Telmisartan + Hydrochlorothiazide: Uses, Dosage, Side Effects & Brands | MedexInfo

Telmisartan + Hydrochlorothiazide

Generic NameTelmisartan + Hydrochlorothiazide

Therapeutic ClassARB + Thiazide Diuretic

Max / 24hTelmisartan 80 mg / HCTZ 25 mg

Common DoseTelmisartan 40 mg + HCTZ 12.5 mg once daily; may increase to 80/25 mg if needed

PregnancyContraindicated in 2nd and 3rd trimester

Indications ▼

Essential hypertension in adults, especially patients inadequately controlled with monotherapy

Hypertension with high cardiovascular risk (stroke, myocardial infarction, diabetes, kidney disease)

Hypertension in patients with left ventricular hypertrophy

Hypertension in patients at risk of heart failure

Combination therapy for patients requiring multiple agents for optimal blood pressure control

Secondary prevention in hypertensive patients with renal or cardiovascular comorbidities

Mechanism & Pharmacokinetics ▼

Mechanism: Telmisartan selectively blocks angiotensin II AT1 receptors, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium and chloride reabsorption in the distal tubules, promoting diuresis and reducing blood volume.

Pharmacokinetics: Telmisartan: Peak plasma 0.5–1 hour, highly protein-bound, hepatic metabolism, half-life ~24 h. HCTZ: Rapidly absorbed, renal excretion, half-life 6–15 h.

Dosage & Administration ▼

Condition	Recommended Dose	Frequency
Essential Hypertension	Telmisartan 40 mg + HCTZ 12.5 mg	Once daily, may increase to 80/25 mg if needed
Elderly / renal impairment	Telmisartan 20 mg + HCTZ 12.5 mg	Once daily, adjust based on BP response and renal function

Note: Administer orally with or without food. Monitor blood pressure, electrolytes, and kidney function regularly.

Side Effects ▼

Dizziness, headache

Fatigue, nausea

Hypotension, syncope

Hyperkalemia, hyponatremia

Rare: Angioedema, renal impairment, hepatic enzyme elevation

Contraindications ▼

Hypersensitivity to telmisartan, HCTZ, or other sulfonamides

Pregnancy (2nd and 3rd trimester)

Severe hepatic impairment or cholestasis

Anuria or severe renal impairment

Drug Interaction ▼

Potassium-sparing diuretics, ACE inhibitors: risk of hyperkalemia

NSAIDs: may reduce antihypertensive effect and increase renal risk

Other antihypertensives: additive BP lowering

Drugs causing electrolyte imbalance (laxatives, corticosteroids): monitor electrolytes

Pregnancy & Lactation ▼

Telmisartan: Contraindicated in 2nd and 3rd trimester

HCTZ: Use with caution, monitor fetal growth

Excretion in breast milk unknown; avoid or monitor infant

Clinical / Research Summary ▼

Therapeutic Role: Effective combination for patients not achieving target BP with monotherapy; reduces cardiovascular morbidity.

Clinical Effectiveness: Lowers systolic and diastolic BP effectively; combination therapy improves adherence and BP control.

Safety Profile: Generally well tolerated; monitor electrolytes, renal, and hepatic function; dizziness and hypotension common.

Current Research: Studies emphasize long-term cardiovascular outcomes, renal protection, and optimization of combination therapy in resistant hypertension.

Patient Counseling Points ▼

Take medication at the same time each day, preferably in the morning

Maintain adequate hydration

Report symptoms of hypotension (dizziness, fainting)

Do not discontinue suddenly

Monitor blood pressure, kidney function, and electrolytes regularly

Storage & Handling ▼

Store below 30°C, protect from moisture and light

Keep out of reach of children

Brand Names (Bangladesh & Global) ▼

Bangladesh (Local Brands):