication that includes appropriate amounts of all three substances. It is often sold in the United States under the brand name of Amturnide.

Hypertension, or high blood pressure, adds to the stress and workload of the arteries and heart. This extra workload on your circulatory system can cause premature damage to your body, causing your heart and arteries to not function correctly. This can lead to damage in blood vessels in your organs, including your heart, brain, and kidneys, which can lead to organ failures such as heart or kidney failure, or a stroke. Lowering your blood pressure will reduce your risk of organ failure, strokes, heart attacks, and many other conditions.

Your doctor may prescribe the compound of aliskiren, amlodipine, and hydrochlorothiazide for other health conditions that these medications may treat. Conditions that this compound has shown to have effects on include angina or acute chest pain, heart failure or other heart malfunction conditions, diabetic kidney disease, or other related or similar conditions.

Each medication used in the compound of aliskiren, amlodipine, and hydrochlorothiazide has a function of its own. These substances work together to treat multiple symptoms of high blood pressure.

Aliskiren

Aliskiren is a renin inhibitor. It is used to block enzymes that cause your blood vessels to contract, which leads to vasoconstriction and high blood pressure. With a proper dosage of Aliskiren, your blood vessels are able to relax and widen to allow more efficient transport of blood and oxygen to the heart, brain, and other organs.

Amlodipine

Amlodipine is a calcium channel blocker, and works by inhibiting the movement of calcium ions into heart and artery cells. This helps the blood vessels relax and ameliorates the effects of excessive constriction, allowing blood to flow more freely through the veins and to the heart while reducing the workload of the heart.

Hydrochlorothiazide

Hydrochlorothiazide is a diuretic or water pill, used to reduce the amount of excess water in the body by increasing urine production and flow. This helps reduce blood pressure as well. This medication is in the thiazide class, which works by decreasing the ability of the kidneys to retain water. It can also increase the reabsorption of calcium in the body.

Conditions treated

  • High blood pressure
  • Hypertension

Type of Medicine

  • Compound medication
  • Direct renin inhibitor
  • Calcium channel blocker
  • Diuretic
  • Thiazide medication

Side Effects

Like all medications, the compound of aliskiren, amlodipine, and hydrochlorothiazide can produce unwanted physical effects in your body in addition to the needed therapeutic effects. Some of these side effects are common and may not have long-term or acute effects on the body, while others are more serious and can cause physical damage, or may be symptoms of underlying conditions that can be dangerous or fatal. Always report all side effects to your physician.

Mild Side Effects

The compound of aliskiren, amlodipine, and hydrochlorothiazide can cause unwanted side effects that may cause inconvenience or discomfort. These side effects are normally a result of your body adjusting to the new medication, and may subside over the course of the treatment. If these side effects become too bothersome or interfere with your life, your doctor may be able to help you find ways to reduce or manage these effects.

Aliskiren, amlodipine, and hydrochlorothiazide may cause stomach discomfort or pain in some patients, indigestion or stomach upset, or a feeling of acid or sour stomach. You may experience symptoms of a cold such as a sore throat, or a runny or stuffy nose. Other mild side effects may include elevated body temperature or fever, headaches, some muscle aches, and lack or loss of physical strength.

Serious Side Effects

In some cases, the compound of aliskiren, amlodipine, and hydrochlorothiazide can trigger side effects that can be dangerous to your health, or that may be symptoms of more serious health problems triggered by the interaction of this medication with your body. If any of these side effects occur, contact your doctor immediately and seek medical attention as soon as possible.

Some side effects that need immediate medical attention include rapid weight gain, or unusual patterns of weight gain or weight loss. If you experience edema, or bloating or swelling of the extremities such as your face, arms and hands, lower legs or feet, contact your doctor. You may experience tingling of the hands or feet, along with unusual sweating and blurred vision. You may experience a feeling of faintness, lightheadedness, or dizziness when getting up suddenly from a lying or sitting position, as well as dizziness during the course of the day. If you feel unusually tired or weak, or experience sudden confusion, contact a doctor. Some patients may find large skin swellings that resemble hives on their extremities, such as the face, eyelids, lips, tongue, and throat, the arms and hands, legs and feet, or sex organs.

Side Effects of Aliskiren

Patients taking any medication with aliskiren as part of the ingredients may suffer some side effects of aliskiren. Many of these side effects are a result of your body getting used to the medication. You may experience gastrointestinal symptoms such as sour stomach, mild abdominal cramps, indigestion, nausea, or diarrhea. You may also experience coughing, headaches, and mild dizziness.

Some patients experience angioedema, which is a swelling of the lower layer of skin and tissue underneath some of your mucous membranes. This may include symptoms like swelling of the mouth, throat, and face, painful or itchy skin in these areas, slight numbness of the skin in affected areas, and hives. If you experience any of these symptoms, contact your doctor. More serious symptoms of angioedema may include medical intervention, such as constriction of the airways, which shows itself as wheezing, gasping, dizziness, and shortness of breath.

Side Effects of Amlodipine

Amlodipine can have side effects when taken with other ingredients in a compound medication. Some common side effects of Amlodipine include stomach pain, nausea, edema or swelling in the legs or ankles, tremors or other abnormal muscle movements, arrhythmia (an irregular heart rate), heart palpitations or a very fast or pounding heart rate, dizziness, and tiredness or unusual sleepiness. These effects can be mild and often go away in a few weeks as your body adjusts to the medication. If they are severe or do not go away after a few weeks, talk to your prescribing doctor or pharmacist about possible drug interactions, alternatives, or treatments for these symptoms. Serious side effects include low blood pressure, which can manifest as lightheadedness, severe dizziness, or fainting. Patients who begin taking medications with amlodipine or who increase a dosage of amlodipine may experience increased chest pain or may have a heart attack. Symptoms of a heart attack include nausea, lightheadedness, pain or discomfort in the chest, pain or discomfort in the upper body, sudden cold sweating, unusual tiredness, and shortness of breath. If you experience these symptoms shortly after beginning or increasing your dose of a medication with amlodipine, seek medical assistance immediately.

Side Effects of Hydrochlorothiazide

Hydrochlorothiazide can have unwanted side effects in addition to its therapeutic side effects when taken as part of a medication. Some mild side effects of hydrochlorothiazide include nausea, headaches, and weight gain. You may also experience photosensitivity, or sensitivity to light, which can manifest as a rash or sunburn when out in the sun. If you experience these side effects of hydrochlorothiazide, inform your doctor. Your doctor may be able to suggest treatments for these symptoms.

Hydrochlorothiazide can cause side effects in some patients which can be more serious and require medical treatment. Some patients show signs of hypokalemia, or a low level of potassium in the blood. Patients experiencing this may have leg cramps, constipation, or an abnormal heart rhythm, or feel excessively tired or weak. You may experience symptoms of hyperglycemia, which can manifest in dry mouth and excessive thirst, a highly increased volume of urination, excessive hunger, blurred vision, fatigue, and tingling in the heels or feet. You may also experience pancreatitis, which can manifest in a burning pain that radiates to your back, severe upper abdominal pain, and nausea to the point of vomiting, which may become worse upon eating. You may experience symptoms of gout, such as a swollen, red, tender, and hot-feeling joint, particularly in the base of the big toe, heels, knees, wrists, and fingers. If you experience these symptoms, seek medical attention immediately.

Dosage

Dosage information for aliskiren, amlodipine, and hydrochlorothiazide is a standard provided by the manufacturer. Your dosage and the intervals at which you take your medication may be different than the standard as determined by your doctor according to your treatment and needs. Always follow your doctor's directions regarding dosage, and do not change your dosage unless you consult with your doctor.

Aliskiren, amlodipine, and hydrochlorothiazide is available in tablet form in tablets of 150/5/12.5 mg, 300/5/25 mg, 300/10/12.5 mg, and 300/10/25 mg. It is taken orally. Normal dosage is not usually more than 300 mg of aliskiren per day, 10 mg of amlodipine per day, and 25 mg of hydrochlorothiazide per day.

Aliskiren, amlodipine, and hydrochlorothiazide is normally taken once per day. Aliskiren, amlodipine, and hydrochlorothiazide should be taken at the same time every day and in the same way, either with or without food. Before you start taking aliskiren, amlodipine, and hydrochlorothiazide, consult with your doctor about setting up the right daily routine to take this medication for you. Consult your doctor if you intend to change the way you take this medication. Ingesting aliskiren, amlodipine, and hydrochlorothiazide with a meal high in fat may make it harder for your body to absorb as much of this medication as necessary.

If you miss a dose of your aliskiren, amlodipine, and hydrochlorothiazide, you should take it as soon as is possible. If it is nearly time for your next dose of aliskiren, amlodipine, and hydrochlorothiazide, and hydrochlorothiazide, avoid taking an additional dose to make up for it. Skip your missed dose and take the next dose on schedule. Double dosing of aliskiren, amlodipine, and hydrochlorothiazide can be dangerous to your health.

Major Drug Interactions

The compound of aliskiren, amlodipine, and hydrochlorothiazide has not been sufficiently tested to rule out interactions with other drugs. However, each of the active ingredients in this compound do have known interactions with other drugs. Keep a list of all medications, drugs, and supplements you are taking or take regularly with you, whether they are prescription drugs or over-the-counter substances. Your doctor or pharmacist should be able to identify any potential interactions between your aliskiren, amlodipine, and hydrochlorothiazide and any other drugs, medications, or supplements you may take.

Aliskiren Interactions

When taking this medication, you should not take angiotension receptor blockers such as cyclosporine or itraconazole. Medications with ACE inhibitors such as benazepril, captopril, fosinopril, perindopril, quinapril, ramipril, moexipril, lisinopril, enalapril, or trandolapril may aggravate or trigger serious side effects of medication containing aliskiren. Patients taking furosemide and aliskiren medications should be monitored. NSAIDs such as aspirin, ibuprofen, or naproxen may have a negative effect on renal function in some patients taking medications with aliskiren.

Amlodipine

When taking this medication, you should limit your dose of simvastatin to 20 mg daily to avoid unwanted effects. Patients taking CYP3A4 inhibitors should be monitored for symptoms of hypotension, which can manifest as dizziness or fainting, and edema, which can manifest as swelling in the extremities. Patients taking CYP3A4 inducers should have their blood pressure monitored.

Hydrochlorothiazide

Hydrochlorothiazide may heighten the risk of lithium toxicity. Patients who take lithium medications or medication with lithium derivatives will need blood checks on a regular basis to prevent lithium poisoning. When taking this medication, your doctor may need to adjust your dosage of anti-diabetic drugs such as insulin. NSAIDs and COX-2 selective agents can block the effect of thiazide diuretics, so patients taking these medications will need to be monitored to see if the diuretic is affecting the body correctly.

Taking hydrochlorothiazide at least 4 hours before or after the administration of ion-exchange medications may help minimize unwanted interaction with medications containing hydrochlorothiazide. Patients using medications with ion-exchange resins, i.e. cholestyramine or colestipol, may wish to discuss the scheduling of their dosage with their doctor.

Warnings

Blood and Urine Tests

Aliskiren, amlodipine, and hydrochlorothiazide can cause health conditions that may not have obvious physical side effects or symptoms. These conditions include hyperuricemia, or high levels of uric acid in your blood, as well as hyperlipidemia, high levels of cholesterol and triglycerides in your blood. Regular blood tests are necessary in patients taking aliskiren, amlodipine, and hydrochlorothiazide. These will help detect any potential problems in the bloodstream as well as monitoring the effects of your medication.

Pregnancy Warning

Aliskiren, amlodipine, and hydrochlorothiazide have been shown to increase the risk of birth defects and fetal or neo-natal death in patients carrying fetuses. Use of aliskiren while pregnant has been shown to cause increased prolonged gestation and labor in animals, and increased intrauterine deaths. Use of this medication during the third and second trimesters of a pregnancy can cause reduced fetal renal function and possible renal failure, fetal skeletal and skull deformations, fetal lung hypoplasia or malformation in tissue, hypotension, and death. Some elements of this medication can also be excreted into human breast milk. Patients who are pregnant or plan to become pregnant in the near future should discuss the use of aliskiren, amlodipine, and hydrochlorothiazide with their doctor before starting a regimen. Aliskiren, amlodipine, and hydrochlorothiazide is not recommended for use by pregnant patients unless no alternatives are possible and the benefit to the parent outweighs the risk to the fetus.

Dizziness

After the first dose of aliskiren, amlodipine, and hydrochlorothiazide, you may experience dizziness or a lightheaded feeling, or you may faint. This may be magnified if you have also been taking a diuretic or water pill. Take your first dose when you do not have to drive, use machines, or perform other tasks that may be dangerous if you are impaired. Be sure that you know how you react to your regular dose of this medication before you are ready to perform these tasks. If you begin to feel dizzy during the course of the day, lie down so you don't faint or lose consciousness, then sit briefly before standing to help prevent further dizziness. If you faint or lose consciousness, contact your doctor immediately and seek medical assistance.

Dehydration

Some side effects of aliskiren, amlodipine, and hydrochlorothiazide such as severe or continuing nausea, vomiting, or diarrhea can cause you to lose too much water in the body, which can lead to low blood pressure. Check with your doctor if you become sick with any of these symptoms while taking this medicine. Sweating can also cause loss of water while taking this medicine, which can lead to these effects. If you exercise or go out in hot weather while you take this medicine, be sure to drink plenty of water and stay hydrated to avoid low blood pressure.

Storage

Aliskiren, amlodipine, and hydrochlorothiazide tablets are shaped like ovals, unscored, and coated in film. They may be violet, white, light pink, pale orange-brown, light red, or brown. These tablets should be stored in their original container, away from excessive heat and moisture. The ideal temperature for storage of aliskiren, amlodipine, and hydrochlorothiazide tablets is 77ºF. Tablets should be stored at room temperature, not colder than 59ºF or warmer than 86ºF.

Summary

Aliskiren, amlodipine, and hydrochlorothiazide is a compound medication usually prescribed to treat high blood pressure, or hypertension, among other conditions. It is available in tablet form and is taken once per day in amounts no more than 300 mg of aliskiren, 10 mg of amlodipine, and 25 mg of hydrochlorothiazide. It needs to be taken at the same time and in the same way per day, whether or not you take it with food.

Aliskiren is a renin inhibitor, which helps your blood vessels relax and allows more efficient transport of blood and oxygen to the heart and other organs. Amlodipine is a calcium channel blocker, which helps the blood vessels relax and reduces stress and workload on your heart. Hydrochlorothiazide is a diuretic or water pill, which helps reduce the amount of excess water in the body.

Aliskiren, amlodipine, and hydrochlorothiazide can induce unwanted side effects in the body. Mild side effects that do not necessarily need medical intervention include gastrointestinal distress such as acid stomach or diarrhea, cold symptoms like a sore throat or a runny nose, fever, headaches, muscle aches, and weakness. More serious side effects include rapid weight gain or weight loss, unusual sweating, or blurred vision. You may experience edema or swelling of the extremities, dizziness, tingling in the extremities, or confusion. Some patients may find hive-like swellings on the face, arms or legs, or genitals.

Patients using aliskiren, amlodipine, and hydrochlorothiazide will need regular blood and urine tests to ensure that the medication is having the desired effect, and to keep track of any potential health problems such as hyperuricemia or hyperlipidemia that may not show obvious symptoms. It is crucial to stay hydrated while taking this medication.

Resources
Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018
Content Source: