Generic Name and Formulations:
Telmisartan, hydrochlorothiazide; 40mg/12.5mg, 80mg/12.5mg, 80mg/25mg; tabs.
Boehringer Ingelheim Pharmaceuticals
Not for initial therapy. May be substituted for titrated components. BP not controlled on telmisartan 80mg/day: one Micardis HCT 80mg/12.5mg tab once daily; may titrate to 160mg/25mg. BP not controlled on HCTZ 25mg/day: one Micardis HCT 80mg/12.5mg tab or 80mg/25mg tab once daily; may titrate to 160mg/25mg if BP uncontrolled after 2–4 weeks. BP controlled on HCTZ 25mg/day but hypokalemic: One Micardis HCT 80mg/12.5mg tab once daily. CrCl ≤30mL/min: not recommended. Hepatic insufficiency or biliary obstruction: initially one Micardis HCT 40mg/12.5mg tab once daily; monitor closely. Severe hepatic impairment: not recommended.
Angiotensin II receptor blocker + diuretic.
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Correct hypovolemia before starting, or monitor closely. Renal or hepatic dysfunction. Renal artery stenosis. Asthma. Diabetes. Postsympathectomy. SLE. Gout. Monitor electrolytes. Acute myopia. Secondary angle-closure glaucoma. Elderly. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.
See Contraindications. Concomitant ACE inhibitors (eg, ramipril): not recommended. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Digoxin, lithium toxicity. Adjust antidiabetic, antigout medications. Hyperkalemia with K+ supplements, K+ sparing diuretics, K+ containing salt substitutes. Hypokalemia with corticosteroids, ACTH. Orthostatic hypotension potentiated by alcohol, CNS depressants. May be antagonized by, and renal toxicity potentiated by NSAIDs (including COX-2 inhibitors): monitor renal function in elderly and/or volume-depleted. Potentiates other antihypertensives. May potentiate nondepolarizing muscle relaxants. May antagonize pressor amines. Reduced absorption with bile acid resins (eg, cholestyramine, colestipol).
Dizziness, GI upset, fatigue, flu-like symptoms, back pain, tachycardia, electrolyte disturbances, orthostatic hypotension, hyperglycemia, hyperuricemia, adverse lipid values, angioedema, rhabdomyolysis (rare).
Tabs—3 x 10 (blister cards)