TELMISARTAN, AMLODIPINE & HYDROCHLOROTHIAZIDE TABLETS

About TELMISARTAN, AMLODIPINE & HYDROCHLOROTHIAZIDE TABLETS

• Telmisartan  an angiotensin II receptor blocker ARB

  
  

  Amlodipine  a calcium channel blocker CCB

  
  

  Hydrochlorothiazide HCTZ  a thiazide diuretic

  
  

  Each one acts via a different mechanism so the combination tends to be more effective than any single drug alone especially in people whose blood pressure is not well controlled with simpler regimens PubMed4Apollo Pharmacy4mediboonpharmacom4

  
  

  How they work Mechanisms of action

  Heres how each component contributes

  
  

  
  

  Component Mechanism

  Telmisartan Blocks the angiotensin II type 1 AT1 receptors  prevents angiotensin II a potent vasoconstrictor from acting  causes vasodilation blood vessels relax  reduces blood pressure Also reduces aldosterone secretion which means less watersalt retention TrueMeds2mediboonpharmacom2

  Amlodipine Calcium channel blocker dihydropyridine class Inhibits calcium influx in vascular smooth muscle arteries  leads to vasodilation  reduces peripheral vascular resistance  lowers blood pressure Also may have effects on heart but mostly for blood vessels TrueMeds1

  Hydrochlorothiazide Diuretic that acts in the kidneys distal convoluted tubule to increase excretion of sodium and water  reduces blood volume which helps lower blood pressure Also some effect in relaxing blood vessels in long term It also causes loss of some electrolytes like potassium and has effects on fluid balance Medicine India1

  
  

  Indications When is it used

  For people with hypertension especially when one or two medications are not enough to control blood pressure 1mg2PubMed2

  
  

  When doctors want to combine different mechanisms ARB  CCB  diuretic to achieve better blood pressure lowering and possibly reduce risks of complications heart attack stroke kidney damage PubMed1

  
  

  May be considered in patients with other risk factors like higher cardiovascular risk where good blood pressure control is very important

  
  

  Common dosages

  Some typical formulations or strengths used in the combined tablets are but these may vary by brand  country  patient

  
  

  Telmisartan 40 mg or 80 mg cardiaticcarecom2indexarepositorycom2

  
  

  Amlodipine usually 25 mg or 5 mg in these combos indexarepositorycom1

  
  

  Hydrochlorothiazide often 125 mg per day when used as the third drug in combinations PubMed1

  
  

  Clinical evidence

  A study in Japanese patients whose blood pressure was not adequately controlled with telmisartan  amlodipine showed that adding HCTZ 125 mg produced significantly greater reductions in both systolic and diastolic blood pressure after 8 weeks compared to continuing with just Telmisartan  Amlodipine PubMed

  
  

  Also in patients who were uncontrolled on amlodipine alone switching to telmisartan  hydrochlorothiazide yielded better control PubMed

  
  

  Potential benefits

  Better blood pressure control vs fewer drugs

  
  

  Lower risk of cardiovascular outcomes heart attack stroke if BP is well managed

  
  

  May reduce risk of targetorgan damage kidneys heart associated with longterm high blood pressure

  
  

  Using a triple combo may reduce pill burden if available as a single tablet and improve adherence

  
  

  Risks  Side effects

  Like all medications there are possible side effects and specific risks to consider

  
  

  Common side effects include

  
  

  Dizziness lightheadedness especially on standing up Apollo Pharmacy2TrueMeds2

  
  

  Swelling of ankles  feet edema due primarily to amlodipine Apollo Pharmacy1

  
  

  Fatigue feeling tired 1mg1

  
  

  Nausea stomach upset Apollo Pharmacy1

  
  

  Changes in electrolytes eg low potassium hypokalemia possibly low sodium HCTZ can also raise uric acid levels cardiaticcarecom2PubMed2

  
  

  Possible increased risk of dehydration especially if fluid intake is low or with excessive sweating mediboonpharmacom1

  
  

  Less common  more serious risks

  
  

  Kidney impairment especially if there is already existing kidney disease The ARB telmisartan can affect kidney function and diuretics alter fluid balance Monitoring is needed Apollo Pharmacy1

  
  

  Electrolyte imbalances potassium sodium magnesium can lead to problems eg arrhythmias

  
  

  Hypotension blood pressure going too low especially when first starting or increasing dose

  
  

  Allergic reactions rare

  
  

  For certain populations pregnancy severe hepatic disease etc might be contraindicated Apollo Pharmacy1

  
  

  Precautions  When it may not be suitable

  Pregnancy  Breastfeeding This combination especially telmisartan part is generally avoided during pregnancy because ARBs can cause harm to the fetus 1mg1

  
  

  Kidney disease Existing impairment means closer monitoring is required

  
  

  Electrolyte disturbances Patients with low potassium or who are taking other medications that affect electrolytes need caution

  
  

  Liver disease Might require dose adjustments or avoidance

  
  

  Other drug interactions Several possible interactions eg other blood pressure medicines potassiumsparing diuretics NSAIDs etc Apollo Pharmacy1

  
  

  What to watch out for  monitoring

  If you are prescribed this combo doctors usually check  advise

  
  

  Regular blood pressure readings to ensure its effective but not too low

  
  

  Kidney function tests creatinine blood urea periodically

  
  

  Electrolyte levels potassium sodium especially with the diuretic

  
  

  Signs of dehydration eg dry mouth excessive thirst low urine

  
  

  Monitor for swelling sudden weight gain or shortness of breath

  
  

  If you have gout since HCTZ can increase uric acid

  
  

  Review all other medications  supplements you are taking to avoid interactions