amturnide

Amturnide contains a combination of aliskiren, amlodipine, and hydrochlorothiazide. Aliskiren is an anti-hypertensive (blood pressure lowering) medication. It works by decreasing substances in the body that narrow blood vessels and raise blood pressure.

Amlodipine is in a group of drugs called calcium channel blockers. Amlodipine relaxes (widens) blood vessels and improves blood flow.

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Amturnide is used to treat high blood pressure (hypertension). This medicine is usually given after other blood pressure medications have been tried without successful treatment of symptoms.

Amturnide may also be used for purposes not listed in this medication guide.

Important information

You should not use Amturnide if you are unable to urinate, or if you are allergic to sulfa drugs.

Do not use Amturnide if you are pregnant. Stop using and tell your doctor right away if you become pregnant.

If you have diabetes, you should not use this medicine together with certain heart or blood pressure medicines (such as Accupril, Benicar, Capoten, Cozaar, Diovan, Lotensin, Mavik, Prinivil, Vasotec, and many others).

Before you take Amturnide, tell your doctor if you have kidney or liver disease, glaucoma, lupus, asthma, congestive heart failure, angina (chest pain), coronary artery disease, an electrolyte imbalance (such as low potassium or magnesium), a penicillin allergy, if you are on a low-salt diet, or if you have ever had an allergic reaction to a blood pressure medication.

Your chest pain may become worse when you first start taking Amturnide or when your dose is increased. Call your doctor if your chest pain is severe or ongoing.

Before taking this medicine

You should not take Amturnide if you are allergic to aliskiren, amlodipine, or hydrochlorothiazide, or if:

• you are unable to urinate; or

• you are allergic to sulfa drugs.

If you have diabetes, you should not use Amturnide together with certain heart or blood pressure medicines, such as:

• azilsartan (Edarbi, Edarbyclor), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, Avalide), losartan (Cozaar, Hyzaar), olmesartan (Azar, Benicar), valsartan (Diovan, Exforge, Tribenzor), telmisartan (Micardis); or

• benazepril (Lotensin), captopril (Capoten, Capozide), enalapril (Vasotec, Vasoretic), fosinopril (Monopril), lisinopril (Prinivil, Zestoretic, Zestril), moexipril (Uniretic, Univasc), perindopril (Aceon), quinapril (Accupril, Accuretic), ramipril (Altace), or trandolapril (Mavik, Tarka).

You may also need to avoid taking these medicines with Amturnide if you have kidney disease.

To make sure Amturnide is safe for you, tell your doctor if you have:

• kidney disease (or if you are on dialysis);

• liver disease;

• heart disease or prior heart attack;

• coronary artery disease (hardened arteries);

• glaucoma;

• asthma or allergies;

• gout;

• systemic lupus erythematosus (SLE);

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

• if you are on a low-salt diet; or

• if you have ever had an allergic reaction to penicillin or a blood pressure medication.

FDA pregnancy category D. Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Amturnide can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether this medicine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Do not give Amturnide to anyone under 18 years old without medical advice.

How should I take Amturnide?

Take Amturnide exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you feel very dizzy.

Your blood pressure will need to be checked often.

If you need surgery or medical tests, tell the surgeon ahead of time that you are using Amturnide. You may need to stop using the medicine for a short time.

Keep using Amturnide as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store Amturnide in the original container at room temperature, away from moisture and heat.

Amturnide dosing information

Usual Adult Dose for Hypertension:

Initial dose: 1 tablet orally daily
The dosage may be increased after 2 weeks of therapy.

Maximum dose: Aliskiren/amlodipine/hydrochlorothiazide 300/10/25 mg orally daily

Comments:
-Amturnide may be substituted for patients receiving aliskiren, amlodipine, and hydrochlorothiazide from separate tablets.
-Tablets should be taken the same way each day, either with or without a meal. (High-fat meals decrease absorption of aliskiren substantially).

Usual Geriatric Dose for Hypertension:

Patients greater than or equal to 75 years of age should start amlodipine at 2.5 mg, a strength which is not available in an Amturnide tablet.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Amturnide?

Do not use potassium supplements or salt substitutes while you are taking this medicine, unless your doctor has told you to.

Avoid taking with foods that are high in fat, which can make it harder for your body to absorb aliskiren.

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of this medicine.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Amturnide side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Amturnide: hives; vomiting, severe stomach pain; dizziness, difficulty breathing; swelling of your face, lips, tongue, or throat.

Your chest pain may become worse when you first start taking the medicine or when your dose is increased. Tell your doctor if your chest pain is severe or ongoing.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• little or no urinating;

• eye pain, vision problems;

• low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;

• high potassium--slow heart rate, weak pulse, muscle weakness, tingly feeling);

• low potassium--confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling;

• lupus-like symptoms--joint pain with fever, skin sores, butterfly-shaped skin rash on your cheeks and nose, numbness or pale appearance of your fingers or toes;

• liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

• severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Amturnide side effects may include:

• swelling in your hands, ankles, or feet;

• headache, dizziness, tired feeling;

• cough;

• diarrhea; or

• cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Amturnide?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with aliskiren, amlodpine, and hydrochlorothiazide, especially:

• antifungal medicine;

• any heart or blood pressure medicines;

• a barbiturate--amobarbital, phenobarbital, secobarbital and others;

• cholesterol medicine--atorvastatin (Lipitor), simvastatin (Zocor), cholestyramine or colestipol;

• cyclosporine;

• a diuretic or "water pill";

• HIV or AIDS medicine (indinavir, ritonavir, and others);

• insulin or oral diabetes medicine;

• lithium;

• narcotic pain medicine (OxyContin, Vicodin, fentanyl, and many others);

• a potassium supplement such as K-Dur, Klor-Con;

• salt substitutes that contain potassium; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with Amturnide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.