Telmisartan + Hydrochlorothiazide
Generic Details
Generic Name
Telmisartan-Hydrochlorothiazide
Other Names
- Micardis HCT
- Telsar-H
Drug Class
- Angiotensin II Receptor Blocker (ARB) and Thiazide Diuretic Combination
Chemical Formula
C33H30N4O2S2.C7H8ClN3O4S2
Molecular Weight
≈ 900.05 g/mol
Mechanism of Action
- Telmisartan blocks the action of angiotensin II, leading to vasodilation and decreased secretion of aldosterone
- Hydrochlorothiazide works by increasing the excretion of sodium and water by inhibiting reabsorption in the kidneys.
Indications
- Hypertension (high blood pressure)
Common Dosage Forms
- Tablet
Typical Dosage
- Telmisartan 40mg-Hydrochlorothiazide 12.5mg or Telmisartan 80mg-Hydrochlorothiazide 12.5mg once daily
Pediatric Dosage
Geriatric Dosage
Side Effects
- Dizziness
- Hypotension
- Hyperkalemia
- Renal dysfunction
- Electrolyte abnormalities
Contraindications
- History of angioedema related to previous treatment with ACE inhibitors
- Anuria
- Severe renal impairment (CrCl < 30mL/min)
- Hypersensitivity to sulfonamide-derived drugs
Pregnancy Category
- Category D - Telmisartan may cause fetal harm when administered to pregnant women
Lactation Safety
- Excretion in breast milk is unknown; Telmisartan is not recommended while breastfeeding.
Drug Interactions
- Lithium
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
- Potassium-sparing diuretics
- Digoxin
Overdose Symptoms
- Hypotension
- Dehydration
- Electrolyte abnormalities
Antidote for Overdose
- Supportive measures and symptomatic treatment
Storage Conditions
- Store at room temperature between 20-25°C (68-77°F)
Pharmacokinetics
- Absorption: Telmisartan: Rapidly absorbed with peak plasma concentrations reached in 0.5-1 hour; Bioavailability approximately 42%
- Distribution: Telmisartan: Highly bound to plasma proteins (>99.5%); Hydrochlorothiazide: Widely distributed
- Metabolism: Telmisartan: Minimal hepatic metabolism via conjugation to inactive metabolites
- Excretion: Telmisartan: Eliminated primarily via feces (97%) and urine (1%); Hydrochlorothiazide: Eliminated mainly through urine
Precautions
- Renal impairment
- Hepatic impairment
- Electrolyte imbalances
- Diabetes mellitus
Warnings
- Hypotension
- Hyperkalemia
- Acute angle-closure glaucoma
- Renal impairment
- Hepatic impairment