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At a glance

Hydrochlorothiazide + Telmisartan combination is used for the treatment of hypertension to lower blood pressure and reduce the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.

Indications
  • Hypertension (high blood pressure) - to lower blood pressure
Pharmacology

Telmisartan selectively blocks the AT1 receptor of angiotensin II, inhibiting vasoconstriction and aldosterone secretion. Telmisartan does not inhibit ACE and does not bind to other hormone receptors or ion channels. Hydrochlorothiazide inhibits Na+/Cl- reabsorption in the distal convoluted tubule, increasing sodium and chloride excretion, which reduces plasma volume and activates the renin-aldosterone system.

Dosage

Adult Dose (Oral):

  • Initial: Telmisartan 80 mg + HCTZ 12.5 mg once daily (in patients not adequately controlled on telmisartan 80 mg monotherapy or controlled on HCTZ 25 mg but experiencing hypokalemia)
  • May titrate up to 160 mg + 25 mg as needed
  • Max: Telmisartan 160 mg & hydrochlorothiazide 25 mg daily

Hepatic Impairment: Initiate with low dose; titrate slowly; monitor

Renal Dose: No dose adjustment necessary; hemodialysis patients are more susceptible to hypotension

Side effects

Common Side Effects:

  • Fatigue
  • Dizziness
  • Nausea
  • Diarrhea
  • Sinus inflammation
  • Flu-like symptoms
  • Upper respiratory tract infection

Others: Drowsiness, flushing, back pain, stomach pain, allergy, fever, leg pain, chest pain, insomnia, dry mouth, elevated liver enzymes, leg cramps, myalgia, dermatitis, weakness, gastric irritation, photosensitivity, urticaria

Use in pregnancy

Use in Pregnancy: Category D; use of drugs acting on the renin-angiotensin system during the second and third trimesters reduces fetal renal function and increases fetal and neonatal morbidity and death; discontinue when pregnancy is detected.

Precautions & warnings

Precautions:

  • Hydrochlorothiazide + Telmisartan may decrease alertness, affect vision or make you feel sleepy and dizzy; do not drive if these symptoms occur
  • May cause dehydration; drink plenty of fluids; inform doctor if extreme thirst, very dry mouth or muscle weakness develops
  • May cause dizziness; get up slowly when rising from a sitting or lying position
  • Not safe during pregnancy and breastfeeding
  • Tell doctor about medical history: kidney disease, liver disease, bile duct blockage, dehydration, mineral imbalance, gout, lupus
  • If diabetic, monitor blood sugar regularly
  • Consult doctor before using potassium supplements or salt substitutes containing potassium
Overdose effects

Overdose: Hypotension, dizziness, tachycardia, bradycardia, hypokalemia, hypochloremia, hyponatremia and dehydration; telmisartan is not removed by hemodialysis; degree of hydrochlorothiazide removal by hemodialysis not established.

Storage conditions

Store in a cool and dry place, protected from light; keep out of reach of children.

Hydrochlorothiazide + Telmisartan — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.