Telmisartan/hctz 80-25mg Tabs

Telmisartan is an angiotensin II receptor blocker (ARB) that selectively blocks the binding of angiotensin II to the AT1 receptor in many tissues, including vascular smooth muscle and the adrenal gland. This inhibits the vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to vasodilation and reduced sodium and water retention. Hydrochlorothiazide is a thiazide diuretic that inhibits the reabsorption of sodium and chloride ions in the distal convoluted tubule, increasing the excretion of sodium, chloride, and water. It also increases potassium and magnesium excretion and decreases calcium excretion.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Signs of pancreatitis (pancreas problems), such as:
+ Severe stomach pain
+ Severe back pain
+ Severe upset stomach or vomiting
Signs of liver problems, including:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Signs of fluid and electrolyte problems, such as:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Abnormal heartbeat
+ Severe dizziness or fainting
+ Increased thirst
+ Seizures
+ Feeling extremely tired or weak
+ Decreased appetite
+ Inability to pass urine or changes in urine output
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or vomiting
Chest pain
Severe dizziness or fainting
Trouble passing urine
Pain while passing urine
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak
Abnormal sensations, such as burning, numbness, or tingling
Shortness of breath
Restlessness
Erectile dysfunction
Rarely, skin cancer has been reported in people taking hydrochlorothiazide. To minimize risk, protect your skin from the sun and follow your doctor's recommendations for skin checks. If you notice any changes in the color or size of a mole, or any new or changing skin lump or growth, contact your doctor immediately.

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:

Common cold symptoms
Dizziness
Fatigue
Weakness
Flu-like symptoms
Back pain
Diarrhea
* Upset stomach

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions and situations to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
A known sulfa allergy.
Certain health conditions, including kidney disease or liver disease.
Dehydration or electrolyte imbalances.
Urinary retention, which means you are unable to pass urine.
Concurrent use of specific medications, such as:
+ Aliskiren
+ Benazepril
+ Captopril
+ Enalapril
+ Fosinopril
+ Lisinopril
+ Moexipril
+ Perindopril
+ Quinapril
+ Ramipril
+ Trandolapril
+ Dofetilide
* If you are breast-feeding, as you should not breast-feed while taking this medication.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your other treatments and health conditions. Never start, stop, or adjust the dose of any medication without consulting your doctor first.

Important Warnings and Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Caution with Daily Activities
Avoid driving and performing tasks that require alertness until you understand how this medication affects you. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and be cautious when climbing stairs.

Managing Diabetes
If you have diabetes, closely monitor your blood sugar levels. Be aware of signs of high blood sugar, such as confusion, drowsiness, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath. Report these symptoms to your doctor.

Monitoring Blood Pressure and Lab Tests
Check your blood pressure as directed by your healthcare provider. Also, have blood work done as scheduled, and discuss the results with your doctor. Note that this medication may affect certain lab tests, so inform all healthcare providers and lab personnel that you are taking this drug.

Interactions with Other Substances
If you are taking a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium product, consult your doctor. Additionally, if you are on a low-salt or salt-free diet, discuss this with your doctor. Before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, or certain natural products, consult your doctor.

Caution with Other Medications and Substances
Before consuming alcohol, marijuana, or other forms of cannabis, or using prescription or OTC medications that may slow your reactions, discuss this with your doctor.

Precautions in Hot Weather
Be cautious in hot weather or during physical activity, and drink plenty of fluids to prevent dehydration. If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these symptoms may lead to low blood pressure.

Eye Problems
This medication can cause eye problems, which, if left untreated, may result in permanent vision loss. If you experience eye problems, symptoms such as changes in vision or eye pain typically occur within hours to weeks of starting the medication. Seek medical attention immediately if you notice these symptoms.

Rare but Serious Reaction
In rare cases, this medication can cause a severe reaction called angioedema, which can be life-threatening. Seek medical help immediately if you experience symptoms such as swelling of the hands, face, lips, eyes, tongue, or throat, difficulty breathing or swallowing, or unusual hoarseness.

Cholesterol and Triglyceride Levels
This medication may increase cholesterol and triglyceride levels. Discuss this with your doctor. If you take cholestyramine or colestipol, consult your pharmacist about how to take these medications with this drug. Be aware of the risk of gout attacks.

Lupus and Sun Sensitivity
If you have lupus, this medication may worsen your condition. Inform your doctor immediately if you experience new or worsening symptoms. Additionally, this medication may increase your risk of sunburn. Take precautions when exposed to the sun, and inform your doctor if you experience increased sun sensitivity while taking this medication.

• Aliskiren (in patients with diabetes or renal impairment)
• Lithium (due to increased lithium levels and toxicity from HCTZ)

• NSAIDs (including COX-2 inhibitors) - may reduce antihypertensive effect and increase risk of renal impairment, especially in dehydrated or elderly patients.
• Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) or potassium supplements - increased risk of hyperkalemia due to telmisartan.
• Digoxin - HCTZ-induced hypokalemia or hypomagnesemia can increase digoxin toxicity.
• Other antihypertensive agents - additive hypotensive effects.

• Corticosteroids - may antagonize the diuretic and antihypertensive effects of HCTZ.
• Bile acid sequestrants (e.g., cholestyramine, colestipol) - may reduce absorption of HCTZ.
• Alcohol, barbiturates, or narcotics - may potentiate orthostatic hypotension.
• Antidiabetic agents (oral agents and insulin) - HCTZ may decrease glucose tolerance, requiring dose adjustment of antidiabetic agents.

• Skeletal muscle relaxants, non-depolarizing (e.g., tubocurarine) - HCTZ may potentiate their effect.

• Dizziness
• Lightheadedness
• Fainting (syncope)
• Excessive fatigue or weakness
• Muscle cramps or pain
• Dry mouth
• Increased thirst
• Nausea
• Vomiting
• Irregular heartbeat
• Swelling of face, lips, tongue, or throat (angioedema)
• Difficulty breathing or swallowing
• Yellowing of skin or eyes (jaundice)
• Signs of infection (fever, sore throat) - rare, but HCTZ can cause blood dyscrasias

Contraindicated during the second and third trimesters of pregnancy due to risk of fetal injury and death. Avoid use in the first trimester as well. If pregnancy is detected, discontinue as soon as possible.

Not recommended during breastfeeding. Hydrochlorothiazide is excreted in human milk and can suppress lactation. It is unknown if telmisartan is excreted in human milk. Due to the potential for serious adverse effects on the breastfed infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Safety and effectiveness have not been established in pediatric patients. Not recommended for use in children.

No overall differences in effectiveness or safety have been observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Monitor renal function and electrolytes closely, as elderly patients are more likely to have age-related decreases in renal function and be on concomitant medications.

• This combination is typically used when monotherapy with telmisartan or HCTZ is insufficient to control blood pressure.
• Take consistently at the same time each day to maintain steady blood pressure control.
• Patients should be advised to report any signs of angioedema (swelling of face, lips, tongue, or throat) immediately.
• Monitor for signs of electrolyte imbalance, especially hypokalemia (due to HCTZ) and hyperkalemia (less common, but possible with telmisartan, especially with renal impairment or potassium-sparing diuretics).
• Educate patients about orthostatic hypotension (dizziness upon standing) and advise them to rise slowly.
• Avoid concomitant use with NSAIDs, especially in patients with dehydration or renal impairment, due to increased risk of acute renal failure and reduced antihypertensive effect.

• Other Angiotensin II Receptor Blockers (ARBs) monotherapy (e.g., telmisartan, valsartan)
• ACE Inhibitors (e.g., lisinopril, enalapril)
• Calcium Channel Blockers (e.g., amlodipine, nifedipine)
• Beta-blockers (e.g., metoprolol, carvedilol)
• Other Diuretics (e.g., loop diuretics, potassium-sparing diuretics)
• Direct Renin Inhibitors (e.g., aliskiren - generally not first-line)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.