telmisartan and hydrochlorothiazide


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telmisartan and hydrochlorothiazide


tel-mi-SAR-tan, hye-droe-klor-oh-THYE-a-zide

Oral route(Tablet)

Drugs that act directly on the renin-angiotensin system can cause injury or death to the developing fetus when used during the second and third trimesters. Stop therapy as soon as possible when pregnancy is detected .

Commonly used brand name(s)

In the U.S.

Micardis HCT

Available Dosage Forms:


Therapeutic Class: Angiotensin II Receptor Antagonist/Thiazide Combination

Pharmacologic Class: Angiotensin II Receptor Antagonist

Chemical Class: Thiazide

Uses For telmisartan and hydrochlorothiazide

Telmisartan and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Telmisartan is an angiotensin II receptor blocker. It works by blocking a substance in the body that causes blood vessels to tighten. As a result, telmisartan relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

Hydrochlorothiazide is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine which helps lower the blood pressure.

telmisartan and hydrochlorothiazide is available only with your doctor's prescription.

Before Using telmisartan and hydrochlorothiazide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For telmisartan and hydrochlorothiazide, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to telmisartan and hydrochlorothiazide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies have not been performed on the relationship of age to the effects of telmisartan and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of telmisartan and hydrochlorothiazide combination in the elderly.

Pregnancy Pregnancy Category Explanation 1st Trimester C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. 2nd Trimester D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk. 3rd Trimester D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk. Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking telmisartan and hydrochlorothiazide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using telmisartan and hydrochlorothiazide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.


Using telmisartan and hydrochlorothiazide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acetyldigoxin Arsenic Trioxide Benazepril Deslanoside Digitalis Digitoxin Digoxin Droperidol Enalapril Enalaprilat Flecainide Ketanserin Levomethadyl Lisinopril Lithium Metildigoxin Moexipril Ouabain Perindopril Proscillaridin Quinapril Ramipril Sotalol Trandolapril

Using telmisartan and hydrochlorothiazide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Alacepril Apazone Aspirin Benazepril Bepridil Bromfenac Captopril Carbamazepine Celecoxib Chlorpropamide Cholestyramine Cilazapril Cyclophosphamide Delapril Diclofenac Diflunisal Digoxin Enalaprilat Enalapril Maleate Etodolac Fenoprofen Flurbiprofen Fosinopril Ginkgo Glipizide Gossypol Ibuprofen Ibuprofen Lysine Imidapril Indomethacin Ketoprofen Ketorolac Licorice Lisinopril Lithium Magnesium Salicylate Meclofenamate Mefenamic Acid Meloxicam Moexipril Nabumetone Naproxen Nepafenac Oxaprozin Pentopril Perindopril Piroxicam Quinapril Ramipril Salicylic Acid Salsalate Spirapril Sulindac Temocapril Tolmetin Topiramate Trandolapril Zofenopril Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of telmisartan and hydrochlorothiazide. Make sure you tell your doctor if you have any other medical problems, especially:

Anuria (not able to form urine) or Kidney disease, severe or Liver disease, severe or Sulfonamide allergy (antibiotic or stomach medicines, e.g., sulfamethoxazole, sulfasalazine, sulfisoxazole, Azulfidine®, Bactrim®, or Septra®)—Should not be used in patients with these conditions. Asthma or Congestive heart failure or Diabetes or Electrolyte imbalances (e.g., low levels of salt, sodium, or magnesium in the body) or Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or Gallbladder disease or gallstones, history of or Glaucoma, secondary angle closure or Gout or Hypercalcemia (high calcium in the blood) or Hyperlipidemia (high cholesterol or fats in the blood) or Liver disease (including cirrhosis) or Myopia, acute (changes in the eyeball causing vision problems) or Systemic lupus erythematosus (an autoimmune disorder)—Use with caution. May make these conditions worse. Sympathectomy—Blood pressure–lowering effects may be increased. Proper Use of telmisartan and hydrochlorothiazide

telmisartan and hydrochlorothiazide should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.

In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these is most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that telmisartan and hydrochlorothiazide will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

You may take telmisartan and hydrochlorothiazide with or without food.


The dose of telmisartan and hydrochlorothiazide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of telmisartan and hydrochlorothiazide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets): For high blood pressure: Adults—One tablet once a day. Your doctor may increase your dose if needed. Children—Use and dose must be determined by your doctor. Missed Dose

If you miss a dose of telmisartan and hydrochlorothiazide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Keep the tablets in the blister pack and remove only the medicine you need when you are ready to take your dose.

Precautions While Using telmisartan and hydrochlorothiazide

It is important that your doctor check your progress at regular visits to make sure that telmisartan and hydrochlorothiazide is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using telmisartan and hydrochlorothiazide while you are pregnant (especially in your second or third trimester) can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using telmisartan and hydrochlorothiazide, tell your doctor right away.

telmisartan and hydrochlorothiazide may cause some people to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to telmisartan and hydrochlorothiazide before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Check with your doctor right away if you become sick while taking telmisartan and hydrochlorothiazide, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. This is more likely to occur in the morning. Getting up slowly may help. When you get up from lying down, sit on the edge of the bed with your feet dangling for 1 or 2 minutes. Then stand up slowly. If the problem continues or gets worse, check with your doctor.

Check with your doctor right away if you experience dizziness, fainting, confusion, muscle pain, weakness, and/or a fast heartbeat. Use extra care if you exercise or if the weather is hot. Heavy sweating can cause dehydration (loss of too much water) or electrolyte imbalances (loss of potassium, magnesium, or sodium in the body).

telmisartan and hydrochlorothiazide may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

Stop using telmisartan and hydrochlorothiazide and check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

Drinking alcohol or taking narcotic pain relievers or sleeping pills with telmisartan and hydrochlorothiazide may intensify feeling lightheaded, dizzy, or faint. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Make sure any doctor or dentist who treats you knows that you are using telmisartan and hydrochlorothiazide. telmisartan and hydrochlorothiazide may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

telmisartan and hydrochlorothiazide Side Effects

Along with its needed effects, a medicine 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:

Less common Bladder pain bloody or cloudy urine blurred vision confusion convulsions decreased urine difficult, burning, or painful urination dizziness, faintness, or lightheadedness when getting up from a lying or sitting position dry mouth fainting fast, pounding, or irregular heartbeat or pulse frequent urge to urinate increased thirst irregular heartbeat loss of appetite lower back or side pain mood changes muscle pain or cramps nausea or vomiting numbness or tingling in the hands, feet, or lips shortness of breath sudden sweating unusual tiredness or weakness Less common or rare Chills cold sweats Rare Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Some side effects 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 Body aches or pain cough difficulty with breathing dizziness ear congestion fever headache loss of voice runny or stuffy nose sneezing sore throat Less common Abdominal or stomach pain acid or sour stomach back pain belching cough producing mucus diarrhea general feeling of discomfort or illness heartburn hoarseness indigestion joint pain loss of appetite muscle aches and pains pain pain or tenderness around the eyes and cheekbones rash shivering stomach discomfort or upset sweating tender, swollen glands in the neck tightness in the chest trouble with sleeping trouble with swallowing voice changes wheezing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: telmisartan and hydrochlorothiazide side effects (in more detail)

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