Sevikar

When a single antihypertensive medicine does not bring blood pressure under control, a combination therapy approach can simplify treatment while providing blood pressure control through two complementary pathways. Sevikar tablets are a branded prescription combination medicine containing olmesartan medoxomil, an ARB, and amlodipine, a calcium channel blocker. The two active ingredients lower blood pressure through different mechanisms and combining them in a single tablet supports adherence to treatment. A prescription can only be issued following a clinical consultation.

Sevikar is a branded combination prescription medicine manufactured by Daiichi Sankyo. Each tablet contains two active ingredients: olmesartan medoxomil (an angiotensin receptor blocker, or ARB) and amlodipine (a dihydropyridine calcium channel blocker). This ARB and calcium channel blocker combination provides blood pressure control through two different but complementary pathways, reducing the hormonal drive to raise blood pressure while simultaneously relaxing blood vessel walls.

Sevikar is licensed in the UK for the treatment of essential hypertension in adults. It is indicated for patients whose blood pressure is not adequately controlled on either olmesartan or amlodipine alone, and as a substitute for patients already taking both medicines as separate tablets.

Three tablet strengths are available: 20 mg/5 mg, 40 mg/5 mg, and 40 mg/10 mg. The first number refers to the olmesartan medoxomil dose and the second to the amlodipine dose.

Sevikar should not be confused with Sevikar HCT, which also contains hydrochlorothiazide as a third component. Sevikar HCT is a separate product with its own licensed strengths. Always check the packaging to confirm you have been dispensed the correct product.

As with all olmesartan-containing medicines, patients taking Sevikar should be aware that olmesartan has been specifically associated with a rare but serious intestinal condition called sprue-like enteropathy. This is covered in detail in the side effects section below. Contact your prescriber promptly if you develop persistent severe diarrhoea with significant weight loss during treatment.

Sevikar lowers blood pressure through the combined and complementary actions of its two active ingredients.

Olmesartan Medoxomil: AT1 Receptor Blockade

Olmesartan medoxomil is a prodrug converted in the body to olmesartan, the active form. Olmesartan blocks the AT1 receptor, through which angiotensin II causes blood vessels to narrow and the body to retain sodium and water. By blocking this receptor, olmesartan prevents angiotensin II from raising blood pressure. Blood vessels remain relaxed, sodium and water retention decreases, and blood pressure falls. Olmesartan has a long duration of action supporting consistent control over 24 hours from a once daily dose.

Amlodipine: Calcium Channel Blockade

Amlodipine blocks voltage dependent calcium channels in the smooth muscle cells of blood vessel walls. Calcium entry normally triggers contraction and narrowing of blood vessels. By blocking this entry, amlodipine allows the smooth muscle to relax, widening the blood vessels (vasodilation). This reduces the resistance against which the heart pumps and lowers blood pressure through a mechanism entirely different from the ARB component.

The combination of AT1 receptor blockade and calcium channel blockade provides additive blood pressure reduction compared to either component alone. These two pathways act through distinct mechanisms, which is why the combination is clinically effective in patients whose blood pressure is not controlled on monotherapy. Both components are delivered in a single once daily tablet, which reduces the daily tablet burden and can support long term adherence to cardiovascular therapy.

Always take Sevikar exactly as your prescriber instructs. The information below summarises key points from the current UK SmPC. Read the Patient Information Leaflet supplied with your medicine before starting treatment.

• Take one tablet once daily, at approximately the same time each day.
• Sevikar can be taken with or without food.
• Swallow the tablet whole with a glass of water. Do not crush or chew the tablet.
• If you miss a dose, take it as soon as you remember on the same day. If you only remember the following day, skip the missed dose and continue as normal. Do not take two doses on the same day.
• Do not stop taking Sevikar without speaking to your prescriber first. Blood pressure requires ongoing management and stopping suddenly can cause it to rise again.
• Your prescriber may arrange periodic blood tests to check kidney function, potassium, and other relevant parameters during treatment.
• The amlodipine component may cause ankle swelling in some patients, particularly at the start of treatment. This is a recognised effect of calcium channel blockers and is covered in the side effects section below.
• Attend all follow up appointments so your blood pressure response can be safely reviewed.

Sevikar is available in three strengths. The appropriate strength is determined by your prescriber based on your blood pressure, your previous treatment with olmesartan or amlodipine as separate medicines, and your individual clinical response.

Sevikar 20 mg/5 mg Tablets

Each tablet contains olmesartan medoxomil 20 mg and amlodipine 5 mg. This is typically the starting strength for patients stepping up from Olmetec 20 mg alone when further blood pressure reduction is needed. It combines the standard lower ARB dose with the standard starting dose of amlodipine.

Sevikar 40 mg/5 mg Tablets

Each tablet contains olmesartan medoxomil 40 mg and amlodipine 5 mg. This strength provides the maximum olmesartan dose combined with the lower amlodipine dose. It is used in patients who were taking Olmetec 40 mg alone and require the addition of a calcium channel blocker component, or in patients whose blood pressure is not adequately controlled on Sevikar 20 mg/5 mg and where increasing the ARB dose is the preferred next step.

Sevikar 40 mg/10 mg Tablets

Each tablet contains olmesartan medoxomil 40 mg and amlodipine 10 mg. This is the highest available strength of Sevikar and provides the maximum dose of both components. The 10 mg amlodipine dose is the maximum licensed dose for amlodipine. This strength is used when blood pressure remains inadequately controlled on the 40 mg/5 mg tablet. All dose decisions are made by your prescriber. Do not change your strength without medical advice. If blood pressure is still not adequately controlled on Sevikar 40 mg/10 mg, adding a third antihypertensive such as a diuretic (for example by switching to Sevikar HCT, which also contains hydrochlorothiazide) may be considered by your prescriber. Any change in treatment must be made under prescriber supervision.

Sevikar can cause side effects from either of its active components. The information below is based on the current UK SmPC. Refer to the Patient Information Leaflet for the full list.

Common Side Effects (may affect up to 1 in 10 people)

• Peripheral oedema (swelling of the ankles and lower legs). This is the most common side effect of Sevikar and is caused by the amlodipine component. It is more likely at the 10 mg amlodipine dose.
• Dizziness, particularly on standing up quickly.
• Headache.
• Flushing or a feeling of warmth, related to the vasodilatory effect of amlodipine.

Uncommon Side Effects (may affect up to 1 in 100 people)

• Palpitations or a faster heart rate.
• Raised blood potassium (hyperkalaemia) from the olmesartan component, particularly in patients with kidney disease.
• Changes in kidney function.
• Nausea or abdominal discomfort.
• Skin rash or itching.

Important: Olmesartan and Sprue-Like Enteropathy

Olmesartan has been specifically associated with a rare but serious intestinal condition known as sprue-like enteropathy. This applies to all olmesartan-containing medicines including Sevikar. The condition causes severe, persistent diarrhoea with significant weight loss and can develop months or years after starting treatment. The MHRA issued a Drug Safety Update in 2013 highlighting this risk. If you develop persistent severe diarrhoea combined with significant weight loss while taking Sevikar, contact your prescriber promptly so that the cause can be investigated. Stopping olmesartan-containing medicines typically leads to improvement if the enteropathy is confirmed. Do not stop your blood pressure medicine without seeking medical advice.

Serious Side Effects: Seek Urgent Medical Attention

Go to your nearest accident and emergency department or call 999 immediately if you experience:

• Angioedema: sudden swelling of the face, lips, tongue, or throat. This is rare but potentially life threatening. Seek emergency help immediately.
• Severe low blood pressure causing fainting or collapse.
• Signs of a severe allergic reaction such as sudden widespread rash, difficulty breathing, or swelling.

Report any suspected side effect to your prescriber, pharmacist, or via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Sevikar May Be Suitable If You:

• Are an adult aged 18 or over with a confirmed diagnosis of essential hypertension.
• Are already taking olmesartan and amlodipine as separate medicines and wish to simplify to a single combination tablet.
• Are already taking olmesartan alone and require the addition of a calcium channel blocker for further blood pressure control.
• Are already prescribed Sevikar and require a repeat prescription through an online prescribing service.

Sevikar Is Not Suitable If You:

• Are pregnant or planning to become pregnant. Olmesartan is contraindicated in pregnancy. ARBs cause serious harm to the developing baby, particularly in the second and third trimesters. Contact your prescriber immediately if you become pregnant while taking Sevikar.
• Are breastfeeding.
• Have severe liver disease or biliary obstruction.
• Have unstable angina or have had a heart attack within the preceding four weeks (contraindication relating to the amlodipine component).
• Have decompensated heart failure.
• Have diabetes or moderate to severe kidney impairment and are also taking aliskiren.
• Have a known allergy or hypersensitivity to olmesartan medoxomil, amlodipine, other dihydropyridines, or any excipient listed in the SmPC.
• Are under 18 years of age.

Tell your prescriber about all medicines you take. Key interactions for Sevikar include those from both the olmesartan and amlodipine components:

• Potassium supplements, potassium-sparing diuretics (such as spironolactone or amiloride), and potassium-containing salt substitutes: these can raise blood potassium to dangerous levels with the olmesartan component.
• NSAIDs such as ibuprofen: regular use can reduce the blood pressure lowering effect of Sevikar and increase the risk of kidney problems.
• Lithium: olmesartan can increase lithium blood levels. Close monitoring is required.
• Aliskiren: contraindicated in combination with olmesartan in patients with diabetes or significant kidney impairment.
• CYP3A4 inhibitors such as itraconazole, ketoconazole, erythromycin, and HIV protease inhibitors: these can increase amlodipine blood levels and may enhance blood pressure lowering.
• CYP3A4 inducers such as rifampicin, carbamazepine, and St John's Wort: these can reduce amlodipine blood levels and reduce its effectiveness.
• Ciclosporin: amlodipine may increase ciclosporin blood levels. Monitoring is required.

Your prescriber will review all current medicines during the clinical assessment before any prescription is considered.

Sevikar is a Prescription Only Medicine. The clinical consultation is the essential first step. A prescription will only be issued if a registered prescriber concludes, based on their individual assessment of your circumstances, that Sevikar is clinically appropriate for you.

During your online consultation with Pharmacy Planet, a registered prescriber will review the information you provide. This includes your blood pressure history, your current antihypertensive treatment, kidney function and electrolyte results where available, any relevant cardiac history, and other medical information. The prescriber will assess whether Sevikar is appropriate, which strength suits your needs, and whether online prescribing is appropriate for your situation.

If you are being managed for hypertension by your GP or a specialist, please keep them informed of all medicines prescribed through online services. Coordinated care supports safe and effective BP regulation and cardiovascular therapy.

Store below 30°C. Store in the original packaging to protect from moisture. Keep out of the sight and reach of children. Do not use after the expiry date printed on the packaging. Do not dispose of medicines via household waste or wastewater. Return unused or out of date tablets to your pharmacist for safe disposal. Full storage instructions are provided in the Patient Information Leaflet supplied with your medicine.

Pharmacy Planet is a GPhC-registered online pharmacy providing access to prescription medicines through a clinically led consultation process. Our registered prescribers and pharmacists are committed to patient safety, clinical accuracy, and responsible prescribing. We follow GPhC standards, MHRA guidance, and ASA advertising regulations in all aspects of our service. Every prescription is reviewed and dispensed by qualified healthcare professionals. We provide clear, factual information to help patients understand their antihypertensive medication and make informed decisions about their combination therapy and cardiovascular therapy. If you have questions about Sevikar or any other medicine, our pharmacy team is available to help. We are committed to transparent, patient centred care.

References

1. Electronic Medicines Compendium (eMC). Sevikar 20 mg/5 mg, 40 mg/5 mg and 40 mg/10 mg film-coated tablets — Summary of Product Characteristics. https://www.medicines.org.uk/emc. Accessed May 2026.
2. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. NICE guideline NG136. https://www.nice.org.uk/guidance/ng136. Accessed May 2026.
3. NHS. High blood pressure (hypertension). https://www.nhs.uk/conditions/high-blood-pressure-hypertension. Accessed May 2026.
4. Joint Formulary Committee. British National Formulary (BNF). Olmesartan medoxomil with amlodipine. BMJ Group and Pharmaceutical Press. https://bnf.nice.org.uk. Accessed May 2026.
5. Medicines and Healthcare products Regulatory Agency (MHRA). Drug Safety Update: Olmesartan medoxomil (Olmetec, Olmetec Plus, Sevikar, Sevikar HCT): severe enteropathy. https://www.gov.uk/drug-safety-update. Accessed May 2026.
6. Medicines and Healthcare products Regulatory Agency (MHRA). Yellow Card — report a side effect. https://yellowcard.mhra.gov.uk. Accessed May 2026.

Combination Antihypertensive Tablets

The table below compares combination tablets that contain two active ingredients in a single dose. These are prescribed when a single medicine does not provide adequate blood pressure control.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation.