Telmisartan & hydrochlorothiazide

Telmisartan/hydrocholorothiazide is a prescription medication used to treat hypertension, or high blood pressure.

It is a single product containing 2 medications: Telmisartan and hydrochlorothiazide.

Telmisartan belongs to a group of drugs called angiotensin II receptor blockers (ARBs), while hydrochlorothiazide belongs to a group of drugs called diuretics, or "water pills." Telmisartan blocks a natural substance that narrows blood vessels, which the heart to pump more efficiently. Hydrochlorothiazide helps the body get rid of excess fluid. 

This medication comes in tablet form, and is usually taken once a day in the morning, with or without food. 

Common side effects of telmisartan/hydrochlorothiazide include frequent urination, sinus pain and congestion, and dizziness.

Do not drive or operate heavy machinery until you know how telmisartan/hydrochlorothiazide affects you.

Telmisartan/hydrochlorothiazide is a prescription medication used to treat hypertension, or high blood pressure. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Telmisartan & hydrochlorothiazide may be found in some form under the following brand names:

• Micardis-HCT

Serious side effects have been reported with telmisartan/hydrochlorothiazide. See the “Drug Precautions” section.

Common side effects of telmisartan/hydrochlorothiazide include the following:

• sinus pain and congestion
• back pain
• diarrhea
• frequent urination (having to pee often)
• dizziness

This is not a complete list of side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• aliskiren (Tekturna)
• digoxin (Lanoxin)
• lithium (Eskalith, Lithobid)
• other medicines for high blood pressure
• NSAIDs (such as aspirin, ibuprofen, naproxen, others)
• corticosteroids (such as prednisone, hydrocortisone, others)
• angiotensin-converting enzyme (ACE) blockers such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril
• angiotensin II receptor blockers such as losartan (Cozaar),  olmesartan (Benicar), valsartan (Diovan)

This is not a complete list of telmisartan/hydrochlorothiazide drug interactions.  Ask your doctor or pharmacist for more information.

Before receiving this medication, tell your doctor if you are allergic to telmisartan, hydrochlorothiazide, sulfa drugs, or any other medication.

Serious side effects have been reported with telmisartan/hydrochlorothiazide including the following:

• hypotension. Hypotension, or low blood pressure, may cause you to feel faint or dizzy. Inadequate fluid intake, excessive sweating, diarrhea, or vomiting can lead to an excessive fall in blood pressure too. Lie down if you feel faint or dizzy. Call your doctor right away.
• high levels of potassium in your blood (hyperkalemia). People with kidney problems, heart failure, or on other medications that increase potassium levels are at higher risk of hyperkalemia. Your doctor may want to measure your potassium levels periodically.
• low levels of potassium in your blood (hypokalemia). Symptoms of low potassium levels include abnormal heart rhythms, muscle weakness, muscle cramps, or paralysis.
• a decline in kidney function. Toxicity from telmisartan/hydrochlorothiazide may occur with kidney dysfunction since it is filtered out of the body by the kidneys. Your doctor may want to monitor your kidney functions with certain blood tests as well. Tell your healthcare provider right away right away if you have any of the following symptoms of kidney dysfunction:
  • swelling of face, ankles, hands, or feet
  • fatigue
  • paleness of skin
  • decreased urination
  • shortness of breath
  • change in blood pressures
  • side effects as mentioned in this section or in the “Side Effects” section of this medication page
• hypersensitivity (severe allergic reaction). Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following:
  • chest pain
  • swelling of the face, eyes, lips, tongue, arms, or legs
  • difficulty breathing or swallowing
  • fainting
  • rash

Telmisartan/hydrochlorothiazide can cause dizziness. Do not drive or operate heavy machinery until you know how this medication affects you.

Do not take telmisartan/hydrochlorothiazide if you:

• are allergic to telmisartan, hydrochlorothiazide, or any of its ingredients
• have diabetes and are taking the drug aliskiren

Tell your doctor if you have prolonged diarrhea or vomiting as this may lead to a serious loss of body water (dehydration) To prevent dehydration, drink plenty of fluids unless your doctor directs you otherwise.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of telmisartan/hydrochlorothiazide, salt substitutes containing potassium should be avoided.

Before taking telmisartan/hydrochlorothiazide, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to telmisartan, hydrochlorothiazide or to any of its ingredients
• have liver problems
• have kidney problems
• have heart problems
• have diabetes
• have gout
• have lupus 
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking telmisartan/hydrochlorothiazide.

Tell your doctor if you are pregnant or plan to become pregnant.

Telmisartan/hydrochlorothiazide should NOT be used during pregnancy. Telmisartan/hydrochlorothiazide can cause injury and death to the developing fetus. 

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if telmisartan crosses into human milk, but hydrochlorothiazide is excreted in human breast milk. There is some evidence hydrochlorothiazide may reduce the amount of breast milk produced by women who take it. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using telmisartan/hydrochlorothiazide.

Take telmisartan/hydrochlorothiazide exactly as prescribed.

Telmisartan/hydrochlorothiazide comes in tablet form and is taken once a day.

This medication can be taken with or without food.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of telmisartan/hydrochlorothiazide at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

The usual recommended dose for Micardis HCT (telmisartan/hydrochlorothiazide) for the treatment of high blood pressure is 80 mg/12.5 mg. This medication may be titrated up to a max dose of 160 mg/25 mg.

If you take too much telmisartan/hydrochlorothiazide, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If telmisartan/hydrochlorothiazide is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store telmisartan/hydrochlorothiazide at room temperature between 59°F to 86°F (15°C to 30°C), away from light and excess moisture.
• Do not remove telmisartan/hydrochlorothiazide tablets from blisters until right before you take them.
• Keep this and all medicines out of the reach of children.

Warning: fetal toxicity

• When pregnancy is detected, discontinue telmisartan/hydrochlorothiazide as soon as possible.
• Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus