Hydrochlorothiazide + Telmisartan

Hydrochlorothiazide + Telmisartan is a angiotensin ii receptor blocker (arb) and thiazide diuretic antihypertensive medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Treatment of hypertension (high blood pressure) in adults when blood pressure is not adequately controlled with telmisartan or a diuretic alone, or when the doctor considers a fixed-dose combination suitable.
• May help reduce the risk of complications related to uncontrolled blood pressure when used as part of an overall treatment plan.

The dose and strength should be selected by the prescribing doctor according to previous blood pressure treatment, response, kidney and liver function, and electrolyte status. It is usually taken once daily, with or without food, at the same time each day. Do not start, stop, or change the dose without medical advice.

• Common or possible effects include dizziness, light-headedness, tiredness, headache, increased urination, nausea, and low blood pressure, especially after the first doses or dehydration.
• Hydrochlorothiazide may cause changes in blood salts such as low potassium or sodium, increased uric acid, increased blood sugar, and increased blood lipids.
• Serious effects can include fainting, severe dehydration, kidney function worsening, allergic reactions, severe skin reactions, pancreatitis, eye pain or vision changes, and symptoms of high potassium such as weakness or irregular heartbeat.

Use with caution in people with kidney disease, liver disease, heart failure, dehydration, vomiting or diarrhoea, electrolyte imbalance, gout, diabetes, lupus, history of allergy to sulfonamide-derived medicines, or previous angioedema. Blood pressure, kidney function, and electrolytes may need monitoring. Avoid excessive alcohol and be careful when driving if dizziness occurs. Use this medicine under the guidance of a registered doctor or pharmacist.

• Potassium supplements, salt substitutes containing potassium, potassium-sparing diuretics, ACE inhibitors, aliskiren, or other ARBs may increase the risk of high potassium, low blood pressure, or kidney problems.
• NSAIDs such as ibuprofen, naproxen, and diclofenac may reduce blood pressure control and increase kidney risk, especially in dehydration or older adults.
• Lithium levels may increase and cause toxicity; this combination is generally avoided unless closely monitored.
• Other blood pressure medicines, alcohol, sedatives, or medicines causing dizziness may increase the risk of low blood pressure.
• Diabetes medicines may need adjustment because hydrochlorothiazide can affect blood glucose.
• Corticosteroids, amphotericin B, stimulant laxatives, or other medicines that lower potassium may increase the risk of low potassium.
• Cholestyramine or colestipol may reduce absorption of hydrochlorothiazide if taken close together.
• Digoxin toxicity risk may increase if potassium becomes low.

• Known allergy to telmisartan, hydrochlorothiazide, other sulfonamide-derived medicines, or any component of the product.
• Pregnancy, especially after the first trimester, because medicines acting on the renin-angiotensin system can seriously harm the fetus.
• Anuria (inability to pass urine) or severe kidney impairment where thiazide diuretics are not appropriate.
• Severe liver impairment, cholestasis, or biliary obstruction.
• Concomitant use with aliskiren in patients with diabetes.
• Severe uncorrected electrolyte disturbances such as low potassium or high calcium.

Hydrochlorothiazide + Telmisartan should not be used during pregnancy. If pregnancy is planned or suspected, medical advice should be sought promptly so the doctor can change to a safer alternative. Breastfeeding is generally not recommended with this combination because hydrochlorothiazide can pass into breast milk and telmisartan has limited safety data; the doctor should choose the safest treatment for the mother and baby.

Store at room temperature, away from excess heat, moisture, and direct sunlight. Keep tablets in the original packaging until use and out of the reach of children. Do not use after the expiry date.