Hydrochlorothiazide Telmisartan

Hydrochlorothiazide Telmisartan Brand Name– Micardis HCT

What is Hydrochlorothiazide Telmisartan

Hydrochlorothiazide Telmisartan are combined together in a once daily oral preparation to manage hypertension.

Hydrochlorothiazide is a thiazide diuretic. Similar to the prototype losartan, telmisartan is a specific and selective angiotensin II antagonist. The half-life of telmisartan (24 hours) is longer than other available angiotensin II antagonists. Compared to losartan, telmisartan is not metabolized to an active metabolite, and lacks uricosuric effects.

Because AT1 receptors are nearly saturated at the starting doses for most angiotensin II antagonists, the antihypertensive dose-response curve for these drugs is nonlinear, with proportionally small decreases in blood pressure attained with increased dosage.

Greater antihypertensive efficacy is generally achieved by adding a small dose of hydrochlorothiazide to the angiotensin II antagonist. Telmisartan tends to reverse the potassium loss associated with HCTZ.

Because telmisartan does not inhibit angiotensin converting enzyme (ACE), it does not result in bradykinin accumulation, which is theorized to cause cough and angioedema associated with ACE inhibitors.

However, angioedema has been rarely associated with telmisartan or other angiotensin II antagonists.

Micardis® HCT was approved by the FDA on November 17, 2000.

Indications

  • hypertension

For the treatment of hypertension in patients who do not respond to monotherapy

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anaphylactoid reactions
  5. anemia
  6. angioedema
  7. aplastic anemia
  8. asthenia
  9. atrial fibrillation
  10. azotemia
  11. back pain
  12. blurred vision
  13. bradycardia
  14. chest pain (unspecified)
  15. cough
  16. diabetes mellitus
  17. diaphoresis
  18. diarrhea
  19. dizziness
  20. dyspepsia
  21. edema
  22. elevated hepatic enzymes
  23. eosinophilia
  24. erythema multiforme
  25. exfoliative dermatitis
  26. fatigue
  27. fever
  28. glycosuria
  29. gout
  30. headache
  31. heart failure
  32. hemolytic anemia
  33. hepatitis
  34. hyperbilirubinemia
  35. hypercalcemia
  36. hypercholesterolemia
  37. hyperglycemia
  38. hyperkalemia
  39. hypertriglyceridemia
  40. hyperuricemia
  41. hypokalemia
  42. hypomagnesemia
  43. hyponatremia
  44. hypovolemia
  45. impotence (erectile dysfunction)
  46. infection
  47. influenza
  48. jaundice
  49. leukopenia
  50. metabolic alkalosis
  51. muscle cramps
  52. myalgia
  53. myocardial infarction
  54. myopia
  55. nausea
  56. nephrolithiasis
  57. ocular hypertension
  58. oliguria
  59. orthostatic hypotension
  60. pancreatitis
  61. pancytopenia
  62. pharyngitis
  63. photosensitivity
  64. pruritus
  65. purpura
  66. rash
  67. renal failure (unspecified)
  68. rhabdomyolysis
  69. sialadenitis
  70. sinus tachycardia
  71. sinusitis
  72. Stevens-Johnson syndrome
  73. syncope
  74. teratogenesis
  75. thrombocytopenia
  76. toxic epidermal necrolysis
  77. urticaria
  78. vomiting
  79. weakness
  80. xanthopsia

Monitoring Parameters

  • blood glucose
  • blood pressure
  • LFTs
  • serum bilirubin (total and direct)
  • serum creatinine/BUN
  • serum electrolytes
  • serum uric acid

Contraindications

  • ACE-inhibitor induced angioedema
  • angioedema
  • anuria
  • asthma
  • breast-feeding
  • children
  • diabetes mellitus
  • electrolyte imbalance
  • geriatric
  • gout
  • heart failure
  • hepatic disease
  • hypercalcemia
  • hyperglycemia
  • hyperkalemia
  • hyperuricemia
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hypotension
  • hypovolemia
  • orthostatic hypotension
  • pancreatitis
  • penicillin hypersensitivity
  • pregnancy
  • renal artery stenosis
  • renal disease
  • renal failure
  • renal impairment
  • sulfonamide hypersensitivity
  • sunlight (UV) exposure
  • surgery
  • sympathectomy
  • syncope
  • systemic lupus erythematosus (SLE)
  • thiazide diuretic hypersensitivity

Interactions

  • Acarbose
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetohexamide
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Albiglutide
  • Albuterol
  • Albuterol; Ipratropium
  • Aldesleukin, IL-2
  • Alemtuzumab
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  • Alfentanil
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Allopurinol
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Alprostadil
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  • Aminolevulinic Acid
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  • Amlodipine; Celecoxib
  • Amobarbital
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  • Amoxicillin; Clarithromycin; Omeprazole
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  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atracurium
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  • Cardiac glycosides
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  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpropamide
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  • Clindamycin; Tretinoin
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  • Diazoxide
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  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Ephedrine
  • Epinephrine
  • Eplerenone
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  • Ertugliflozin; Metformin
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  • Escitalopram
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  • Esomeprazole; Naproxen
  • Estradiol
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  • Ethanol
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  • Famotidine; Ibuprofen
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flavoxate
  • Fluconazole
  • Fluocinolone; Hydroquinone; Tretinoin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurbiprofen
  • Fluticasone; Salmeterol
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  • Fluvoxamine
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  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fospropofol
  • Gallium Ga 68 Dotatate
  • General anesthetics
  • Glimepiride
  • Glimepiride; Pioglitazone
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  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
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  • Halobetasol; Tazarotene
  • Halofantrine
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  • Halothane
  • Homatropine; Hydrocodone
  • Hydralazine; Isosorbide Dinitrate, ISDN
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  • Hydrochlorothiazide, HCTZ; Moexipril
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  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
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  • Hydromorphone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
  • Ibuprofen
  • Ibuprofen lysine
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