Use in pregnancy: There is no experience with the use of olmesartan medoxomil-hydrochlorothiazide in pregnant women. Studies in mice and rats using olmesartan medoxomil-hydrochlorothiazide combinations do not indicate a teratogenic effect, but foetotoxicity has been shown in rats. Thiazides cross the placental barrier and appear in cord blood. They may cause foetal electrolyte disturbances and possible other reactions that have occurred in adults. Cases of neonatal thrombocytopenia, or foetal or neonatal jaundice have been reported with maternal thiazide therapy.
Therefore, olmesartan medoxomil-hydrochlorothiazide is contraindicated during the 2nd and 3rd trimesters of pregnancy. In addition, olmesartan medoxomil-hydrochlorothiazide must not be used during the 1st trimester. If pregnancy occurs during therapy, olmesartan medoxomil-hydrochlorothiazide must be discontinued as soon as possible. (See Contraindications.)
Use in lactation: Olmesartan is excreted in the milk of lactating rats but it is not known whether olmesartan is excreted in human milk. Thiazides appear in human milk and may inhibit lactation. Mothers must not breastfeed if they are taking olmesartan medoxomil-hydrochlorothiazide. (See Contraindications.)
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