Tribenzor is a combination blood pressure medication containing three active ingredients: olmesartan (an angiotensin II receptor blocker (ARB)), amlodipine (a calcium channel blocker), and hydrochlorothiazide (a diuretic (water pill)). It's used to treat high blood pressure in adults who've already taken blood pressure medication before. As a tablet that's taken by mouth once a day, the dosage depends on your previous treatments. The medication is available as brand name and generic versions. Common side effects include dizziness and swelling in arms and legs.
High blood pressure in adults
Tribenzor is a combination of three medications that work together to lower blood pressure.
Olmesartan is an angiotensin II receptor blocker (ARB). It lowers blood pressure by blocking angiotensin II. This is a hormone that typically causes your blood vessels to become more narrow, which raises your blood pressure.
Amlodipine is a calcium channel blocker (CCB). It relaxes your blood vessels to lower your blood pressure.
Hydrochlorothiazide is a thiazide diuretic (water pill). It works in your kidneys to remove extra water and certain electrolytes, like sodium and potassium, from your body. This reduces the fluid in your blood vessels, helping to lower blood pressure.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bloating or swelling of the face, arms, hands, lower legs, or feet
rapid weight gain
tingling of the hands or feet
unusual weight gain or loss
Less common
Bladder pain
bloody or cloudy urine
body aches or pain
difficult, burning, or painful urination
difficulty with breathing
fainting
frequent urge to urinate
headache
loss of voice
lower back or side pain
swelling of the joints
unusual tiredness or weakness
Incidence not known
Persistent non-healing sore
pink growth
reddish patch or irritated area
shiny bump
white, yellow or waxy scar-like area
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Conveniently combines three medications in a single pill
Can be taken with or without food
Taken by mouth once a day
Not for people who've never taken blood pressure medications before
Not safe to take while pregnant or breastfeeding
Can cause dizziness and swelling
Mark your calendar for appointments and blood work while taking Tribenzor. Your care team will order tests like potassium, kidney function, and blood pressure during treatment. They might also change your dose based on the lab results.
Take Tribenzor with or without food. If it hurts your stomach, taking it with food might help.
You can take Tribenzor at any time of day. But since it contains hydrochlorothiazide, which can make you urinate more often, you might prefer taking it in the morning or early afternoon to avoid waking up at night. It's best to take Tribenzor at the same time every day.
It's important to take Tribenzor every day as prescribed. Managing your blood pressure helps prevent severe and life-threatening health problems, such as heart attack, stroke, and heart failure.
Check your blood pressure regularly at home to track how well Tribenzor is working. Record your readings and share them with your prescriber.
Don't change your Tribenzor dose or stop it suddenly without talking to your prescriber. Doing so can cause your blood pressure to rise quickly.
Olmesartan, amlodipine, and hydrochlorothiazide interact with many medications. Make sure to tell your care team about all of the medications you're taking before and during treatment.
You might feel dizzy when you start taking Tribenzor and when your provider raises your dose. This side effect should lessen over time as you continue taking the medication and your body gets used to your new blood pressure. But if you faint, stop taking this medication and tell your prescriber right away.
Before going outside, apply sunscreen and wear clothing to protect your skin from the sun. The hydrochlorothiazide in Tribenzor can make your skin more sensitive to sunlight, so it’s important to protect your skin when outdoors.
Try to limit foods high in potassium and potassium-containing salt substitutes. Eating them with Tribenzor might cause high potassium, which can lead to nausea, vomiting, or muscle weakness.
Tribenzor can cause severe harm to an unborn baby if taken during pregnancy. Let your care team know if you're pregnant or thinking of becoming pregnant, they might recommend a safer medication.
It's generally not recommended that you breastfeed during treatment with Tribenzor. Animal studies show that the medication can pass into breast milk, though it's not clear how this might affect the nursing baby. To be safe, speak to your prescriber about alternatives to breastfeeding or safer blood pressure medications you can take during this time.
Tribenzor can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking high doses of diuretic medications | History of narrow heart valves (aortic or mitral stenosis)
Sometimes, taking Tribenzor can cause your blood pressure to drop too much, which can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start this medication or when the dose is raised. It also might be more likely to happen if you're dehydrated or if you're taking a high dose of a diuretic. Make sure to stay well hydrated to avoid having blood pressure that's too low. Sit down slowly while holding onto something if you feel dizzy from low blood pressure. Let your care team know if your blood pressure drops too much. Get medical help immediately if you fall and hit your head.
Risk factors: Severe coronary artery disease
Although rare, it's possible for some people to have worsening chest pain or a heart attack while taking Tribenzor. The risk is higher when you first start this medication or when your dose is raised. Your risk is also higher if you have a heart condition called coronary artery disease (CAD). Get medical help right away if you have chest pain, pressure in the chest, heartburn, dizziness, or trouble breathing.
Risk factors: Heart failure | Certain kidney problems | Taking other medications that can cause kidney damage
Although ARBs like olmesartan in Tribenzor can protect the kidneys, they can sometimes affect kidney function and cause them to not work as well. This can happen to anyone. But the effects can be more serious in people with severe heart failure, people with certain kidney problems, or people who take medications that can worsen kidney function. Let your prescriber know if you're having problems with urination, as this could be a sign that your kidneys aren't working as well.
Risk factors: Taking other medications that can change electrolyte, blood sugar, or cholesterol levels
Tribenzor can affect the level of certain electrolytes, including sodium, potassium, and magnesium in your body. It can also change your blood sugar levels and raise the cholesterol and triglycerides levels.
You might need regular blood tests done while taking Tribenzor to check that your electrolyte, blood sugar, and cholesterol levels are normal. Let your care team know about all the medications you're taking because some of them can cause similar changes. Tell your care team if you experience an irregular heartbeat, weakness, low energy, muscle weakness or cramps, reduced urination, nausea, or vomiting. These can be signs of electrolyte imbalances.
Risk factors: History of lupus
Risk factors: Sulfa or penicillin allergies
Although rare, some people experience vision changes or eye pain within hours or weeks of starting taking hydrochlorothiazide, an ingredient in Tribenzor. Tell your prescriber right away about any vision changes and stop taking Tribenzor, as untreated symptoms could lead to permanent vision loss.
Rarely, people who take olmesartan experience serious diarrhea called sprue-like enteropathy. Sometimes, this happens months to years after starting the medication. In severe cases, the diarrhea can lead to weight loss, stomach pain, tiredness, nausea, and vomiting. If you experience severe diarrhea that doesn't seem to get better after a few days after taking Tribenzor, get medical help right away. Make sure to stay hydrated with fluids and electrolytes.
Adults: The typical dose, which depends on your previous blood pressure medication, is taken by mouth once per day. Your prescriber might adjust your dose after 2 weeks. The maximum dose is 40 mg/10 mg/25 mg (olmesartan/amlodipine/hydrochlorothiazide) once per day.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Unable to urinate
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Cosette Pharmaceuticals, Inc. (2023). TRIBENZOR- olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide tablet, film coated [package insert]. DailyMed.
Dezsi, C.A. (2016). The Different Therapeutic Choices with ARBs. Which One to Give? When? Why? American Journal of Cardiovascular Drugs.
Torrent Pharmaceuticals Limited. (2023). OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE [package insert]. DailyMed.
U.S. Food and Drug Administration. (2016). FDA drug safety communication: FDA approves label changes to include intestinal problems (sprue-like enteropathy) linked to blood pressure medicine olmesartan medoxomil.
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