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Tribenzor 40mg/5mg/12.5mg Tablet
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Indications & Clinical Uses
- Tribenzor 40 mg/5 mg/12.5 mg (olmesartan medoxomil, amlodipine and hydrochlorothiazide) tablets combine an angiotensin II receptor blocker, a calcium channel blocker and a thiazide diuretic in one tablet to treat high blood pressure (hypertension) in adults.
- It is approved for patients whose blood pressure is not adequately controlled on two of these three drug classes, or as a replacement for the same three components already being taken separately; Tribenzor is not indicated as first-line, initial therapy for hypertension.
- It is taken once daily by mouth, with or without food, and lowers blood pressure to reduce the risk of stroke and heart attack, though it does not treat the underlying cause of high blood pressure.
- Tribenzor is not approved for heart failure or for kidney protection outside its blood-pressure-lowering effect, and different strength combinations of the same three ingredients exist, so the exact 40/5/12.5 mg strength must be checked against the prescription.
Side Effects
- Tribenzor carries a boxed warning: drugs that act on the renin-angiotensin system, including the olmesartan component, can cause injury and death to a developing fetus, so Tribenzor must be stopped as soon as pregnancy is detected.
- Commonly reported effects, each in 2 percent or more of patients, include dizziness, swelling of the legs or ankles (peripheral oedema), headache, tiredness, common cold-like symptoms, muscle spasms, nausea, upper respiratory infection, diarrhoea, urinary tract infection and joint swelling.
- Report urgently any signs of a severe allergic reaction, a fast or irregular heartbeat, severe dizziness or fainting (which can mean blood pressure has dropped too low), unusual muscle weakness or cramping (possible low potassium from the diuretic), or reduced urine output, which can signal kidney problems.
- Photosensitivity (increased sunburn risk) has also been reported with the thiazide component.
Precautions & Warnings
- Tribenzor must be stopped immediately if pregnancy is confirmed, and it should not be used while breastfeeding.
- It is not recommended in patients with severe kidney impairment or significant liver disease, and kidney function, electrolytes (especially potassium and sodium) and blood pressure are monitored periodically, particularly after starting or adjusting the dose or in people also taking diuretics.
- Excessive drops in blood pressure can occur in people who are already volume- or salt-depleted, so this is corrected before starting treatment.
- Tribenzor is not for initial (first-line) therapy for hypertension.
- Caution is needed in diabetes, gout or lupus, which can be affected by the thiazide component, and in liver impairment, which can be worsened by amlodipine.
- Avoid strenuous activity in hot weather without adequate fluids, since the diuretic component increases dehydration risk.
- Discuss driving only if you feel dizzy or unusually tired after starting or changing the dose.
Avoid Interactions
- Do not combine Tribenzor with other medicines that block the renin-angiotensin system, such as ACE inhibitors or aliskiren, especially in people with diabetes or kidney impairment, because of an increased risk of low blood pressure, high potassium and kidney problems; combining an ARB with aliskiren in diabetes is specifically avoided.
- NSAIDs, including over-the-counter ibuprofen, can reduce Tribenzor's blood-pressure-lowering effect and worsen kidney function, particularly in older adults or those who are dehydrated.
- Lithium levels can rise to toxic levels with the hydrochlorothiazide component and are not usually combined without close monitoring.
- Taking simvastatin with Tribenzor's amlodipine component raises the risk of muscle toxicity, so the simvastatin dose is generally limited.
- Potassium supplements, potassium-sparing diuretics and salt substitutes can raise potassium too high when combined with the olmesartan component.
- Tell your healthcare provider about every medicine, including supplements, you take.
References
Frequently Asked Questions
Tribenzor (olmesartan, amlodipine and hydrochlorothiazide) treats high blood pressure in adults whose pressure is not controlled on two of these three drug types alone. It combines an ARB, a calcium channel blocker and a diuretic in one daily tablet. It is not used as first-line hypertension therapy.
Tribenzor is taken by mouth once a day, with or without food, at about the same time each day. Do not stop it suddenly without medical advice, since blood pressure can rise again. Several strength combinations exist, so always confirm your exact 40/5/12.5 mg dose.
Common effects include dizziness, ankle or leg swelling, headache, tiredness and muscle spasms. Tribenzor carries a boxed warning for harm to an unborn baby, so it must be stopped as soon as pregnancy is confirmed. Report irregular heartbeat, severe dizziness or reduced urination promptly.
Avoid combining Tribenzor with ACE inhibitors or aliskiren, which raises the risk of low blood pressure and high potassium. NSAIDs like ibuprofen can blunt its blood-pressure effect. Limit simvastatin doses with it, and avoid potassium supplements or salt substitutes without checking with your provider first.
Your healthcare provider checks blood pressure, kidney function and blood potassium and sodium periodically, especially after starting or changing your dose. This helps catch dehydration, low potassium or reduced kidney function early, which are more likely if you are also taking other diuretics or become unwell with vomiting or diarrhoea.
No. Tribenzor carries a boxed warning because drugs acting on the renin-angiotensin system, including its olmesartan component, can injure or kill a developing fetus. Stop Tribenzor as soon as pregnancy is confirmed and discuss alternative blood pressure treatment with your provider straight away.

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