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INTRODUCTION
HHTELM H TABLET is a combination of Hydrochlorothiazide and Telmisartan which belongs to the group of medicines called Antihypertensive agents. It is used to treat hypertension (high blood pressure) when treatment with single agents is not effective.
Hypertension (also known as high blood pressure) is a medical condition in which the force of the blood exerted against the walls of the artery remains very high, and as a result it may lead to severe damage to the blood vessels supplying several vital organs, such as heart, kidney, or brain. If left untreated, it may cause serious complications such as heart attack, heart failure, stroke or even blindness.
By lowering blood pressure, HHTELM H TABLET can also reduce the risk of heart attack (myocardial infarction) or stroke. During treatment with HHTELM H TABLET your doctor will constantly monitor your kidney functions, blood pressure, electrolyte levels and blood sugar levels to avoid the risk of unwanted side effects.
Before taking HHTELM H TABLET inform your doctor if you have any heart, liver, or kidney problems. You must also inform your doctor if you have diabetes, low blood pressure or are severely dehydrated due to excessive vomiting or diarrhea.
HHTELM H TABLET is also not suitable for use in pregnant or breastfeeding women as it may cause serious harm to the growing baby. Stop taking HHTELM H TABLET and inform your doctor immediately if you become pregnant while undergoing therapy with HHTELM H TABLET.
The most common side effects of taking HHTELM H TABLET are low blood pressure, dizziness, low or high blood potassium levels, pins and needles, muscle pain, diarrhoea, dry mouth, erectile dysfunction and increased blood uric acid levels. Contact your doctor if any of these side effect worsens.
USES OF HHTELM H TABLET
- Treats Hypertension (high blood pressure)
- Prevents the risk of heart attack or stroke
HOW HHTELM H TABLET WORKS
HHTELM H TABLET is an antihypertensive medicine. It relaxes your blood vessels and improves blood flow across them. It also reduces thickness of the blood by removing excess fluids from the body in the form of urine. Collectively, these actions reduce the strain on the heart and helps the heart to pump blood more smoothly with less pressure.
DIRECTIONS FOR USE
Take HHTELM H TABLET as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.
Try to take HHTELM H TABLET at the same time each day. HHTELM H TABLET can be taken with or without food.
Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and health condition.
Continue to take HHTELM H TABLET for the stipulated duration instructed by your doctor without any interruption to achieve better results.
SIDE EFFECTS OF HHTELM H TABLET
COMMON
- dizziness
UNCOMMON
- low or high blood potassium levels
- pins and needles (paraesthesia)
- vertigo (spinning sensation)
- fast or irregular heartbeat
- low blood pressure causing dizziness while standing up
- diarrhoea, dry mouth, flatulence
- back pain, muscle spasm or pain
- erectile dysfunction (inability to get or keep an erection)
- increased blood uric acid levels
- sore throat, sinus inflammation, common cold, cough
- urinary tract infections
- anaemia
- kidney problems
RARE
- low blood sugar levels
- low blood platelet count (causing unusual bleeding or bruising)
- high blood calcium levels
- headache
Stop taking HHTELM H TABLET and contact your doctor immediately if you experience any of the following side effects such as:
- signs of allergic reactions (such as skin rash, swelling of the face, lips, mouth, or throat causing difficulty in breathing or swallowing)
- severe skin reactions (such as skin rash with itching and redness, blistering and peeling of skin, skin swelling and inflammation of mucous membrane)
- sepsis (infection of blood characterized by sever signs of illness and fever)
- eye pain, swelling, decrease in vision (signs of fluid accumulation in the eye)
- skin reactions or unexpected skin lesions
- increased skin sensitivity towards sunlight, sunburn, redness, itching, swelling and blistering of skin
- signs of severe dehydration (such as dry mouth, feeling weak or tired, drowsiness, restlessness, muscle weakness, nausea, vomiting and fast heart rate)
HOW TO MANAGE SIDE EFFECTS
Nausea and vomiting:
Take HHTELM H TABLET with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
Headache:
Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
WARNING & PRECAUTIONS
PREGNANCY
HHTELM H TABLET is not recommended for use in pregnant women as it may cause serious harm to the growing fetus. Therefore, inform your doctor before taking HHTELM H TABLET if you are pregnant, think you may be pregnant or planning to have a baby. If you become pregnant while undergoing therapy with HHTELM H TABLET, stop taking it and consult your doctor immediately.
BREASTFEEDING
HHTELM H TABLET is not recommended for use in breastfeeding women. Therefore, consult your doctor before taking it.
DRIVING AND USING MACHINES
Do not drive or handle any heavy tools or machines if you experience dizziness or drowsiness after taking HHTELM H TABLET.
ALCOHOL
Avoid consumption of alcohol while taking HHTELM H TABLET as it might make you feel dizzier and drowsier.
KIDNEY
HHTELM H TABLET is not recommended for use in patients with severe kidney problems. It should be used with caution in patients with other kidney problems (such as kidney transplant, narrowing of renal arteries). Therefore, consult your doctor before taking it.
LIVER
HHTELM H TABLET is not recommended for use in patients with severe liver impairment (such as cholestasis, jaundice, biliary obstruction). It should be used with caution in patients with mild to moderate liver problems. Therefore, consult your doctor before taking it.
ALLERGY
Do not take HHTELM H TABLET if you are allergic to Telmisartan or Hydrochlorothiazide.
HEART DISEASE
HHTELM H TABLET should be used with caution in patients with heart problems (such as irregular heart rhythm, problems with heart muscle or valves). Therefore, consult your doctor before taking it.
OTHERS
HHTELM H TABLET is not recommended for use if you:
- have diabetes related kidney problems
- have low potassium levels in blood
- have high calcium levels in blood
Before taking HHTELM H TABLET, inform your doctor if you:
- have primary hyperaldosteronism (problems in adrenal gland)
- have low blood pressure
- are severely dehydrated (due to diarrhea, vomiting or excess sweating)
- are on a low-salt diet
- have diabetes
- have gout (painful joints)
- have had skin cancer
- have an auto-immune disease condition affecting the skin (such as SLS)
- are scheduled for any upcoming surgery
Use in Pediatrics:
HHTELM H TABLET is not recommended for use in children and adolescents (aged below 18 years). Therefore, consult your doctor before taking it.
Use in Geriatrics:
HHTELM H TABLET should be used with caution in the elderly patients. Therefore, consult your doctor before taking it.
INTERACTIONS
A. Drug-Drug interactions:
Before taking HHTELM H TABLET inform to your doctor, if you are taking any of these medicines:
- antidepressants such as lithium, citalopram, fluoxetine, paroxetine, nefazodone, St. John’s wort (herbal medicine used to treat depression
- other medicines used to treat elevated blood pressure (such as aliskiren, bosentan, methyldopa, guanethidine, captopril, enalapril, lisinopril, verapamil, diltiazem, losartan, valsartan)
- potassium supplements or potassium-sparing diuretics such as spironolactone, triamterene or amiloride (used to retain or increase potassium levels in the body)
- non-steroidal anti-inflammatory drugs (used for pain relief) such as indomethacin, celecoxib, ibuprofen, aspirin
- heparin (a medicine used to prevent or treat blood clots)
- medicines used to treat bacterial infections (Ex. erythromycin, clarithromycin, telithromycin, trimethoprim, sparfloxacin, pentamidine, penicillin-G)
- baclofen (a medicine used for relaxing muscles)
- amifostine (a kidney protectant used along with chemotherapeutic agents)
- medicines used to treat mental disorders such as depression, psychosis, or anxiety (Ex. pimozide, amisulpride, haloperidol)
- corticosteroids (used to treat inflammation) Ex. prednisolone
- amphotericin B (a medicine used to treat fungal infections)
- carbenoxolone (a medicine used to treat mouth ulcers)
- allopurinol (a medicine used to treat gout)
- cyclophosphamide or methotrexate (medicine used to treat cancer)
- laxatives (used to treat constipation) Ex. lactulose
- corticotropin (a medicine used to correct hormone problems)
- medicines used to lower blood cholesterol levels (such as cholestyramine and colestipol)
- insulin, metformin (medicines used to treat diabetes)
- noradrenaline (a medicine used to increased blood pressure)
- tubocurarine, dantrolene (medicine used as a muscle relaxant)
- calcium supplements and/or vitamin D supplements
- atropine or biperiden used for abdominal or stomach spasms or cramps
- amantadine (medicine used to treat Parkinson’s disease)
- medicines to control the heart rhythm (Ex. quinidine, disopyramide, amiodarone, sotalol, digoxin)
- medicines used to treat mental disorders (Ex. thioridazine, chlorpromazine, levomepromazine)
- medicines used to treat allergic reactions (Ex. terfenadine)
Overdosage:
If you or anyone else accidentally take too much of HHTELM H TABLET, consult your doctor immediately or visit the nearby hospital. Overdosage may cause undesirable effects such as low blood pressure, rapid heartbeat, vomiting, slow heartbeat, dizziness, low blood levels of potassium (resulting in nausea, sleepiness and muscle cramps or irregular heartbeat), reduced kidney function including kidney failure.
SYNOPSIS
| Drug | : | Hydrochlorothiazide, Telmisartan |
| Pharmacological Category | : | Thiazide diuretics, Angiotensin-II receptor blockers |
| Therapeutic Indication | : | High blood pressure |
| Dosage Forms | : | Tablet |
MORE INFORMATION
- Keep HHTELM H TABLET out of reach of children
- Store HHTELM H TABLET at room temperature
FAQs ABOUT HHTELM H TABLET
Q: What are the uses of HHTELM H TABLET?
A: HHTELM H TABLET is used to treat hypertension. It can also be used to prevent the risk of heart attack or stroke.
Q: What type of a medicine is HHTELM H TABLET?
A: HHTELM H TABLET is an antihypertensive medicine. It relaxes your blood vessels and improves blood flow across them. It also reduces thickness of the blood by removing excess fluids from the body in the form of urine. Collectively, it reduces the strain on the heart and helps the heart to pump blood more smoothly with less pressure.
Q: What happens when I stop taking HHTELM H TABLET?
A: Do not stop taking HHTELM H TABLET without consulting your doctor as your blood pressure may raise once again. Make sure to take HHTELM H TABLET for the stipulated duration recommended by your doctor to achieve maximum results.
Q: What is the best time to take HHTELM H TABLET?
A: HHTELM H TABLET can be taken with or without meals. Your doctor will decide the best time for you to take HHTELM H TABLET based on your age, body weight and disease condition.
Q: What to do if I forgot to take a dose of HHTELM H TABLET?
A: If you forgot to take a dose of HHTELM H TABLET, take it as soon as you remember. However, if it is time for the next dose of HHTELM H TABLET, skip the missed dose and take the next one regularly. Do not take a double dose of HHTELM H TABLET to compensate the missed ones.
Q: What precautions should be followed while taking HHTELM H TABLET?
A: Before taking HHTELM H TABLET, inform your doctor if you have any heart, liver or kidney problems. You must also inform your doctor if you have diabetes, low blood pressure volume or are severely dehydrated. Stop taking HHTELM H TABLET and consult your doctor immediately if you become pregnant. Regularly visit your doctor and take all the necessary blood test recommended by your doctor without fail.
Q: Can I consume alcohol while taking HHTELM H TABLET?
A: Avoid consumption of alcohol while taking HHTELM H TABLET as it might make you feel dizzier and drowsier.
Q: What happens if I accidentally take more HHTELM H TABLET?
A: If you or anyone else accidentally took more HHTELM H TABLET, consult your doctor immediately. Overdosage may cause low blood pressure, abnormal heartbeat, dizziness, vomiting, decreased kidney functions, nausea, sleepiness and muscle cramps.
Q: Can I take HHTELM H TABLET daily?
A: Take HHTELM H TABLET as advised by your physician. Your doctor will evaluate your health condition and suggests whether can you take HHTELM H TABLET every day or not.
Q: Is HHTELM H TABLET safe to use in diabetic patients?
A: HHTELM H TABLET may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking HHTELM H TABLET as a precaution. Your doctor will closely monitor you blood sugar levels to avoid the risk of side effects.
Q: What are the side effects of HHTELM H TABLET?
A: The most common side effects of taking HHTELM H TABLET are low blood pressure, dizziness, low or high blood potassium levels, pins and needles, muscle pain, diarrhoea, dry mouth, erectile dysfunction and increased blood uric acid levels. Contact your doctor if any of these side effect worsens.
Q: Can I stop taking HHTELM H TABLET once my symptoms subside?
A: No. Do not stop taking HHTELM H TABLET without consulting your doctor. As hypertension is a chronic condition, long term treatment may be necessary to control its symptoms. Therefore, take HHTELM H TABLET as advised by your doctor for the stipulated duration. Premature discontinuation of therapy may increase your blood pressure once again.
Q: Can HHTELM H TABLET be taken during pregnancy?
A: HHTELM H TABLET is not recommended for use in pregnant women as it may cause serious harm to the growing fetus. Therefore, inform your doctor before taking HHTELM H TABLET if you are pregnant, think you may be pregnant or planning to have a baby. If you become pregnant while undergoing therapy with HHTELM H TABLET, stop taking it and consult your doctor immediately.
Q: Is HHTELM H TABLET safe to use in kidney disease?
A: HHTELM H TABLET is not recommended for use in patients with severe kidney problems. It should be used with caution in patients with other kidney problems (such as kidney transplant, narrowing of renal arteries). Your doctor will access your health condition and suggest a suitable dose for you. Therefore, it is important to inform your doctor if you have any kidney problems before taking HHTELM H TABLET as a precaution.
Q: Can the use of HHTELM H TABLET affect the liver?
A: Yes. HHTELM H TABLET may affect the way your liver work. It can elevate the levels of certain liver enzymes in your body. Therefore, it is strictly not recommended for use in patients with severe liver diseases. It should be used with caution in patients with other minor liver problems. Consult your doctor before taking it.
REFERENCES
- KD. Tripathi. Antihypertensive Drugs. Drugs Affecting Renin-Angiotensin System and Plasma Kinins. Essentials of medical pharmacology. Seventh edition. 2013. Page – 559, 561 & 562.
- Roberto Fogari, MD, Annalisa Zopppi, MD, Amedeo Mugellini, MD, Paolo Preti, MD, Maurizio Destro, MD, Andrea Rinaldi MD, and Giuseppe Derosa, MD. Effectiveness of hydrochlorothiazide in combination with telmisartan and olmesartan in adults with moderate hypertension not controlled with monotherapy: a prospective, randomized, open-label, blinded end point (PROBE), parallel-arm study. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. February 2008. [Accessed on 14th December 2022]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969955/
- Kazuo Eguchi, Satoshi Hoshide, Tomoyuki Kabutoya, Kazuyuki Shimada, Kazuomi Kario. Is very low dose hydrochlorothiazide combined with candesartan effective in uncontrolled hypertensive patients? NIH. National Library of Medicine. National Center for Biotechnology Information. Pubmed.gov. December 2010. [Accessed on 14th December 2022]. https://pubmed.ncbi.nlm.nih.gov/20827176/
- Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in December 2021] [Accessed on 14th December 2022]. https://www.medicines.org.uk/emc/files/pil.8603.pdf
- Hikma Pharmaceuticals USA Inc. Telmisartan and Hydrochlorothiazide Tablet. Dailymed.com. [Revised in July 2021]. [Accessed on 14th December 2022]. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7be16898-c8ee-43df-a013-edc01c3c96a2
- Glenmark Arzneimittel GmbH. Electronic Medicines Compendium (EMC). [Revised in November 2019] [Accessed on 14th December 2022]. https://www.medicines.org.uk/emc/files/pil.9981.pdf
- Central Drugs Standard Control Organization. Telmisartan 40mg/80mg+ Hydrochlorthiazide 12.5mg/12.5mg tablet. August 2003. [Accessed on 14th December 2022]. https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadApprovalNewDrugs/dciApprovedfdc.pdf
USEFUL DIAGNOSTIC TESTS
- Kidney function test
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