Hydrochlorothiazide + Telmisartan - instructions for use, dose, side effects, contraindications

Has hypotensive and diuretic effect. Displays sodium and stores potassium in the blood plasma. Diuretic effect begins two hours after taking the drug. The maximum effect is noted after 4 hours and lasts for 6-12 hours. At the initial normal arterial pressure, there is no decrease.

Telmisartan

Angiotensin II receptor antagonist selectively binds to AT₁receptors in the vessels, the adrenal cortex, the heart, the kidneys. Prevents the effect of angiotensin II on renal blood flow and blood pressure.

Does not affect the concentration in the blood plasma of low-density lipoproteins,triglycerides and glucose. Improves renal blood flow, without affecting the mechanisms of self-regulation of the kidneys. In patients with healthy kidneys, increases natriuresis and does not cause retention of sodium ions in patients with renal insufficiency.

Has hypotensive, vasodilating, nephroprotective effect, reducing the excretion of albumins, increases the rate of glomerular filtration and renal blood flow. With prolonged use suppresses the proliferation of smooth muscle vessels and myocardium caused by angiotensin II.

The hypotensive effect after taking the drug lasts for 24 hours, with regular admission a stable therapeutic effect is established after 2-3 weeks and is not accompanied by an increase in the heart rate. Does not cause withdrawal syndrome after discontinuation.

Pharmacokinetics:

Hydrochlorothiazide

The highest concentration of the drug in the blood plasma is observed 3-4 hours after oral administration.

Bioavailability of 60-80%, communication with blood plasma proteins - up to 70-75%. Metabolism in the liver.

The half-life is 6-9 hours.

Elimination by the kidneys (99%), decreased in chronic renal failure and in the elderly.

Telmisartan

After oral administration, an empty stomach is absorbed in the gastrointestinal tract up to 50%. The maximum concentration in the blood plasma is achieved after 0.5-1.5 hours. The connection with plasma proteins is 99.5%.

Metabolism in the liver.

Half-life is 20 hours. Elimination by the kidneys.

Indications:

It is used for the treatment of arterial hypertension.

ICD-10

IX.I10-I15.I15 Secondary Hypertension

IX.I10-I15.I10 Essential [primary] hypertension

Contraindications:

Hyperkalemia, decompensated diabetes mellitus, Addison's disease, gout, individual intolerance, stenosis of the single kidney artery, primary aldosteronism, children under 18 years.

Carefully:

Chronic renal failure, hypokalemia, hyponatremia, renovascular hypertension, advanced age, impaired liver function, chronic heart failure, hypertrophic cardiomyopathy, recently performed kidney transplantation, hypersensitivity.

Pregnancy and lactation:

Recommendations for FDA - Category C in I trimester, category D in II and III trimester. It enters the breast milk, reduces lactation: it is recommended to stop breastfeeding during treatment.

Dosing and Administration:

Inside, 1 tablet of 12.5 / 40 mg and 12.5 / 80 mg once a day, regardless of food intake.

The highest daily dose: 12.5 / 80 mg.

The highest single dose: 12.5 / 80 mg.

Side effects:

Hydrochlorothiazide

Central and peripheral nervous system: a change in mood and psyche, headache, dizziness, paresthesia.

Respiratory system: respiratory distress syndrome, pneumonitis.

Hemopoietic system: aplastic anemia, hemolytic anemia, agranulocytosis, leukopenia, thrombocytopenia.

The cardiovascular system: arrhythmia, vasculitis.

Digestive system: pancreatitis, cholecystitis, constipation, anorexia,

Musculoskeletal system: myalgia, convulsions.

Dermatological reactions: photosensitization.

Sense organs: transient visual impairment.

urinary system: interstitial nephrosis.

Reproductive system: decreased potency.

Allergic reactions.

Telmisartan

Central and peripheral nervous system: headache, dizziness, asthenia.

Respiratory system: rhinitis.

The cardiovascular system: postural hypotension.

Digestive system: dyspeptic disorders, vomiting, diarrhea.

Allergic reactions.

Overdose:

Hydrochlorothiazide

Dehydration, pronounced electrolyte disorders, lowering blood pressure, tachycardia, confusion, lethargy, dry mouth, muscle weakness, drowsiness, hypotension, oliguria, shock.

Treatment is symptomatic.

Telmisartan

Arterial hypotension.

Treatment is symptomatic.

Interaction:

Hydrochlorothiazide

Potentiates the effect of antihypertensive drugs.

Nonsteroidal anti-inflammatory drugs weaken the hypotensive and diuretic effect.

Increases the toxicity of cardiac glycosides.

Reduces the clearance of amantadine, increasing its toxicity.

Reduces the level of iodine in the plasma.

Increases the level of bilirubin.

With the simultaneous use of barbiturates, narcotic analgesics, ethanol, the risk of orthostatic hypotension increases.

Telmisartan

At simultaneous application with blockers of slow calcium channels and thiazide diuretics, a mutual enhancement of hypotensive effect is observed.

When used simultaneously with non-steroidal anti-inflammatory drugs, there is a chance of developing acute renal failure.

Special instructions:

Monitoring of kidney function.

At the initial stage of treatment, it is not recommended to drive vehicles and work with moving mechanisms.

Instructions

Hydrochlorothiazide + Telmisartan (Hydrochlorothiazidum + Telmisartanum)