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telmisartan and diuretics

C09DA07

Forms & Strengths

Telmisartan 40 mg / Hydrochlorothiazide 12.5 mg tablet
Telmisartan 80 mg / Hydrochlorothiazide 12.5 mg tablet
Telmisartan 80 mg / Hydrochlorothiazide 25 mg tablet

Adult Dosing

Initial: 1 tablet daily when monotherapy is insufficient
Titration: May increase dose after 2 to 4 weeks based on blood pressure response
Maximum dose: Telmisartan 80 mg / Hydrochlorothiazide 25 mg once daily

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established

Indications

Treatment of hypertension, particularly in patients not adequately controlled on monotherapy
Reduction of cardiovascular risk in patients unable to take ACE inhibitors

Mechanism of Action

Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the AT1 receptor
Hydrochlorothiazide inhibits active chloride reabsorption in the distal convoluted tubule, increasing sodium, chloride, and water excretion

Contraindications

Hypersensitivity to telmisartan, sulfonamide-derived drugs, or any component
Anuria
Co-administration with aliskiren in patients with diabetes mellitus
Pregnancy (second and third trimesters)

Adverse Reactions

Dizziness
Fatigue
Upper respiratory tract infection
Hypotension
Hypokalemia
Hyperuricemia
Elevated serum creatinine

Drug Interactions

Lithium: Risk of increased lithium toxicity
Non-steroidal anti-inflammatory drugs (NSAIDs): May reduce antihypertensive effect and worsen renal function
Dual blockade of the renin-angiotensin system (e.g., ACE inhibitors or aliskiren): Increased risk of hypotension, hyperkalemia, and renal impairment
Potassium-sparing diuretics or potassium supplements: May lead to hyperkalemia

Curated Content: Needs Vetting Before Put to Clinical Use