Generic Name: telmisartan/hydrochlorothiazide (TEL-mi-SAR-tan/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Micardis HCT
Hydrochlorothiazide/telmisartan can cause injury or even death to a developing fetus when used during pregnancy. If you think you may be pregnant, contact your doctor right away. If you are planning to become pregnant, talk with your doctor about other treatment options.
Hydrochlorothiazide/telmisartan is used for:
Treating high blood pressure. It may also be used for other conditions as determined by your doctor.
Hydrochlorothiazide/telmisartan is a combination angiotensin II receptor blocker and diuretic. The angiotensin II receptor blocker works by relaxing the blood vessels. Exactly how the diuretic works to decrease blood pressure is not known, but it helps the kidneys to eliminate fluid and sodium from the body.
Do NOT use hydrochlorothiazide/telmisartan if:
- you are allergic to any ingredient in hydrochlorothiazide/telmisartan or to any other sulfonamide medicine (eg, sulfamethoxazole)
- you are pregnant
- you have severe liver or kidney problems or are unable to urinate
- you are also taking aliskiren and you have either diabetes or kidney problems
- you are taking dofetilide, ketanserin, or ramipril
Contact your doctor or health care provider right away if any of these apply to you.
Before using hydrochlorothiazide/telmisartan:
Some medical conditions may interact with hydrochlorothiazide/telmisartan. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are able to become pregnant
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have ever had a severe reaction (eg, swelling of the hands, face, lips, eyes, throat, or tongue; trouble swallowing or breathing; hoarseness) after taking any other angiotensin II receptor blocker or an angiotensin-converting enzyme (ACE) inhibitor (eg, captopril)
- if you are dehydrated, have low blood volume, have severe or persistent diarrhea or vomiting, or are on a low-salt (sodium) diet
- if you have high or low blood electrolyte levels (eg, sodium, chloride, potassium, magnesium, calcium)
- if you have asthma; gout; heart problems (eg, congestive heart failure); liver, gallbladder, or kidney problems; high blood cholesterol or lipid levels; parathyroid gland problems; diabetes; or systemic lupus erythematosus
- if you have recently had a certain type of nerve surgery (sympathectomy)
- if you have never taken another medicine for high blood pressure
Some MEDICINES MAY INTERACT with hydrochlorothiazide/telmisartan. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Potassium supplements or potassium-sparing diuretics (eg, spironolactone) because the risk of high blood potassium levels may be increased
- ACE inhibitors (eg, lisinopril, ramipril) or aliskiren because the risk of certain side effects (eg, kidney problems, high blood potassium levels, low blood pressure) may be increased
- Dofetilide or ketanserin because the risk of irregular heartbeat may be increased
- Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, celecoxib, ibuprofen, indomethacin) because they may decrease hydrochlorothiazide/telmisartan's effectiveness and the risk of kidney problems may be increased
- Adrenocorticotropic hormone (ACTH), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), diuretics (eg, furosemide), other medicines for high blood pressure, or narcotic pain medicines (eg, morphine) because they may increase the risk of hydrochlorothiazide/telmisartan's side effects
- Cholestyramine or colestipol because they may decrease hydrochlorothiazide/telmisartan's effectiveness
- Diazoxide, digoxin, or lithium because the risk of their side effects may be increased by hydrochlorothiazide/telmisartan
- Insulin or other diabetes medicine (eg, glipizide, metformin) because their effectiveness may be decreased by hydrochlorothiazide/telmisartan
This may not be a complete list of all interactions that may occur. Ask your health care provider if hydrochlorothiazide/telmisartan may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use hydrochlorothiazide/telmisartan:
Use hydrochlorothiazide/telmisartan as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take hydrochlorothiazide/telmisartan by mouth with or without food.
- Do not remove hydrochlorothiazide/telmisartan from the blister until you are ready to take it.
- Drinking extra fluids while you are taking hydrochlorothiazide/telmisartan is recommended. Check with your doctor for instructions.
- Hydrochlorothiazide/telmisartan may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.
- If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with hydrochlorothiazide/telmisartan.
- Continue to take hydrochlorothiazide/telmisartan even if you feel well. Do not miss any doses.
- If you miss a dose of hydrochlorothiazide/telmisartan, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use hydrochlorothiazide/telmisartan.
Important safety information:
- Hydrochlorothiazide/telmisartan may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use hydrochlorothiazide/telmisartan with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Hydrochlorothiazide/telmisartan may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Report any light-headedness or fainting to your doctor immediately. Your risk of light-headedness or fainting may be increased if you experience diarrhea, vomiting, excessive sweating; do not drink enough fluids; or are on a low-salt diet.
- Hydrochlorothiazide/telmisartan contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting hydrochlorothiazide/telmisartan. Contact your doctor immediately if you experience symptoms, such as vision changes (eg, decreased vision clearness) or eye pain.
- Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
- Hydrochlorothiazide/telmisartan may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to hydrochlorothiazide/telmisartan. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Tell your doctor or dentist that you take hydrochlorothiazide/telmisartan before you receive any medical or dental care, emergency care, or surgery.
- If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.
- Your doctor may have also prescribed a potassium supplement for you. If so, follow the dosing carefully. Do not start taking additional potassium on your own or change your diet to include more potassium without first checking with your doctor.
- Check with your doctor before you use a salt substitute or a product that has potassium in it.
- Diabetes patients - Hydrochlorothiazide/telmisartan may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Hydrochlorothiazide/telmisartan may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
- Hydrochlorothiazide/telmisartan may interfere with certain lab tests, including parathyroid function tests. Be sure your doctor and lab personnel know you are taking hydrochlorothiazide/telmisartan.
- Lab tests, including kidney function, blood pressure, and blood electrolytes, may be performed while you use hydrochlorothiazide/telmisartan. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use hydrochlorothiazide/telmisartan with caution in the ELDERLY; they may be more sensitive to its effects.
- Hydrochlorothiazide/telmisartan should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Hydrochlorothiazide/telmisartan may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Hydrochlorothiazide/telmisartan is found in breast milk. Do not breast-feed while taking hydrochlorothiazide/telmisartan.
Possible side effects of hydrochlorothiazide/telmisartan:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; dizziness; nausea; tiredness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); chest pain; confusion; decrease in sexual ability; decreased, difficult, or painful urination; depression; drowsiness; eye pain; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; increased or excessive sweating; muscle pain, tenderness, or cramps; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent dizziness or light-headedness; severe or persistent dry mouth, nausea, or stomach pain; shortness of breath; sluggishness; swelling of the arms or legs; unusual bruising or bleeding; unusual thirst, tiredness, or weakness; vision changes (eg, decreased vision clearness); vomiting; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; fast, slow, or irregular heartbeat; severe or unusual dizziness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, drowsiness; dry eyes; fast heartbeat; nausea; restlessness; unusual thirst, tiredness, or weakness; vomiting).Proper storage of hydrochlorothiazide/telmisartan:
Store hydrochlorothiazide/telmisartan at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep hydrochlorothiazide/telmisartan out of the reach of children and away from pets.
- If you have any questions about hydrochlorothiazide/telmisartan, please talk with your doctor, pharmacist, or other health care provider.
- Hydrochlorothiazide/telmisartan is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take hydrochlorothiazide/telmisartan or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about hydrochlorothiazide/telmisartan. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to hydrochlorothiazide/telmisartan. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using hydrochlorothiazide/telmisartan.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.