Hydrochlorothiazide + Telmisartan
Indications
Hydrochlorothiazide + Telmisartan is used for:
Hypertension, Diabetic nephropathy
Adult Dose
Oral
Hypertension
Adult 1 tab (40-80 mg telmisartan/12.5-25 mg) once daily.
Max: Telmisartan 160 mg & hydrochlorothiazide 25 mg daily.
Hepatic Impairment
Initiate therapy with low dose; titrate slowly; monitor
Child Dose
Renal Dose
Renal impairment
Dose adjustment not necessary
Hemodialysis patients are more susceptible to hypotension
Administration
May be taken with or without food.
Contra Indications
Severe hepatic impairment, biliary obstructive disorders. Pregnancy. Lactation.
Precautions
Hepatic insufficiency, biliary obstruction, renal impairment, renaly artery stenosis. Correct volume depletion before initiating treatment. Monitor serum potassium levels regularly, especially in elderly and renally-impaired patients.
Lactation: discontinue drug or do not nurse
Pregnancy-Lactation
Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters)
Interactions
Lithium, kaliuretic diuretics, laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G, salicylates, K-sparing diuretics, K supplements, K salt substitutes drugs that cause hyperkalaemia, digitalis glycosides, antiarrhythmic agents, drugs known to induce torsades de pointes, alcohol, barbiturates, narcotics, oral antidiabetics, insulin, anion-exchange resins, NSAIDs, nondepolarising skeletal muscle relaxants, pressor amines, allopurinol, Ca salts, beta-blockers, diazoxide, anticholinergics, amantadine, cytotoxics.
Adverse Effects
Side effects of Hydrochlorothiazide + Telmisartan :
1-10%
Telmisartan
Upper respiratory infection (7%),Urinary tract infection (1%),Back pain (3%),Diarrhea (3%),Myalgia (3%),Fatigue (1%),Sinusitis (3%),Peripheral edema (1%),Chest pain (1%),Hypertension (1%),Dyspepsia (1%),Headache (1%),Dizziness (1%),Pharyngitis (1%)
Frequency Not Defined
Hydrochlorothiazide
Anorexia,Epigastric distress,Hypotension,Orthostatic hypotension,Photosensitivity,Anaphylaxis,Anemia,Confusion,Erythema multiforme,Stevens-Johnson syndrome,Exfoliative dermatitis including toxic epidermal necrolysis,Dizziness,Hypokalemia and/or hypomagnesemia,Hyperuricemia
Potentially Fatal: Rarely angioedema, rash, pruritus and urticaria.
Mechanism of Action
Hydrochlorothiazide inhibits the reabsorption of Na and chloride in the distal tubules causing increased excretion of Na and water K and hydrogen ions.
Telmisartan is a nonpeptide AT1 angiotensin II receptor antagonist. It exerts antihypertensive activity by preventing angiotensin II from binding to AT1 receptors thus inhibiting the vasoconstricting and aldosterone-secreting effects of angiotensin II.