Telmisartan and Hydrochlorothiazide 

Telmisartan HCTZ 

Telmisartan HCTZ is an FDA-approved combination medication used to treat blood pressure. It contains telmisartan and hydrochlorothiazide. It comes in the form of tablets with strengths of 40mg/12.5mg, 80mg/12.5 mg, and 80 mg/25 mg, to be taken once daily with or without food. It functions by relaxing blood vessels and reducing fluid retention. It is suitable for use in adults; however, it should not be the first treatment option for hypertension. For safe and efficient use of the medication, you should use Telmisartan HCTZ exactly as directed by your doctor and consult an expert medical practitioner if you have any questions or concerns related to medication usage.   

Product Overview

Telmisartan HCTZ is a combination medication containing telmisartan, an angiotensin II receptor blocker or ARB & Hydrochlorothiazide or HCTZ, a thiazide diuretic. Telmisartan works by relaxing blood vessels to lower blood pressure, while HCTZ helps reduce fluid retention by increasing urine production. Together, they are used to treat hypertension and effectively manage blood pressure to reduce the chance of heart disease, stroke, and kidney problems.

This medication is available in three strengths: 40mg/12.5mg, 80mg/12.5mg & 80 mg/25 mg. It is taken orally once daily, with or without food, as directed by your doctor. Suitable for adults, it is essential to take this medication consistently at the same time each day to maximize its effectiveness. Telmisartan HCTZ should not be the first treatment option for hypertension; it is prescribed when other medications are unsuitable or ineffective.

While generally well-tolerated, some common side effects of Telmisartan HCTZ include dizziness, fatigue, and nausea. Serious side effects are rare but require immediate medical attention. Precautions include avoiding use in pregnancy, severe kidney or liver disease, and certain allergies. In case of a missed dose, take it as soon as remembered unless it’s close to the next dose—never double up. Store in a cool, dry place, away from moisture, and out of reach of children. Always consult your doctor for guidance on usage, dosage, and potential interactions.

What Are the Uses of Telmisartan HCTZ?

It is used to treat:

• Hypertension 

What Are the Forms & Strengths of Telmisartan HCTZ?

It comes in the form of a tablet with the following strengths:

• 40 mg/12.5 mg
• 80 mg/12.5 mg
• 80 mg/25 mg

What Are the Recommended Dosage of Telmisartan HCTZ?

For Hypertension

• Initial dosage: The usual starting dose is 40 mg telmisartan / 12.5 mg hydrochlorothiazide once daily.
• Maintenance dosage: Depending on the patient’s blood pressure response, this can range from 40 mg / 12.5 mg to 80 mg / 25 mg once daily.
• Maximum dosage: The maximum recommended daily dose is 80 mg telmisartan / 25 mg hydrochlorothiazide.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Use Telmisartan HCTZ? 

• This medication should not be used to first treat your condition. It is indicated for use only when other medicines have failed to give you the desired results or are not suitable for you to use.
• This medication should be used in addition to weight control and certain dietary and lifestyle changes. Talk to your physician, pharmacist, or healthcare provider for more information. Before making dietary changes, consult a dietician. 
• Before taking Telmisartan HCTZ, you should carefully read and follow the instructions for use given in the patient information leaflet & medication guide provided by your pharmacist or healthcare provider. If you have any questions or concerns or do not understand any part of the leaflet, ask your physician. 
• The medication dosage is based on the medical condition being treated & the patient’s response to treatment. 
• Telmisartan HCTZ will not cure your condition but will help control it. If this medication is determined to be safe for you to use, your doctor may recommend you continue taking this medication for the rest of your life. If hypertension is not treated promptly, it may cause blood vessel problems, heart failure, kidney disease, or stroke. 
• You should swallow the Telmisartan HCTZ tablet as a whole. Do not chew, break, or crush it. You may take it orally with or without food and a glass of water. 
• Usually, patients with hypertension do not feel ill. It is crucial to take Telmisartan HCTZ exactly as your doctor prescribed. Do not take more or less of it, in large doses or more than prescribed. 
• If you also take certain medications such as colestipol or cholestyramine, you should take it at least four to six hours before or four hours after taking Telmisartan HCTZ.    
• To get the most benefit from your medication, you should maintain consistency in dosage and try to take it around the same time every day to help you remember it. 
• You should continue taking Telmisartan HCTZ even if you feel well. Do not discontinue taking Telmosartan HCTZ without consulting your doctor. 
• You should tell your doctor if your condition does not get better or if it worsens. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Telmisartan HCTZ Work?

Telmisartan HCTZ works by combining two medications to effectively lower blood pressure. Telmisartan is an ARB or angiotensin II receptor blocker that relaxes blood vessels by blocking the movement of a substance in the body that causes blood vessels to tighten. This allows blood to flow more smoothly & the heart to pump more efficiently. Hydrochlorothiazide (HCTZ) is a thiazide diuretic or water pill that prevents you from absorbing too much salt, which can lead to fluid retention. By increasing the amount of urine you produce, HCTZ helps reduce blood pressure and swelling. Together, these medications help manage hypertension more effectively than either would alone.

Important Safety Information for Using Telmisartan HCTZ

What Are the Side Effects of Telmisartan HCTZ?

Common Side Effects of Telmisartan HCTZ: Common side effects are those that occur relatively frequently but are generally not considered dangerous. These effects are usually not serious and often subside as your body adjusts to the medication. If these symptoms still persist or become worse, it’s advisable to consult your healthcare provider. Here are some common side effects of Telmisartan HCTZ:

• Dizziness
• Fatigue
• Back pain
• Sinusitis
• Diarrhea
• Upper respiratory tract infection
• Headache
• Nausea

Mild Side Effects of Telmisartan HCTZ: Mild side effects caused by this medication are typically less frequent than common side effects and are generally not cause for significant concern. However, if these effects become bothersome or persistent, it’s important to discuss them with your doctor. They may be able to suggest ways to manage these effects or adjust your treatment if necessary. Here are some mild side effects that may occur with Telmisartan HCTZ:

• Dry mouth
• Muscle cramps
• Indigestion
• Rash
• Increased urination
• Dry cough
• Flu-like symptoms
• Mild allergic reactions 

Serious Side Effects of Telmisartan HCTZ: Serious side effects are less common but can potentially be harmful and require immediate medical attention. While these effects are rare, it’s crucial to be aware of them and seek medical help if they occur. If you experience any of the following serious side effects while taking Telmisartan HCTZ, immediately contact your healthcare provider or seek prompt medical assistance:

•  Confusion, severe headache, weakness in the arm or legs, difficulty walking, slurred speech, loss of coordination, feeling unsteady, high fever, very stiff muscles, tremors, or extreme sweating.

• Signs and symptoms of a serious eye problem such as sudden vision loss, tunnel vision, blurred vision, eye pain or swelling, or halos around the lights. 
• Serious heart symptoms including rapid, irregular heartbeats, fluttering in the chest, sudden dizziness, shortness of breath, lightheadedness, or passing out. 
• Unusual changes in urine amount or yellowing of the eyes/skin.
• Signs of a severe allergic reaction, including anaphylaxis, such as trouble breathing, hives, and swelling of the lips/mouth/tongue/throat.  
• Signs and symptoms of an electrolyte imbalance such as increased thirst, dizziness, confusion, vomiting, muscle pain or weakness, vomiting, lack of energy, rapid heartbeat, seizure, or little or no urine. 

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Telmisartan HCTZ? 

There are certain warnings that you should consider while using Telmisartan HCTZ. 

• You should avoid salt substitutes or potassium supplements unless instructed otherwise by your doctor. You should also avoid alcohol consumption as it may further decrease your blood pressure levels and can cause certain unwelcome side effects. 
• While receiving treatment with this medication, you should avoid getting dehydrated. Stay hydrated, and if this medication makes you dizzy, do not drive a vehicle, use heavy machinery, or engage in tasks that require mental attention or clear vision.
• You should not discontinue using this medication without consulting an expert medical provider, as it can raise your blood pressure levels. You should continue taking it even if you feel well. 
• You should not use Telmisartan HCTZ if you are unable to urinate. 
• If you have diabetes or kidney disease, you should not take Telmisartan HCTZ alongside any medication that contains aliskiren, a blood pressure medication. 
• If you plan to have surgery, including a dental procedure, you should tell your doctor beforehand about all the medications you are using, including Telmisartan HCTZ. You should also tell them about all prescriptions, non-prescriptions, over-the-counter drugs, and herbal or vitamin supplements. 
• You should monitor your blood pressure regularly while receiving treatment with Telmisartan HCTZ and share the report with your doctor. You should also regularly visit your doctor to check for unwanted side effects and determine whether this medication is working as it should. 
• This medication may increase your risk of developing skin cancer. You should limit your time under the sun and avoid tanning beds and sunlamps. To prevent skin conditions, wear protective clothing and sunscreen when under the sun. Your doctor may recommend that you have skin examinations on a regular basis. 
• You should also avoid getting overheated or dehydrated while exercising, in hot water, or by not drinking enough fluids. 
• You should not treat yourself for colds, pain, or coughs without consulting your medical team. Some ingredients present in medications used to treat colds or pain can raise your blood pressure.    

What Are the FDA Boxed Warnings for Telmisartan HCTZ?

A boxed warning has been issued for Telmisartan HCTZ by the FDA due to the risk of fetal toxicity. The key factors of the boxed warnings are as follows:

• If you are pregnant or if you suspect a pregnancy while you are using this medication, you should tell your doctor immediately. If you are pregnant, you should discontinue using  Telmisartan HCTZ immediately, as it can cause severe harm, including death to the unborn baby.
• You should use effective methods of contraception while you are using Telmisartan HCTZ.  

What Are the Telmisartan HCTZ Precautions?

Before using Telmisartan HCTZ, you should discuss with your doctor if this medication is appropriate for you to use. You should use it only if the benefits of Telmisartan HCTZ outweigh the risks associated with its use. For this medication, you should consider the following factors:

• Before using Telmisartan HCTZ, tell your doctor if you have an allergy to this medication, telmisartan, hydrochlorothiazide, or any other medication. This medication contains certain inactive ingredients, which may cause severe allergic reactions or other issues. You can ask your pharmacist for the full list of the ingredients present in the prescription medication. 
• Before using Telmisartan HCTZ, you should share your complete medical and family history with your doctor, especially if you have any of the following conditions:
  • Anuria 
  • Congestive heart failure
  • Diabetes
  • Electrolyte imbalance 
  • Fluid imbalance 
  • Gall bladder disease 
  • Gallstones 
  • Glaucoma 
  • Gout 
  • High cholesterol or fats in the blood 
  • Kidney disease 
  • Liver problems 
  • Myopia 
  • Sulfa drug allergy 
  • Systemic lupus erythematosus 
  • Sympathectomy 
• The safety & efficacy of Telmisartan HCTZ have not been established in pediatric patients, so you should consult a licensed medical professional before using telmisartan and hydrochlorothiazide in patients belonging to this age group. 
• It is not unknown if Telmisartan HCTZ passes into your breast milk while nursing a baby and causes harm to the breastfeeding infant. Consult your doctor before breastfeeding while using Telmisartan HCTZ.
• This medication may cause dehydration. To prevent this, you should drink plenty of fluids and tell your doctor immediately if you experience increased thirst, muscle weakness, or very dry mouth. 
• Telmisartan HCTZ can cause dizziness. To avoid this, you should rise slowly after sitting or lying down for a long time. 
• Telmisartan HCTZ can cause harm (potentially life-threatening) to the unborn baby when taken during pregnancy. You should tell your doctor if you are pregnant, suspect a pregnancy, or plan to get pregnant while using this medication. Discuss the risks & benefits of this medication when used during your condition with them in detail. 

What Are the Contraindications of Telmisartan HCTZ?

Telmisartan HCTZ is contraindicated for use in patients who have:

• Allergy to telmisartan, hydrochlorothiazide, or any other ingredients in the medication.
• Pregnancy 
• Severe kidney or liver disease 
• Anuria 

What If You Missed a Dose of Telmisartan HCTZ?

• If you have missed a dose of Telmisartan HCTZ, you should take it as soon as you remember. 
• However, if the time to take your next dose of Telmisartan HCTZ is approaching, you may omit the missed dose and continue taking your medication according to your regular dosing schedule.
• You should not take double or extra doses of Telmisartan HCTZ to compensate for the missed dose. 
• To prevent missing doses, you can try setting a reminder on your phone. Medication reminders work best for this purpose.  

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Telmisartan HCTZ?

Telmisartan HCTZ overdose symptoms may include fast or slow heart rate, light-headedness, or fainting. If you experience any of the following symptoms, you should immediately seek medical attention. You can call 911, a medical professional, or a poison control helpline. You can also head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

How to Store a Telmisartan HCTZ?

• Store Telmisartan HCTZ tightly closed in its original container at a controlled temperature, away from direct light, moisture, and heat.
• Do not keep it in the bathroom, near the sink, or in places with high humidity, as moisture can harm the medication. 
• You should keep all medications, including Telmisartan HCTZ, in a safe place that is out of the sight and reach of children and pets. 
• Do not keep medications that are no longer needed or have passed their expiration date, which is the last date of the month mentioned in the back of the blister pack or carton. Discard them safely. 
• You should not pour them into the wastewater, flush them down the toilet, or throw them into the trash. 
• You should dispose of unwanted medications in such a way that prevents children, animals, and other people from consuming them. 
• The best way to eliminate unwanted medications is to give them in a medicine take-back program.
• For more information on how to dispose of unwanted medications, you should consult your local waste disposal company, healthcare provider, or pharmacist. 

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Telmisartan HCTZ?

Telmisartan HCTZ can interact with various medications, potentially influencing its efficacy or increasing the risk of unwelcome side effects. Before using Telmisartan HCTZ, you should consult your doctor and tell them about all the medications you are using or plan to use, including all prescription, non-prescription, over-the-counter drugs, herbal or vitamin supplements. Here’s an overview of some important drug interactions:

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Albuterol
• Aliskiren
• Alogliptin
• Amphetamine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Benazepril
• Benzphetamine
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Canagliflozin
• Captopril
• Cefepime
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Codeine
• Cyclosporine
• Dabigatran Etexilate
• Dapagliflozin
• Deslanoside
• Desmopressin
• Dexibuprofen
• Dexketoprofen
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Dihydrocodeine
• Dipyrone
• Dofetilide
• Droperidol
• Droxicam
• Dulaglutide
• Empagliflozin
• Enalapril
• Enalaprilat
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fentanyl
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Formoterol
• Fosinopril
• Furosemide
• Glimepiride
• Glipizide
• Glyburide
• Hydromorphone
• Ibuprofen
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Ketanserin
• Ketoprofen
• Ketorolac
• Levomethadyl
• Linagliptin
• Liraglutide
• Lisdexamfetamine
• Lisinopril
• Lithium
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Mavorixafor
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Meperidine
• Methadone
• Methamphetamine
• Methotrexate
• Metildigoxin
• Miglitol
• Moexipril
• Morniflumate
• Morphine
• Morphine Sulfate Liposome
• Mycophenolate Mofetil
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oliceridine
• Ouabain
• Oxaprozin
• Oxymorphone
• Oxyphenbutazone
• Parecoxib
• Perindopril
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Porfimer
• Potassium Citrate
• Potassium Phosphate
• Pramlintide
• Proglumetacin
• Propyphenazone
• Proquazone
• Proscillaridin
• Quinapril
• Ramipril
• Repaglinide
• Repotrectinib
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Sparsentan
• Sufentanil
• Sulindac
• Tacrolimus
• Tapentadol
• Tenofovir Alafenamide
• Tenoxicam
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Tramadol
• Trandolapril
• Trimethoprim
• Valdecoxib
• Vildagliptin
• Vonoprazan

What Are the Other Telmisartan HCTZ Interactions?

In addition to drug interactions, Telmisartan HCTZ can interact with various herbs, supplements, food items, and beverages. 

• Certain herbal supplements like St. John’s Wort may decrease the effectiveness of the medication. 
• Grapefruit and grapefruit juice can potentially increase the concentration of telmisartan in the blood, enhancing its effects and side effects. 
• Licorice root may exacerbate potassium loss caused by the hydrochlorothiazide component. 
• Salt substitutes or foods high in potassium should be consumed cautiously, as they may lead to excessive potassium levels when combined with telmisartan. 
• Alcohol can increase the blood pressure-lowering effect, potentially causing dizziness or fainting. 
• Caffeine may reduce the efficacy of the medication. 
• Some patients may need to monitor their vitamin D and calcium intake, as hydrochlorothiazide can affect calcium metabolism.

As always, it’s important to discuss your diet, supplement use, and lifestyle habits with your healthcare provider to ensure the safe & efficient use of Telmisartan HCTZ. 

[Note: This isn’t a complete list, and there could be other drugs that interact with Telmisartan HCTZ. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Telmisartan HCTZ Alternatives?

Telmisartan HCTZ is a combination medication used to treat hypertension, but it may not be suitable for everyone due to individual health conditions, side effects, or other factors. Fortunately, there are several alternatives available that can effectively manage high blood pressure. These alternatives include other combination drugs similar to Telmisartan HCTZ, as well as different classes of antihypertensive medications. The choice of an alternative depends on various factors, such as the patient’s specific medical needs, potential side effects, and overall health profile. Discussing with a licensed healthcare professional is essential to determine the most appropriate alternative. Here are some common alternatives to Telmisartan HCTZ:

• Losartan
• Hydrochlorothiazide
• Metoprolol
• Atenolol
• Norvasc (amlodipine besylate)
• Carvedilol 

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Telmisartan HCTZ Cost & Coupons

You can save on Telmisartan HCTZ by using available coupons and discounts. Many pharmacies offer digital or printable coupons that you can use when you buy Telmisartan HCTZ online from Canada. Additionally, some manufacturers provide savings cards or assistance programs that help reduce costs. It’s best recommended to check with your pharmacist or visit online coupon sites to find the best available deals. Another option is to explore prescription discount programs or apps, which may offer lower prices at participating pharmacies. Always consult with your medical provider to make sure that using a coupon or discount program is appropriate for your situation and doesn’t interfere with your insurance coverage.

Frequently Asked Questions

Should telmisartan hydrochlorothiazide be taken in the morning or at night?

It is typically recommended that Telmisartan HCTZ be taken in the morning. This is because the hydrochlorothiazide component is a diuretic, which increases urine production, potentially leading to frequent urination. Taking it in the morning helps avoid nighttime urination, which can disrupt sleep. However, your doctor may provide specific advice based on your health needs, so following their instructions is important.

Does telmisartan have a diuretic in it?

Yes, Telmisartan HCTZ contains a diuretic. The hydrochlorothiazide component is a thiazide diuretic that helps reduce fluid retention by increasing urine output. This diuretic effect complements the blood pressure-lowering action of telmisartan, an angiotensin II receptor blocker. Together, they help manage hypertension more effectively. However, it’s essential to discuss with your doctor if this combination is suitable for you, especially if you have kidney or electrolyte concerns.

When should you take telmisartan, morning or night?

When taken alone, Telmisartan can be taken either in the morning or at night, depending on your doctor’s recommendation and your blood pressure pattern. However, when combined with hydrochlorothiazide, taking it in the morning is generally advised to avoid nocturnal diuresis, which can disrupt sleep. Consistency in the timing of the dose is crucial to maintaining stable blood pressure levels. Always follow your doctor’s guidance on the best time to take your medication.

Is telmisartan safe for kidneys?

Telmisartan is generally considered safe for kidneys and is often prescribed to protect kidney function in patients with hypertension or diabetes. However, when combined with hydrochlorothiazide, monitoring is essential, as the diuretic can affect kidney function, especially in individuals with pre-existing kidney conditions. Regular check-ups & blood tests are recommended to ensure kidney health while using this medication. Discuss any kidney-related concerns with your healthcare provider.

What is the disadvantage of telmisartan?

One disadvantage of telmisartan is the potential for side effects, such as dizziness, fatigue, and, in rare cases, elevated potassium levels (hyperkalemia). Additionally, telmisartan may not be suitable for pregnant women bacause of the risk of harm to the developing unborn baby. When combined with hydrochlorothiazide, there is also an increased risk of electrolyte imbalances and dehydration. As with any medication, weighing the benefits and potential drawbacks with your healthcare provider before starting treatment is important.

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