Hydrochlorothiazide / Telmisartan Side Effects

Medically reviewed by Drugs.com. Last updated on May 18, 2024.

Applies to hydrochlorothiazide / telmisartan: oral tablet.

Precautions

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby, especially in your second or third trimester. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. You may need to stop using this medicine.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. This could be a sign of a serious eye problem. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have stomach pain, confusion, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, trouble breathing, or weakness or heaviness of the legs. Do not use medicines, supplements, or salt substitutes containing potassium without first checking with your doctor.

This medicine may increase your risk of getting skin cancer (eg, non-melanoma skin cancer). Avoid sun exposure. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Talk to your doctor if you have concerns about this risk.

Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you are drinking alcohol or using pain relievers or sleeping pills.

Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.

Other side effects

Some side effects of hydrochlorothiazide / telmisartan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Serious side effects

Along with its needed effects, hydrochlorothiazide/telmisartan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / telmisartan:

For healthcare professionals

Applies to hydrochlorothiazide / telmisartan: oral tablet.

General adverse events

The most common adverse effect was upper respiratory tract infection.^[Ref]

Respiratory

• Common (1% to 10%): Sinusitis, upper respiratory tract infection, cough
• Uncommon (0.1% to 1%): Dyspnea
• Rare (less than 0.1%): Bronchitis, pharyngitis, respiratory distress, pneumonitis, pulmonary edema

Hydrochlorothiazide:

• Very common (10% or more): Upper respiratory tract infection (10%)
• Common (1% to 10%): Sinusitis
• Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Telmisartan:

• Common (1% to 10%): Sinusitis, upper respiratory tract infection
• Uncommon (0.1% to 1%): Cough
• Frequency not reported: Asthma, rhinitis, dyspnea, epistaxis
• Postmarketing reports: Interstitial lung disease^[Ref]

Other

• Common (1% to 10%): Fatigue, influenza-like symptoms, pain
• Uncommon (0.1% to 1%): Chest pain

Hydrochlorothiazide:

• Common (1% to 10%): Fatigue, influenza-like symptoms
• Frequency not reported: Weakness, pyrexia

Telmisartan:

• Common (1% to 10%): Fatigue, influenza-like symptoms
• Uncommon (0.1% to 1%): Asthenia
• Frequency not reported: Earache, fever, malaise, leg edema, peripheral edema, dependent edema, chest pain
• Postmarketing reports: Weakness, edema, face edema, pain^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, headache
• Uncommon (0.1% to 1%): Syncope, paresthesia, vertigo

Hydrochlorothiazide:

• Common (1% to 10%): Dizziness
• Frequency not reported: Lightheadedness

Telmisartan:

• Common (1% to 10%): Dizziness
• Rare (less than 0.1%): Somnolence
• Frequency not reported: Tinnitus, migraine, hypoesthesia, cerebrovascular disorder, vertigo, paresthesia, hypoesthesia, involuntary muscle contraction
• Postmarketing reports: Headache, syncope^[Ref]

Gastrointestinal

• Common (1% to 10%): Diarrhea, nausea
• Uncommon (0.1% to 1%): Dry mouth, flatulence
• Rare (less than 0.1%): Abdominal pain, constipation, dyspepsia, vomiting, gastritis

Hydrochlorothiazide:

• Common (1% to 10%): Diarrhea, nausea
• Frequency not reported: Sialadenitis, pancreatitis, stomach discomfort, cramping, gastric irritation

Telmisartan:

• Common (1% to 10%): Diarrhea, nausea
• Rare (less than 0.1%): Stomach discomfort
• Frequency not reported: Hemorrhoids, gastroenteritis, enteritis, gastroesophageal reflux, toothache, non-specific gastrointestinal disorder, flatulence, constipation, gastritis, dry mouth,
• Postmarketing reports: Dyspepsia, abdominal pain^[Ref]

Renal

• Common (1% to 10%): BUN increased 11.2 mg/dL or greater, serum creatinine increased 0.5 mg/dL or greater

Hydrochlorothiazide:

• Frequency not reported: Nephritis interstitial, renal dysfunction, renal failure

Telmisartan:

• Uncommon (0.1% to 1%): Renal impairment, acute renal failure^[Ref]

Genitourinary

• Common (1% to 10%): Urinary tract infection
• Uncommon (0.1% to 1%): Erectile dysfunction
• Frequency not reported: Impotence

Hydrochlorothiazide:

• Frequency not reported: Glycosuria

Telmisartan:

• Uncommon (0.1% to 1%): Urinary tract infection
• Frequency not reported: Micturition frequency, cystitis, impotence
• Postmarketing reports: Erectile dysfunction^[Ref]

Hematologic

• Common (1% to 10%): Hemoglobin decreased 2 g/dL or greater
• Uncommon (0.1% to 1%): Hematocrit decreased 9% or more

Hydrochlorothiazide:

• Frequency not reported: Aplastic anemia, hemolytic anemia, bone marrow depression, leukopenia, neutropenia, agranulocytosis, thrombocytopenia

Telmisartan:

• Uncommon (0.1% to 1%): Anemia
• Rare (less than 0.1%): Eosinophilia, thrombocytopenia, hemoglobin decreased^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Tachycardia, arrhythmias, hypotension, orthostatic hypotension

Hydrochlorothiazide:

• Frequency not reported: Vasculitis necrotizing

Telmisartan:

• Uncommon (0.1% to 1%): Bradycardia
• Frequency not reported: Palpitation, angina pectoris, abnormal ECG, flushing, hypertension
• Postmarketing reports: Atrial fibrillation, congestive heart failure, myocardial infarction, blood pressure increased, hypertension aggravated, hypotension, postural hypotension^[Ref]

Musculoskeletal

• Uncommon (0.1% to 1%): Back pain, muscle spasm, myalgia
• Rare (less than 0.1%): Arthralgia, muscle cramp, pain in limb, blood creatine phosphokinase increased
• Frequency not reported: Leg pain, cramps in legs
• Postmarketing reports: Exacerbation or activation of systemic lupus erythematosus

Hydrochlorothiazide:

• Frequency not reported: Lupus-like syndrome, muscle spasm

Telmisartan:

• Rare (less than 0.1%): Arthrosis, tendon pain, tendonitis, tenosynovitis
• Frequency not reported: Arthritis, arthralgia, leg pain, leg cramps, myalgia
• Postmarketing reports: Back pain, muscle cramps, creatine phosphokinase increased, rhabdomyolysis^[Ref]

Metabolic

• Uncommon (0.1% to 1%): Hypokalemia, blood uric acid increased
• Rare (less than 0.1%): Hyperuricemia, hyponatremia

Hydrochlorothiazide:

• Frequency not reported: Diabetes mellitus inadequate control, anorexia, appetite decreased, electrolyte imbalance, hypercholesterolemia, hyperglycemia, hypovolemia, triglycerides increased, hyperuricemia

Telmisartan:

• Uncommon (0.1% to 1%): Hyperkalemia
• Rare (less than 0.1%): Hypoglycemia in diabetic patients
• Frequency not reported: Diabetes mellitus, gout, hypercholesterolemia
• Postmarketing reports: Uric acid increased^[Ref]

Psychiatric

• Uncommon (0.1% to 1%): Anxiety
• Rare (less than 0.1%): Depression, insomnia, sleep disorder

Hydrochlorothiazide:

• Frequency not reported: Restlessness

Telmisartan:

• Frequency not reported: Nervousness, insomnia, anxiety, depression^[Ref]

Dermatologic

• Rare (less than 0.1%): Angioedema, erythema, pruritus, rash, hyperhidrosis, urticaria
• Frequency not reported: Sweating increased

Hydrochlorothiazide:

• Frequency not reported: Photosensitivity reactions, skin vasculitis, toxic epidermal necrolysis, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, purpura, urticaria

Telmisartan:

• Rare (less than 0.1%): Eczema, drug eruption, toxic skin eruption, toxicoderma, rash, angioedema
• Frequency not reported: Dermatitis, sweating increased, pruritus
• Postmarketing reports: Urticaria, erythema^[Ref]

Hepatic

• Rare (less than 0.1%): Abnormal hepatic function/liver disorder, hepatic enzyme increased
• Frequency not reported: Serum bilirubin increased

Hydrochlorothiazide:

• Frequency not reported: Jaundice hepatocellular, jaundice cholestatic

Telmisartan:

• Postmarketing reports: Abnormal hepatic function/liver disorder^[Ref]

Ocular

• Rare (less than 0.1%): Visual disturbance, vision blurred

Hydrochlorothiazide:

• Frequency not reported: Xanthopsia, acute myopia, acute angle-closure glaucoma, transient blurred vision

Telmisartan:

• Frequency not reported: Conjunctivitis, abnormal vision^[Ref]

Immunologic

Hydrochlorothiazide:

• Frequency not reported: Anaphylactic reactions, hypersensitivity, allergy

Telmisartan:

• Rare (less than 0.1%): Sepsis, hypersensitivity, anaphylactic reactions
• Frequency not reported: Allergy, infection, fungal infection, abscess, otitis media^[Ref]

See also:

Further information

Hydrochlorothiazide/telmisartan side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer