TREATMENT FOR HTN

• 1. Angiotensin-Converting Enzyme (ACE) Inhibitors:

• Brand Names: Lisinopril (Prinivil, Zestril), Enalapril (Vasotec), Ramipril (Altace)
• Indication: Hypertension, heart failure, diabetic nephropathy
• Dosage: Typically started at a low dose and gradually increased. For example, lisinopril
10-40 mg once daily.

• 2. Angiotensin II Receptor Blockers (ARBs):

• Brand Names: Losartan (Cozaar), Valsartan (Diovan), Olmesartan (Benicar)
• Indication: Hypertension, heart failure, diabetic nephropathy
• Dosage: Dosages vary by medication. For example, losartan 50-100 mg once daily.
• 3. Calcium Channel Blockers (CCBs):
• Brand Names: Amlodipine (Norvasc), Diltiazem (Cardizem), Verapamil (Calan)
• Indication: Hypertension, angina, arrhythmias
• Dosage: Dosages vary by medication. For example, amlodipine 5-10 mg once daily.

• 4. Diuretics:
• Brand Names: Hydrochlorothiazide (Microzide), Furosemide (Lasix)
• Indication: Hypertension, edema, heart failure
• Dosage: Dosages vary by medication. For example, hydrochlorothiazide 12.5-25 mg
once daily.
• 5. Beta-Blockers:
• Brand Names: Atenolol (Tenormin), Metoprolol (Lopressor), Propranolol (Inderal)
• Indication: Hypertension, angina, arrhythmias
• Dosage: Dosages vary by medication. For example, metoprolol succinate 25-200 mg once daily.

• 6. Alpha-Blockers:
• Brand Name: Doxazosin (Cardura)
• Indication: Hypertension, benign prostatic hyperplasia (BPH)
• Dosage: Typically started at a low dose and gradually increased. For example, doxazosin 1-16 mg once daily.

• 7. Renin Inhibitors:
• Brand Name: Aliskiren (Tekturna)
• Indication: Hypertension
• Dosage: Dosages vary. For example, aliskiren 150-300 mg once daily.
• 8. Direct Vasodilators:
• Brand Name: Hydralazine (Apresoline)
• Indication: Hypertension
• Dosage: Typically divided into multiple doses. For example, hydralazine 25-100 mg
in divided doses.

• 9. Combination Medications:
• Various medications are available as fixed-dose combinations to improve
convenience and adherence.
COMBINATION THERAPY

• 1. Amlodipine + Benazepril:
• Brand Name: Lotrel
• Indication: Hypertension
• Dose: The typical starting dose is 2.5 mg amlodipine / 10 mg benazepril once daily, which can be titrated
as needed.

• 2. Amlodipine + Valsartan:
• Brand Name: Exforge
• Indication: Hypertension
• Dose: The starting dose is usually amlodipine 5 mg / valsartan 160 mg once daily. The dose can be
adjusted based on the patient's response.
• 3. Hydrochlorothiazide + Losartan:
• Brand Name: Hyzaar
• Indication: Hypertension
• Dose: The starting dose is hydrochlorothiazide 12.5 mg / losartan 50 mg once daily. Dosage
adjustments can be made as necessary.

• 4. Hydrochlorothiazide + Lisinopril:
• Brand Name: Zestoretic or Prinzide
• Indication: Hypertension
• Dose: The starting dose is hydrochlorothiazide 12.5 mg / lisinopril 10 mg once daily.
Dosage adjustments may be required.
• 5. Valsartan + Hydrochlorothiazide:
• Brand Name: Diovan HCT
• Indication: Hypertension
• Dose: The typical starting dose is valsartan 80 mg / hydrochlorothiazide 12.5 mg once daily,
with possible dose adjustments.

• 6. Olmesartan + Amlodipine + Hydrochlorothiazide:

• Brand Name: Tribenzor
• Indication: Hypertension
• Dose: The starting dose is usually olmesartan 20 mg / amlodipine 5 mg /
hydrochlorothiazide 12.5 mg once daily. Dosage adjustments may be needed.
• 7. Amlodipine + Aliskiren + Hydrochlorothiazide:
• Brand Name: Amturnide
• Indication: Hypertension
• Dose: The starting dose is amlodipine 5 mg / aliskiren 150 mg / hydrochlorothiazide 12.5 mg once
daily. Dose adjustments may be made.

• 8. Perindopril + Amlodipine:
• Brand Name: Prestalia
• Indication: Hypertension
• Dose: The starting dose is perindopril 3.5 mg / amlodipine 2.5 mg once daily. Dosage adjustments can
be considered.

• 9. Telmisartan + Amlodipine:
• Brand Name: Twynsta
• Indication: Hypertension
• Dose: The starting dose is telmisartan 40 mg / amlodipine 5 mg once daily, with potential dose
adjustments.
HTN WITH COMORBIDITIES

• 1. Hypertension with Diabetes:

• Combination: Angiotensin-converting enzyme inhibitor (ACE inhibitor) + Diuretic
(Thiazide-like diuretic or Thiazide diuretic)
• Brand Names: Lisinopril + Hydrochlorothiazide (Zestoretic), Enalapril +
Hydrochlorothiazide (Vaseretic)
• Indication: To control blood pressure in patients with hypertension and diabetes.
• Doses: Vary based on individual patient needs and response. For example,
Lisinopril 10 mg/12.5 mg to 20 mg/25 mg once daily.
• 2. Hypertension with Chronic Kidney Disease (CKD):
• Combination: Angiotensin receptor blocker (ARB) + Diuretic
• Brand Names: Losartan + Hydrochlorothiazide (Hyzaar), Irbesartan +
Hydrochlorothiazide (Avalide)
• Indication: To manage blood pressure in patients with hypertension and chronic
kidney disease.
• Doses: Doses depend on the specific medication and the patient's renal function.
For instance, Losartan 50 mg/12.5 mg to 100 mg/25 mg once daily.
• 3. Hypertension with Ischemic Heart Disease:
• Combination: Beta-blocker + Angiotensin receptor blocker (ARB) or ACE inhibitor
• Brand Names: Metoprolol succinate + Valsartan (Exforge HCT), Bisoprolol +
Hydrochlorothiazide (Ziac)
• Indication: To control blood pressure in patients with hypertension and a history of
ischemic heart disease.
• Doses: Dosages vary based on individual patient characteristics. For example,
Metoprolol succinate 25 mg/160 mg/12.5 mg to 100 mg/320 mg/25 mg once daily.
• 4. Hypertension with Heart Failure:
• Combination: Angiotensin receptor-neprilysin inhibitor (ARNI)
• Brand Name: Sacubitril + Valsartan (Entresto)
• Indication: For patients with chronic heart failure (NYHA class II-IV) to reduce the
risk of cardiovascular death and hospitalization.
• Doses: Titration is recommended, starting with Sacubitril 24 mg/Valsartan 26 mg
twice daily, increasing to 97 mg/103 mg twice daily.