Hydrochlorothiazide / Olmesartan Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 30, 2025.

Applies to hydrochlorothiazide / olmesartan: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Drugs that act directly on the renin-angiotensin system can cause injury or death to the developing fetus when used during pregnancy.

Stop therapy as soon as possible if pregnancy is detected.

Other side effects

Some side effects of hydrochlorothiazide / olmesartan 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:

More common side effects

• back pain
• body aches or pain
• chills
• cough
• difficulty with breathing
• ear congestion or pain
• fever
• headache
• head congestion
• hoarseness or other voice changes
• loss of voice
• runny or stuffy nose
• sneezing
• sore throat

Less common side effects

• acid or sour stomach
• belching
• difficulty with moving
• dizziness or lightheadedness
• feeling of constant movement of self or surroundings
• heartburn
• indigestion
• joint pain, stiffness, or swelling
• loss of appetite
• muscle pain or stiffness
• pain, swelling, or redness in the joints
• sensation of spinning
• stomach discomfort or upset
• weakness

Incidence not known

• diarrhea
• muscle pain or stiffness
• nervousness
• weakness or heaviness of the legs

Serious side effects

Along with its needed effects, hydrochlorothiazide/olmesartan 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 while taking hydrochlorothiazide / olmesartan:

Less common side effects

• bladder pain
• bloating or swelling of the face, arms, hands, lower legs, or feet
• bloody or cloudy urine
• blurred vision
• chest pain
• difficult, burning, or painful urination
• flushed, dry skin
• frequent urge to urinate
• fruit-like breath odor
• increased hunger
• increased urination
• joint pain, stiffness, or swelling
• lower back, side, or stomach pain
• rapid weight gain
• sweating
• swelling of the feet or lower legs
• tingling of the hands or feet
• troubled breathing
• unexplained weight loss
• unusual weight gain or loss

Rare side effects

• swelling or puffiness of the face

Incidence not known

• convulsions
• decrease in amount of urine
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• rash
• severe diarrhea with weight loss

For healthcare professionals

Applies to hydrochlorothiazide / olmesartan: oral tablet.

General adverse events

The most common side effect was dizziness.^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, headache
• Uncommon (0.1% to 1%): Syncope

Hydrochlorothiazide:

• Common (1% to 10%): Dizziness, headache
• Postmarketing reports: Lightheadedness, paresthesia

Olmesartan:

• Common (1% to 10%): Dizziness, headache^[Ref]

Respiratory

• Common (1% to 10%): Bronchitis, pharyngitis, sinusitis, upper respiratory tract infection, coughing, nasopharyngitis

Hydrochlorothiazide:

• Common (1% to 10%): Bronchitis, nasopharyngitis, pharyngitis
• Uncommon (0.1% to 1%): Sinusitis, upper respiratory tract infection, cough
• Frequency not reported: Pneumonitis, pulmonary edema

Olmesartan:

• Common (1% to 10%): Bronchitis, nasopharyngitis, sinusitis, upper respiratory tract infection, cough, pharyngitis, rhinitis^[Ref]

Other

• Common (1% to 10%): Vertigo, Influenza-like symptoms, chest pain, fatigue, peripheral edema
• Uncommon (0.1% to 1%): Weakness
• Postmarketing reports: Asthenia, lethargy, malaise

Hydrochlorothiazide:

• Common (1% to 10%): Vertigo, influenza-like symptoms
• Uncommon (0.1% to 1%): Chest pain, fatigue, peripheral edema
• Frequency not reported: Weakness, fever

Olmesartan:

• Common (1% to 10%): Vertigo, chest pain, fatigue, influenza-like symptoms, peripheral edema, pain
• Postmarketing reports: Asthenia, lethargy, malaise^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea, gastroenteritis, nausea, abdominal pain, dyspepsia
• Postmarketing reports: Sprue-like enteropathy, vomiting

Hydrochlorothiazide:

• Uncommon (0.1% to 1%): Diarrhea, dyspepsia, nausea, gastroenteritis
• Frequency not reported: Sialadenitis, cramping, gastric irritation
• Postmarketing reports: Constipation

Olmesartan:

• Common (1% to 10%): Diarrhea, dyspepsia, nausea, gastroenteritis, abdominal pain
• Postmarketing reports: Vomiting, sprue-like enteropathy^[Ref]

Musculoskeletal

• Common (1% to 10%): Back pain, creatine phosphokinase increased, arthralgia, arthritis, myalgia
• Uncommon (0.1% to 1%): Pain in limb, spinal disorder
• Postmarketing reports: Rhabdomyolysis

Hydrochlorothiazide:

• Common (1% to 10%): Arthralgia, back pain, pain in limb
• Uncommon (0.1% to 1%): Spinal disorder
• Frequency not reported: Muscle spasm

Olmesartan:

• Common (1% to 10%): Arthralgia, back pain, pain in limb, arthritis, skeletal pain, creatine phosphokinase increased
• Uncommon (0.1% to 1%): Spinal disorder, myalgia
• Postmarketing reports: Rhabdomyolysis^[Ref]

Metabolic

• Common (1% to 10%): Hyperlipemia, hyperglycemia, blood uric acid increased, hyperuricemia
• Uncommon (0.1% to 1%): Blood glucose increased, blood potassium decreased, blood potassium increased, hypertriglyceridemia
• Postmarketing reports: Hyperkalemia

Hydrochlorothiazide:

• Common (1% to 10%): Blood glucose increased, blood potassium decreased
• Uncommon (0.1% to 1%): Blood uric acid increased
• Frequency not reported: Hyperglycemia, glycosuria, hyperuricemia
• Postmarketing reports: Anorexia, loss of appetite

Olmesartan:

• Common (1% to 10%): Hypertriglyceridemia, hyperglycemia, hyperuricemia
• Uncommon (0.1% to 1%): Blood glucose increased, blood potassium decreased, blood uric acid increased
• Rare (less than 0.1%): Hyperkalemia
• Frequency not reported: Hypercholesterolemia^[Ref]

Hepatic

• Common (1% to 10%): GGT increased, AST increased, ALT increased

Hydrochlorothiazide:

• Uncommon (0.1% to 1%): ALT increased, AST increased, GGT increased
• Frequency not reported: Pancreatitis, intrahepatic cholestatic jaundice

Olmesartan:

• Common (1% to 10%): ALT increased, AST increased, GGT increased^[Ref]

Genitourinary

• Common (1% to 10%): Hematuria, urinary tract infection

Hydrochlorothiazide:

• Common (1% to 10%): Urinary tract infection

Olmesartan:

• Common (1% to 10%): Urinary tract infection, hematuria^[Ref]

Psychiatric

• Uncommon (0.1% to 1%): Anxiety, insomnia

Hydrochlorothiazide:

• Uncommon (0.1% to 1%): Anxiety, insomnia
• Frequency not reported: Restlessness
• Postmarketing reports: Sleep disturbances, depression

Olmesartan:

• Common (1% to 10%): Insomnia
• Uncommon (0.1% to 1%): Anxiety^[Ref]

Dermatologic

• Common (1% to 10%): Rash, facial edema
• Uncommon (0.1% to 1%): Eczema
• Postmarketing reports: Alopecia, pruritus, urticaria

Hydrochlorothiazide:

• Frequency not reported: Purpura, photosensitivity, urticaria, Stevens-Johnson syndrome, toxic epidermal necrolysis
• Postmarketing reports: Rash, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus, erythematosus

Olmesartan:

• Uncommon (0.1% to 1%): Rash
• Postmarketing reports: Alopecia, pruritus, urticaria^[Ref]

Immunologic

• Common (1% to 10%): Influenza
• Uncommon (0.1% to 1%): Viral infection
• Frequency not reported: Angioedema
• Postmarketing reports: Anaphylactic reactions

Hydrochlorothiazide:

• Uncommon (0.1% to 1%): Influenza, viral infection
• Frequency not reported: Anaphylactic reactions

Olmesartan:

• Common (1% to 10%): Influenza
• Uncommon (0.1% to 1%): Viral infection
• Postmarketing reports: Angioedema, anaphylactic reactions^[Ref]

Renal

• Uncommon (0.1% to 1%): Blood creatinine increased
• Postmarketing reports: Acute renal failure

Hydrochlorothiazide:

• Uncommon (0.1% to 1%): Blood creatinine increased
• Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis

Olmesartan:

• Uncommon (0.1% to 1%): Blood creatinine increased
• Postmarketing reports: Acute renal failure^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Palpitations, hypotension, orthostatic hypotension

Hydrochlorothiazide:

• Frequency not reported: Vasculitis, cutaneous vasculitis
• Postmarketing reports: Cardiac arrhythmias, postural hypotension

Olmesartan:

• Uncommon (0.1% to 1%): Tachycardia, angina pectoris
• Rare (less than 0.1%): Hypotension^[Ref]

Hematologic

Hydrochlorothiazide:

• Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia
• Postmarketing reports: Bone marrow depression^[Ref]

Ocular

Ocular side effects have included idiosyncratic reactions to the hydrochlorothiazide component resulting in acute transient myopia and acute angle-closure glaucoma.^[Ref]

Further information

Hydrochlorothiazide/olmesartan side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer