Action and Spectrum

Mechanism of action

The combination of eprosartan and hydrochlorothiazide is used to treat hypertension in patients without adequate blood pressure control with either drug alone. The combination of these two drugs works by lowering blood pressure through different mechanisms of action, which results in a more significant reduction in blood pressure than either drug alone

Spectrum

The spectrum of activity of this combination is primarily limited to the treatment of hypertension

Drug Interaction

Adverse Reaction

Frequency defined:

1-10%

Back pain (3%)

Decreased neutrophil count (1%)

Increased BUN (1%)

Eporsartan

Cough (4%)

Fatigue (2%)

Urinary tract infection (1%)

Rhinitis (4%)

Pharyngitis (4%)

Upper respiratory tract infections (8%)

Abdominal pain (2%)

Hypertriglyceridemia (1%)

Depression (1%)

Cough (4%)

Viral infection (2%)

Frequency undefined:

Hydrochlorothiazide

Epigastric distress

Orthostatic hypotension

Anaphylaxis

Confusion

Steven Johnson syndrome

Dizziness

Hyperuricemia

Anorexia

Hypotension

Photosensitivity

Anemia

Erythema multiforme

Hypokalemia

Headache

Black Box Warning

Black box warning

Drugs that immediately affect the renin-angiotensin system can harm or even kill a growing baby. If pregnancy is found, stop taking the medication as soon as possible

Contraindication / Caution

Contraindications

• Allergy: eprosartan and hydrochlorothiazide should not be used in individuals who are allergic to either medication or any of its components
• Anuria: eprosartan and hydrochlorothiazide are contraindicated in individuals with anuria (absence of urine production)
• Severe renal impairment: eprosartan and hydrochlorothiazide are not recommended for individuals with severe renal impairment
• Hepatic impairment: eprosartan and hydrochlorothiazide should be used with caution in individuals with hepatic impairment
• Pregnancy: eprosartan and hydrochlorothiazide should not be used during pregnancy as they may harm the developing fetus
• Breastfeeding: eprosartan and hydrochlorothiazide should not be used while breastfeeding as they may be excreted in breast milk and may harm the infant
• Hypercalcemia: eprosartan and hydrochlorothiazide are contraindicated in individuals with hypercalcemia (high calcium levels in the blood)
• Hypokalemia: eprosartan and hydrochlorothiazide should be used with caution in individuals with hypokalemia (low potassium levels in the blood)

Caution

Some cautions of eprosartan and hydrochlorothiazide include:

• Pregnancy: eprosartan and hydrochlorothiazide should not be used during pregnancy as they may harm the developing fetus
• Kidney function: eprosartan and hydrochlorothiazide can reduce kidney function, especially in people with pre-existing kidney problems
• Liver function: eprosartan can cause liver damage in rare cases, so people with pre-existing liver problems should be monitored closely
• Low blood pressure: Both eprosartan and hydrochlorothiazide can cause low blood pressure, especially in people who are dehydrated or have a low blood volume
• Electrolyte imbalances: hydrochlorothiazide can cause electrolyte imbalances, such as low levels of potassium or sodium, which can lead to muscle weakness or cramping, irregular heartbeat, and other complications
• Drug interactions: eprosartan and hydrochlorothiazide can interact with other medications, including non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, and certain antidepressants

Pregnancy / Lactation

Pregnancy consideration:

It should not be used during pregnancy as they may harm the developing fetus

Lactation:

It should not be used while breastfeeding as it may be excreted in breast milk and may harm the infant

Pregnancy category:

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology

The combination of eprosartan and hydrochlorothiazide can effectively manage hypertension because they work through different mechanisms to lower blood pressure. By widening blood vessels and reducing fluid in the body, they can help to lower blood pressure and reduce the risk of complications associated with high blood pressure

Pharmacodynamics

When eprosartan and hydrochlorothiazide are used together, they work through different mechanisms to lower blood pressure. eprosartan blocks the AT1 receptor to widen blood vessels, while hydrochlorothiazide reduces the fluid volume in the body through increased urine production. This combination can lead to a more significant reduction in blood pressure than either medication alone

Pharmacokinetics

Absorption

eprosartan and hydrochlorothiazide are well absorbed after oral administration, with peak plasma concentrations reached within 1-2 hours. is rapidly absorbed after oral administration, with peak plasma concentrations reached within 1-2 hours

Distribution

eprosartan is highly protein-bound (approximately 98%) and distributes mainly in the plasma. hydrochlorothiazide is widely distributed throughout the body and is moderately protein-bound (approximately 40-70%).

Metabolism

It undergoes minimal metabolism and is primarily eliminated unchanged in the urine and feces

Elimination/Excretion

The elimination half-life of eprosartan is approximately 5-9 hours, and the kidneys primarily eliminate it. The elimination half-life of hydrochlorothiazide is approximately 6-15 hours, and the kidneys primarily eliminate it

Adminstartion

Administration

The recommended starting dose of eprosartan/hydrochlorothiazide combination products is one tablet or capsule once daily, which may be increased based on blood pressure response

Patient Information Leaflet

Patient information leaflet

Generic Name: eprosartan/hydrochlorothiazide

Why do we use eprosartan/hydrochlorothiazide?

eprosartan and hydrochlorothiazide are used in combination to treat high blood pressure (hypertension) in adults