What it's for (Indications)
- This medication is primarily used for the treatment of hypertension (high blood pressure).
- It is also indicated for reducing cardiovascular (heart and blood vessels) related events in patients with established atherosclerotic (hardening of blood vessels) cardiovascular disease and in patients with type 2 diabetes with end-organ damage.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | The usual starting dose for telmisartan is 40 mg once daily, with a therapeutic range spanning 20 mg to 80 mg daily. Hydrochlorothiazide is effective in doses from 12.5 mg to 50 mg once daily. To minimize dose-independent side effects, combination therapy is typically initiated only after monotherapy with either agent has failed to achieve the desired blood pressure reduction. For patients with depletion of intravascular volume, this condition should be corrected, or telmisartan should be initiated under close medical supervision. Similarly, patients with biliary obstructive disorders or hepatic insufficiency should have treatment started under close medical supervision. |
Safety & Warnings
Common Side Effects
- Clinical trials indicate that the overall incidence of adverse experiences with telmisartan/hydrochlorothiazide combination is comparable to placebo, with most effects being mild and transient.
- Commonly reported side effects include upper respiratory tract infections, back pain, and sinusitis.
- Hydrochlorothiazide can cause dose-dependent side effects such as hypokalemia.
Serious Warnings
- Black Box Warning: WARNING: FETAL TOXICITY. When pregnancy is detected, telmisartan and hydrochlorothiazide must be discontinued as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
- This medication should be used with extreme caution in patients with impaired hepatic (liver) function, including those with biliary obstructive disorders or hepatic insufficiency, requiring close medical supervision.
- Caution is also advised for patients with bilateral renal artery stenosis and those with mild to moderate renal impairment.
- Patients with renovascular hypertension and elderly patients should be carefully monitored.
- The medication may impair glucose tolerance.
- Patients with intravascular volume depletion should have their condition corrected prior to initiating therapy, or treatment should be started under close medical supervision due to the risk of symptomatic hypotension.
- Avoid driving as this medication may affect your ability to drive.
- Avoid consuming alcohol while taking this medicine.
- Breastfeeding mothers should not use this medication; consult a doctor if no alternative medicine is available.
How it Works (Mechanism of Action)
Telmisartan is an angiotensin II receptor blocker (ARB), which acts by selectively blocking the binding of angiotensin II to the AT1 receptor, leading to vasodilation and reduction in blood pressure. Hydrochlorothiazide is a thiazide diuretic, which acts by increasing the excretion of sodium, chloride, and water by inhibiting their reabsorption in the distal convoluted tubule, thereby reducing blood volume and blood pressure. The combined action provides an additive antihypertensive effect.
Commercial Brands (Alternatives)
No other brands found for this formula.