Telmisartan and Hydrochlorothiazide (Systemic)

Brand Names : Micardis HCT, Micardis Plus

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For telmisartan and hydrochlorothiazide, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to telmisartan. Tell your doctor if you have ever had any unusual or allergic reaction to hydralazine, sulfonamides (sulfa drugs), bumetanide, furosemide, acetazolamide, dichlorphenamide, or methazolamide or to hydrochlorothiazide or any of the other thiazide diuretics (water pills). Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Use of telmisartan during pregnancy, especially during the second and third trimesters (after the first 3 months) can cause low blood pressure, severe kidney failure, or possibly death in the newborn. Therefore, it is important that you check with your doctor immediately if you think that you may have become pregnant. When hydrochlorothiazide is used during pregnancy, it may cause side effects including jaundice, blood problems, and low potassium in the newborn infant. Be sure that you have discussed this with your doctor before taking this medicine.

Breast-feeding - It is not known whether telmisartan passes into breast milk. However, telmisartan passes into the milk of lactating rats. Because this medicine may cause serious side effects, breast-feeding is generally not recommended while you are taking it.

Children - Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of telmisartan and hydrochlorothiazide in children with use in other age groups.

Older adults - This medicine has been tested in patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking telmisartan and hydrochlorothiazide combination , it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Alcohol or
• Barbiturates (e.g., Phenobarbital, Fiorinal) or
• Narcotic pain medicine (e.g., morphine, codeine, Oxycontin) - May cause blood pressure to decrease when standing up from a sitting or lying position.

• Diuretics (e.g., Bumex, Diamox, Lasix) - Telmisartan and hydrochlorothiazide with diuretics may cause blood pressure to become too low.

• Lithium (e.g., Eskalith, Lithobid) - Risk of lithium overdose, even at usual doses, lithium level may be increased.

Other medical problems - The presence of other medical problems may affect the use of telmisartan and hydrochlorothiazide. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy or
• Asthma, bronchial - May have an increased risk of allergic reaction to hydrochlorothiazide
• Congestive heart failure (severe) - May worsen condition and cause kidney problems
• Dehydration (fluid and electrolyte loss due to excessive perspiration, vomiting, diarrhea, long-term diuretic therapy, dialysis, or dietary salt restriction) or
• Sympathectomy - Blood pressure-lowering effects may be increased
• Diabetes mellitus (sugar diabetes) - May require a dosage adjustment of diabetes medicine
• Systemic lupus erythematosis - Hydrochlorothiazide may cause this condition to become active or worse
• A blockage in the gallbladder or bile ducts, or
• Liver disease - Blood levels of telmisartan may be higher in patients with this condition. If hydrochlorothiazide causes loss of too much water from the body, problems can become much worse
• No urination, or
• Kidney disease - Use of telmisartan and hydrochlorothiazide may cause kidney or urinary problems to become worse.