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Active Substance: telmisartan / hydrochlorothiazide
Common Name: telmisartan / hydrochlorothiazide
ATC Code: C09DA07
Marketing Authorisation Holder: Bayer Pharma AG
Active Substance: telmisartan / hydrochlorothiazide
Status: Authorised
Authorisation Date: 2002-04-19
Therapeutic Area: Hypertension
Pharmacotherapeutic Group: Agents acting on the renin-angiotensin system

Therapeutic Indication

Treatment of essential hypertension.

Kinzalkomb fixed-dose combination (40 mg telmisartan / 12.5 mg hydrochlorothiazide, 80 mg telmisartan / 12.5 mg hydrochlorothiazide) is indicated in patients whose blood pressure is not adequately controlled on telmisartan alone.

Kinzalkomb fixed-dose combination (80 mg telmisartan / 25 mg hydrochlorothiazide) is indicated in patients whose blood pressure is not adequately controlled on Kinzalkomb (80 mg telmisartan / 12.5 mg hydrochlorothiazide) or patients who have been previously stabilised on telmisartan and hydrochlorothiazide given separately.

What is Kinzalkomb?

Kinzalkomb is a medicine that contains two active substances, telmisartan and hydrochlorothiazide. It is available as tablets (40 mg or 80 mg telmisartan and 12.5 mg hydrochlorothiazide; 80 mg telmisartan and 25 mg hydrochlorothiazide).

What is Kinzalkomb used for?

Kinzalkomb is used in adult patients who have essential hypertension (high blood pressure) that is not adequately controlled by telmisartan alone. ‘Essential’ means that the hypertension has no obvious cause.

The medicine can only be obtained with a prescription.

How is Kinzalkomb used?

Kinzalkomb is taken by mouth once a day with liquid, with or without food. The dose of Kinzalkomb to be used depends on the dose of telmisartan that the patient was taking before: patients who were receiving 40 mg telmisartan should take the 40/12.5-mg tablets, and patients who were receiving 80 mg telmisartan should take the 80/12.5-mg tablets. The 80/25-mg tablets are used in patients whose blood pressure is not controlled using the 80/12.5-mg tablets or who have been stabilised using the two active substances taken separately before switching to Kinzalkomb.

How does Kinzalkomb work?

Kinzalkomb contains two active substances, telmisartan and hydrochlorothiazide.

Telmisartan is an ‘angiotensin-II-receptor antagonist’, which means that it blocks the action of a hormone in the body called angiotensin II. Angiotensin II is a powerful vasoconstrictor (a substance that narrows blood vessels). By blocking the receptors to which angiotensin II normally attaches, telmisartan stops the hormone having an effect, allowing the blood vessels to widen.

Hydrochlorothiazide is a diuretic, which is another type of treatment for hypertension. It works by increasing urine output, reducing the amount of fluid in the blood and reducing blood pressure.

The combination of the two active substances has an additive effect, reducing the blood pressure more than either medicine alone. By lowering blood pressure, the risks associated with high blood pressure, such as having a stroke, are reduced.

How has Kinzalkomb been studied?

Kinzalkomb has been studied in five main studies involving a total of 2,985 patients with mild to moderate hypertension. In four of these studies, Kinzalkomb was compared with placebo (a dummy treatment) and with telmisartan taken alone in a total of 2,272 patients. The fifth study compared the effects of remaining on the 80/12.5-mg tablet with switching to the 80/25-mg tablet in 713 patients who had not responded to the 80/12.5-mg tablet. In all studies, the main measure of effectiveness was the reduction in diastolic blood pressure (the blood pressure measured between two heartbeats).

What benefit has Kinzalkomb shown during the studies?

Kinzalkomb was more effective at reducing diastolic blood pressure than telmisartan taken alone and than placebo. In patients who were not controlled on the 80/12.5-mg tablet, switching to the 80/25-mg tablet was more effective in reducing diastolic blood pressure than remaining on the lower dose.

What is the risk associated with Kinzalkomb?

The most common side effect with Kinzalkomb (seen in between 1 and 10 patients in 100) is dizziness. For the full list of all side effects reported with Kinzalkomb, see the Package Leaflet.

Kinzalkomb must not be used in women who are more than three months pregnant. Its use during the first three months of pregnancy is not recommended. Kinzalkomb must also not be used in people who have severe liver, kidney or bile problems, blood potassium levels that are too low, or blood calcium levels that are too high. In patients with type 2 diabetes or in patients with moderate or severe kidney impairment, Kinzalkomb must also not be used in combination with aliskiren-containing medicines (also used to treat essential hypertension). For the full list of restrictions, see the package leaflet.

Care must be taken when using Kinzalkomb with other medicines that have an effect on blood potassium levels. The full list of these medicines is given in the package leaflet.

Why has Kinzalkomb been approved?

The CHMP decided that Kinzalkomb’s benefits are greater than its risks for the treatment of essential hypertension in patients whose blood pressure is not adequately controlled on telmisartan alone. The Committee recommended that Kinzalkomb be given marketing authorisation.

What measures are being taken to ensure the safe and effective use of Kinzalkomb?

A risk management plan has been developed to ensure that Kinzalkomb is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Kinzalkomb, including the appropriate precautions to be followed by healthcare professionals and patients.

Other information about Kinzalkomb

The European Commission granted a marketing authorisation valid throughout the European Union for Kinzalkomb on 19 April 2002.

For more information about treatment with Kinzalkomb, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Source: European Medicines Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.