Overview

Telmisartan is a newer type of blood pressure medicine known as an angiotensin II receptor blocker (ARB for short). As the name implies, telmisartan blocks angiotensin II receptors. This decreases the effectiveness of a chemical known as angiotensin II, which normally causes blood vessels to narrow (constrict). By blocking the effects of angiotensin II, telmisartan causes blood vessels to relax.
Hydrochlorothiazide is a diuretic, which is commonly referred to as a "water pill." It works by increasing the amount of salt and water that the kidneys remove from the blood. This extra salt and water are passed out through the urine. By increasing the amount of water removed from the blood, hydrochlorothiazide causes a decrease in blood volume.

Indications?

High Blood Pressure (Hypertension)

Contraindications

Second and third trimesters of pregnancy.

Biliary obstructive disorders.

Severe hepatic impairment.

Side Effects

Fixed dose combination of losartan and Hydrochlorothiazide is well tolerated. Adverse effects have been limited to those that were reported previously with losartan potassium and/or Hydrochlorothiazide, Adverse effects are generally mild and transient in nature and do not require discontinuation of therapy. The most commonly reported adverse effects are abdominal pain, edema/swelling, palpitation, back pain dizziness, cough, sinusitis, rash, predisposition to upper respiratory infection.

Dosage

Oral:
Disclaimer:To be taken only after consulting with the doctor.

Storage

This medicinal product does not require any special temperature storage conditions. Store in the original package in order to protect from moisture.

Pharmacology

Pharmacokinetics

Telmisartan is orally well absorbed and metabolized to an active metabolite which is more potent than Losartan as AT1 antagonist. Orally administered hydrochlorothiazide is rapidly absorbed and diuretic effect is seen in 1 hour and their duration lasts up to 12-24 hours. Both telmisartan and hydrochlorothiazide has longer duration of actions. These agents are bound to plasma proteins to varying degrees and this has no correlation to their half-life.

Pharmacodynamics

The pharmacodynamics of telmisartan & hydrochlorothiazide has been investigated in vitro and in vivo in rodents, guinea pigs, rabbits and dogs. The combination of telmisartan with hydrochlorothiazide (40 mg/12.5 mg and 80 mg/12.5 mg) is expected to benefit patients with hypertension who are not adequately responsive to telmisartan alone.

Interactions

• Complementry mechanism of action
• Reduction in peripheral resistence with ARB
• Reduction of fluid volume with Diuretics
• ARBs counteract reactive increase in blood pressure related to diuretic induced renin secretion
• ARBs ameliorates diuretic induced potassium depletion
• Well tolerated; fewer metabolic disturbances
• No significant variation in pharmacokinetic parameters of telmisartan in presence of hydrochlorothiazide

Combination of telmisartan with hydrochlorothiazide was found to be more effective than each agent alone in lowering blood pressure. Indeed , combining telmisartan with hydrochlorothiazide enhances the antihypertensive efficacy of telmisartan in patients not adequately controlled with telmisartan alone.