Generic

Telmisartan + Hydrochlorothiazide

Indications

Telmisartan and hydrochlorothiazide is demonstrated for the treatment of hypertension, to lower blood weight. Bringing down blood weight diminishes the hazard of lethal and nonfatal cardiovascular occasions, fundamentally strokes and myocardial areas of dead tissue. These benefits have been seen in controlled trials of antihypertensive drugs from a wide assortment of pharmacologic classes counting the classes to which this medicate mainly has a place. There are no controlled trials illustrating chance lessening with Telmisartan and Hydrochlorothiazide.

Control of tall blood weight ought to be portion of comprehensive cardiovascular chance administration, counting, as fitting, lipid control, diabetes administration, antithrombotic treatment, smoking cessation, work out, and restricted sodium admissions. Numerous patients will require more than one medicate to attain blood weight objectives. For particular counsel on objectives and administration, see distributed rules, such as those of the National Tall Blood Weight Instruction Program’s Joint National Committee on Avoidance, Location, Assessment, and Treatment of Tall Blood Weight (JNC).

Various antihypertensive drugs, from a assortment of pharmacologic classes and with diverse instruments of activity, have been appeared in randomized controlled trials to diminish cardiovascular dreariness and mortality, and it can be concluded that it is blood weight decrease and not a few other pharmacologic property of the drugs, that’s generally capable for those benefits. The biggest and most steady cardiovascular result advantage has been a diminishment within the hazard of stroke, but decreases in myocardial dead tissue and cardiovascular mortality too have been seen routinely.

Raised systolic or diastolic weight causes expanded cardiovascular hazard, and the supreme chance increment per mmHg is more prominent at higher blood weights, so that indeed unassuming decreases of extreme hypertension can give considerable advantage. Relative chance diminishment from blood weight diminishment is comparative over populaces with changing outright chance, so the outright advantage is more noteworthy in patients who are at higher hazard free of their hypertension (for illustration, patients with diabetes or hyperlipidemia), and such patients would be anticipated to advantage from more forceful treatment to a lower blood weight goal.

Pharmacology

Telmisartan: Angiotensin II is shaped from angiotensin I in a response catalyzed by angiotensin-converting chemical (Pro, kininase II). Angiotensin II is the central pressor specialist of the renin-angiotensin framework, with impacts that incorporate vasoconstriction, incitement of amalgamation and discharge of aldosterone, cardiac incitement, and renal reabsorption of sodium. Telmisartan pieces the vasoconstrictor and aldosteronesecreting impacts of angiotensin II by specifically blocking the authoritative of angiotensin II to the AT1 receptor in numerous tissues, such as vascular smooth muscle and the adrenal organ. Its activity is in this manner autonomous of the pathways for angiotensin II amalgamation.

Hydrochlorothiazide: Hydrochlorothiazide could be a thiazide diuretic. Thiazides influence the renal tubular instruments of electrolyte reabsorption, specifically expanding excretion of sodium salt and chloride in roughly identical sums. By implication, the diuretic activity of hydrochlorothiazide diminishes plasma volume, with ensuing increments in plasma renin action, increments in aldosterone emission, increments in urinary potassium misfortune, and diminishes in serum potassium. The renin-aldosterone connect is intervened by angiotensin II, so coadministration of an ARB tends to invert the potassium misfortune related with these diuretics. The mechanism of the antihypertensive impact of thiazides isn’t completely caught on.

Dosage & Administration

Initiate a patient whose blood pressure is not adequately controlled with telmisartan monotherapy 80 mg: Telmisartan and hydrochlorothiazide 80 mg/12.5 mg once daily. Dose can be titrated up to 160 mg / 25 mg after 2 to 4 weeks, if necessary.

Initiate a patient whose blood pressure is not adequately controlled by 25 mg once daily of hydrochlorothiazide, or is controlled but who experiences hypokalemia with this regimen: Telmisartan and hydrochlorothiazide 80 mg / 12.5 mg once daily. Dose can be titrated up to 160 mg / 25 mg after 2 to 4 weeks, if necessary.

Telmisartan and hydrochlorothiazide may be administered with other antihypertensive drugs.

Interaction

Co-administration of telmisartan did not result in a clinically significant interaction with acetaminophen, amiodipine, glyburide, simvastatin, hydrochlorothiazide, warfarin, or ibuprofen. Telmisartan is not metabolized by the cytochrome P450 system and had no effects in vitro on cytochrome P450 enzymes, except for some inhibition of CYP2C19.

Telmisartan is not expected to interact with drugs that inhibit or are metabolized by cytochrome P450 enzymes, except for possible inhibition of the metabolism of drugs metabolized by CYP2C19.

In clinical trials, amiodipine has been safely administered with thiazide diuretics, beta-blockers, angiotensin converting enzyme inhibitors, long-acting nitrates, sublingual nitroglycerin, digoxin, warfarin, non-steroidal anti-inflammatory drugs, antibiotics, and oral hypoglycemic drugs.

The following have no clinically relevant effects on the pharmacokinetics of amiodipine: cimetidine, grapefruit juice, sildenafil. Amiodipine has no clinically relevant effects on the pharmacokinetics or pharmacodynamics of the following: atorvastatin, digoxin, warfarin.

Contraindications

• Known hypersensitivity to this product or any of its components.
• Pregnancy & lactation.
• Biliary obstructive disorders, severe hepatic impairment, hypotension, cardiogenic shock, left ventricle outflow tract obstruction.

Side Effects

Upper respiratory infection (7%), urinary tract infection (1%), back discomfort (3%), and diarrhea (3%). Telmisartan (3 percent ), Myalgia (3%), Fatigue (1%), Sinusitis (3%), Peripheral edema (1%), Chest pain (1%), Hypertension (1%), Dyspepsia (1%), Dyspepsia (1%), Dyspepsia (1%), Dyspepsia (1%), Dyspepsia (1%), Dyspepsia (1%), Dyspepsia (1%), Dy (1 percent ), Headache (1%), dizziness (1%), and pharyngitis (1%). (1 percent )

Anorexia, epigastric discomfort, hypotension, orthostatic hypotension, photosensitivity, and anaphylaxis are all side effects of hydrochlorothiazide. Exfoliative dermatitis, including toxic epidermal necrolysis, Anemia, Confusion, Erythema multiforme, Stevens-Johnson syndrome, Exfoliative dermatitis, Stevens-Johnson syndrome Dizziness, Hyperuricemia, hypokalemia, and/or hypomagnesemia

Pregnancy & Lactation

D is the pregnancy category. During the second and third trimesters of pregnancy, medications that act on the renin-angiotensin system impair fetal renal function and increase fetal and newborn morbidity and death. The oligohydramnios that result can cause fetal lung hypoplasia and skeletal abnormalities. Skull hypoplasia, anuria, hypotension, renal failure, and mortality are all possible newborn side effects. If you suspect you’re pregnant, stop taking Telmisartan with hydrochlorothiazide as soon as possible.

Nursing Mothers: Telmisartan has been found in the milk of breastfeeding rats, however it is unknown whether it is excreted in human milk. Human milk contains thiazides. Because of the risk of bad effects on the nursing infant, consider whether to stop breastfeeding or stop taking the drug, keeping in mind the drug’s importance to the mother.

Precautions & Warnings

• Avoid fetal or neonatal exposure
• Hypotension: Correct any volume or salt depletion before initiating therapy. Observe for signs and symptoms of hypotension
• Titrate slowly in patients with hepatic or severe renal impairment
• Heart failure: Monitor for worsening
• Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker
• Myocardial infarction: Uncommonly, initiating a CCB in patients with severe obstructive coronary artery disease may precipitate myocardial infarction or increased angina.

Therapeutic Class

Combined antihypertensive preparations.

Storage Conditions

Do not store above 30°C. Protect from light and high humidity. Keep out of the reach of children.

Pharmaceuticals name

ACI Limited