Telma H 40mg Tablet 15'S

Introduction About TELMA H 40MG TABLET

Telma H 40mg Tablet is a combination of Telmisartan and Hydrochlorothiazide that is used for the management of hypertension (high blood pressure). By lowering high blood pressure, it helps reduce the risk of strokes, heart attacks, and kidney problems.

You can take Telma H Tablet with or without food. The dosage will depend on your condition and how you respond to the medication. It is best to take it at the same time every day. Continue taking it as prescribed by your doctor, even if you start feeling better. This medicine contains a diuretic (water pill) that increases urination, so it is advisable not to take it within four hours of bedtime. For maximum benefit, use it regularly. Since high blood pressure often has no symptoms, stopping the medication can increase your risk of heart attack or stroke.

Common side effects of this medication include dizziness, fatigue, headache, electrolyte imbalances, dehydration, feeling tired, nausea, shortness of breath, and heartbeat changes. Frequent urination is not a side effect of this medicine. It is the purpose of this medicine as frequent urination helps control your blood pressure. You may experience other possible side effects, but most are rare. Make sure you read the leaflet that comes with your medicines and tell your doctor if you are bothered by side effects or they do not go away. It may be possible to adjust your dose or try a different medicine.

Avoid using potassium supplements or salt substitutes unless advised by your doctor. This medication is not recommended during pregnancy or breastfeeding. Consult your doctor before taking it if you have kidney or liver disease, heart issues, or diabetes. Consuming alcohol can further lower your blood pressure and may increase the risk of side effects.

Uses Of TELMA H 40MG TABLET

• Hypertension (high blood pressure)

Benefits of TELMA H 40MG TABLET

1. Helps lower high blood pressure (hypertension): Reduces the risk of stroke and heart attacks
2. Contains two active ingredients Telmisartan (an ARB) and Hydrochlorothiazide (a diuretic): Improves overall cardiovascular health.

How TELMA H 40MG TABLET Works

Telmisartan is an angiotensin II receptor blocker (ARB) that works by blocking the action of a hormone called angiotensin II, which normally causes blood vessels to constrict (tighten). By inhibiting this hormone, Telmisartan helps to relax and widen blood vessels, making it easier for the heart to pump blood and lowering blood pressure, Hydrochlorothiazide is a diuretic (often called a "water pill") that helps reduce the amount of water in the body by increasing urination, which lowers the volume of fluid circulating in the bloodstream. This also helps lower blood pressure.

Together, these two ingredients work to reduce blood pressure effectively, making it easier for the heart to pump blood and reducing the risk of complications related to hypertension, like strokes or heart attacks.

How to use TELMA H 40MG TABLET

Follow your doctor's instructions regarding the exact dosage. Do not exceed the recommended daily dosage.

How to Take Telma H 40mg Tablet?

• Take one tablet of Telma H 40mg daily or as prescribed by your doctor
• It is typically recommended to take the tablet with or without food
• For best results, take the tablet at the same time each day
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication

What if I forgot to take TELMA H 40MG TABLET

If you miss a dose, take it as soon as you remember unless it is close to the time for your next dose. Do not take two doses at once.

Do Not Stop Suddenly:

Avoid abruptly stopping the medication without consulting your doctor, as this can lead to sudden increase in blood pressure and increase the risk of heart attack or stroke.

Side Effects Of TELMA H 40MG TABLET

Like all medicines, Telma H 40mg Tablet may cause certain side effects in some individuals, although not everybody gets them.

The most common side effects of taking Telma H 40mg Tablet are:

• Dizziness
• Fatigue
• Headache
• Electrolyte imbalances
• Dehydration
• Feeling tired
• Nausea
• Shortness of breath
• Heartbeat changes

When to consult your doctor?

• Severe allergic reactions symptoms such as rash, itching, or swelling, especially of the face/tongue/throat, severe dizziness or trouble breathing
• Low blood pressure (hypotension) symptoms such as dizziness, fainting, or lightheadedness
• Kidney problems symptoms such as reduced urine output, swelling in the legs/feet, or unusual tiredness, dark-colored urine, or blood in the urine
• Elevated potassium levels (hyperkalemia) symptoms such as muscle weakness, slow or irregular heartbeat, or tingling/numbness
• Severe dehydration or electrolyte imbalance symptoms such as excessive thirst, dry mouth, confusion, or muscle cramps
• Liver problems symptoms such as yellowing of the skin or eyes (jaundice), dark urine, or upper stomach pain
• Stroke symptoms such as sudden numbness or weakness (especially on one side of the body), confusion, trouble speaking or understanding speech, vision problems, or difficulty walking

How To Manage Side Effects

Dizziness Or Drowsiness

• Sit or Lie Down: If you feel dizzy, sit down or lie down immediately to prevent falling. Keep your head still and close your eyes if needed.
• Hydrate: Dehydration can cause dizziness, so drink water or electrolyte-replenishing drinks like sports drinks.
• Avoid Sudden Movements: When standing or sitting, do so slowly to avoid triggering dizziness. Take your time when getting up.
• Eat Small, Regular Meals: Low blood sugar can cause dizziness, so eat small meals throughout the day and avoid skipping meals.
• Fresh Air: Sometimes dizziness can be alleviated by taking slow, deep breaths in a well-ventilated area.

Headache

• Rest in a Quiet, Dark Room: Find a calm, quiet space away from bright lights and loud noises. Lie down and close your eyes.
• Hydrate: Dehydration can contribute to headaches, so drink plenty of water.
• Apply a Cold or Warm Compress: A cold pack on your forehead may reduce pain, or a warm compress on your neck or shoulders can relieve tension.
• Over-the-Counter Pain Relief: You can take over-the-counter pain relievers like acetaminophen or ibuprofen if appropriate for you. Follow the recommended dosage.
• Practice Relaxation Techniques: Deep breathing exercises, meditation, or gentle stretching can help reduce stress and alleviate headache symptoms.

Nausea And Vomiting

Eat Small, Frequent Meals: Avoid heavy or greasy foods. Opt for bland foods like crackers, toast, or bananas.

Stay Hydrated: Sip on clear fluids like water, ginger tea, or electrolyte drinks, Avoid caffeinated and carbonated beverages.

Ginger: Ginger is a natural remedy for nausea. Try ginger tea, ginger candies, or ginger ale (ensure it contains real ginger).

Avoid Strong Odors: Minimize exposure to smells that might trigger nausea, such as perfumes or cooking odors.

Warning & Precautions

Pregnancy

Contraindicated

Telma H 40mg Tablet is not recommended for use during pregnancy due to clear evidence of potential harm to the developing baby.  However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

Breastfeeding

Contraindicated

Telma H 40mg Tablet is not recommended for use while breastfeeding. Limited human studies indicate that the medication may transfer into breast milk and potentially harm the infant. Please consult your doctor.

Driving and Using Machines

Use with Caution

Do not drive or operate machines if you experience dizziness or drowsiness.

Alcohol

Consult your doctor

Consuming alcohol while taking this medication can enhance its blood pressure-lowering effects such as dizziness or fainting. It is advisable to avoid alcohol.

Kidney

Consult your doctor

Telma H 40mg Tablet is not recommended for use in patients with severe kidney problems and should be used with caution in patients with other kidney problems (such as kidney transplant, narrowing of renal arteries). Please consult your doctor.

Liver

Consult your doctor

Telma H 40mg Tablet is not recommended for use in patients with severe liver impairment (such as cholestasis, jaundice, biliary obstruction) and should be used with caution in patients with mild to moderate liver problems. Please consult your doctor.

Allergy

Contraindicated

Do not take Telma H 40mg Tablet if you are allergic to Telmisartan or Hydrochlorothiazide or any other ingredients of this medicine.

Heart Disease

Use with Caution

Telma H 40mg Tablet should be used with caution in patients with heart problems (such as irregular heart rhythm, problems with heart muscle or valves). Please consult your doctor before taking it.

Use In Pediatrics

Contraindicated

Telma H 40mg Tablet is not recommended for use in children and adolescents (under 18 years of age). Consult your pediatrician before giving it.

Use In Geriatrics

Use with Caution

Telma H 40mg Tablet should be used with caution in elderly patients. Dosage adjustment and careful monitoring are required in such patients. Consult and inform your doctor before taking it.

Other Warnings for TELMA H 40MG TABLET

Before taking Telma H 40mg 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

Who should not take [GBNKEYWORD

Telma H 40mg 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

Safety Advice

• Take one tablet of Telma H 40mg daily or as prescribed by your doctor
• It is typically recommended to take the tablet with or without food
• For best results, take the tablet at the same time each day
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication
• Make sure to monitor your blood pressure regularly, particularly when beginning the medication
• Hydration is crucial as Hydrochlorothiazide can cause increased urination, potentially leading to dehydration or low potassium levels. It is important to drink plenty of fluids unless your doctor has given you different instructions
• Hydrochlorothiazide can lead to electrolyte imbalances, such as low levels of potassium, sodium, or magnesium. Your doctor may monitor your blood tests to track these changes
• Consuming alcohol while taking this medication can enhance its blood pressure-lowering effects, which may cause dizziness or fainting. It is advisable to avoid alcohol
• Telma H is not recommended during pregnancy, particularly in the second and third trimesters, as it may pose risks to the baby. If you are pregnant or planning to become pregnant, be sure to inform your doctor right away. It is also not recommended while breastfeeding
• Certain medications may interact with Telma H, such as other blood pressure medications, diabetes medications, potassium-sparing diuretics, lithium, and NSAIDs. Be sure to inform your doctor about all the medications you are currently taking

Diet and Lifestyle Advice

01.Telma H 40mg Tablet Vs Cozaar

2. Telma H 40mg Vs Norvasc

3. Telma H 40mg Tablet Vs Zestril

Drug - Drug interaction

Inform your physician if you are taking any of the following medicine before taking Telma H 40mg Tablet:

1. Other Antihypertensive Drugs

• Interactions: Telma H 40mg may have an additive effect when used with other antihypertensive drugs like ACE inhibitors, ARBs, or calcium channel blockers, leading to excessive lowering of blood pressure.
• Effect: Hypotension (low blood pressure), dizziness, or fainting.
• Management: Blood pressure should be monitored closely. Dose adjustments may be needed for other antihypertensives to avoid excessive blood pressure reduction.

2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

• Interactions: NSAIDs (e.g., ibuprofen, naproxen) can reduce the blood pressure-lowering effects of Telma H 40mg, and they may also increase the risk of kidney damage.
• Effect: Reduced efficacy of antihypertensive action, potential kidney toxicity.
• Management: Use NSAIDs cautiously, monitor kidney function regularly, and consider using alternative pain relievers (e.g., acetaminophen).

3. Potassium-Sparing Diuretics or Potassium Supplements

• Interactions: Combining Telma H 40mg with potassium-sparing diuretics (e.g., spironolactone) or potassium supplements can increase the risk of hyperkalemia (elevated potassium levels).
• Effect: Hyperkalemia, which can cause irregular heartbeats or cardiac arrest.
• Management: Monitor serum potassium levels frequently. Avoid potassium supplements or potassium-sparing diuretics unless absolutely necessary.

4. Lithium

• Interactions: Telmisartan (Telma H) can increase lithium levels in the blood, leading to lithium toxicity.
• Effect: Lithium toxicity, which includes symptoms such as tremors, confusion, and seizures.
• Management: Monitor lithium levels regularly. If necessary, adjust the dose of lithium or switch medications.

5. Diuretics (Other than Hydrochlorothiazide)

• Interactions: Other diuretics, especially loop diuretics (e.g., furosemide), can cause a significant drop in blood pressure when combined with Telma H.
• Effect: Severe hypotension.
• Management: Close monitoring of blood pressure is essential. Dose adjustments or discontinuation of the other diuretic may be necessary.

6. ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors)

• Interactions: Combining Telmisartan with ACE inhibitors (e.g., enalapril, lisinopril) may increase the risk of hyperkalemia and renal impairment, especially in patients with pre-existing kidney disease.
• Effect: Elevated potassium levels and kidney dysfunction.
• Management: Avoid combination if possible, especially in patients with renal impairment. Regular monitoring of kidney function and potassium levels is crucial.

7. Alcohol

• Interactions: Alcohol can enhance the blood pressure-lowering effect of Telma H 40mg, leading to increased risk of hypotension.
• Effect: Dizziness, fainting, or low blood pressure.
• Management: Limit alcohol consumption, and monitor blood pressure carefully.

8. Rifampin (Antibiotic)

• Interactions: Rifampin can increase the clearance of Telmisartan, reducing its effectiveness.
• Effect: Reduced effectiveness of blood pressure control.
• Management: Blood pressure should be monitored regularly, and the dose of Telma H may need to be adjusted.

9. Corticosteroids

• Interactions: The use of corticosteroids (e.g., prednisone) with Telma H can increase the risk of electrolyte imbalances, particularly hypokalemia.
• Effect: Electrolyte disturbances, including low potassium levels.
• Management: Monitor potassium levels, and adjust the dose of corticosteroids or consider potassium supplementation.

10. Cyclosporine

• Interactions: Telmisartan can increase the levels of cyclosporine, leading to nephrotoxicity (kidney damage).
• Effect: Kidney damage, particularly in patients with renal impairment.
• Management: Monitor kidney function and cyclosporine levels closely. Adjust the dose of cyclosporine if necessary.

Synopsis

More Information

FAQs About TELMA H 40MG TABLET

References

1. KD. Tripathi. Antihypertensive Drugs. Drugs Affecting Renin-Angiotensin System and Plasma Kinins. Essentials of medical pharmacology. Seventh edition. 2013. Page – 559, 561 & 562.

2. 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 18th Feb 2025]  

3. 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 18th Feb 2025]  

4. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in December 2021] [Accessed on 18th Feb 2025]  

5. Hikma Pharmaceuticals USA Inc. Telmisartan and Hydrochlorothiazide Tablet. Dailymed.com. [Revised in July 2021]. [Accessed on 18th Feb 2025]

6. Glenmark Arzneimittel GmbH. Electronic Medicines Compendium (EMC). [Revised in November 2019] [Accessed on 18th Feb 2025]  

7. Central Drugs Standard Control Organization. Telmisartan 40mg/80mg+ Hydrochlorthiazide 12.5mg/12.5mg tablet. August 2003. [Accessed on 18th Feb 2025]  

Useful Diagnostic Tests

• Kidney function test (KFT)
• Cardiac Risk Profile

Author Details

Written By Dr. Karthikeyan Rajagopal - M.Pharm (Pharmacology)

Reviewed For Accuracy By Dr. Thamada Manikanta Praveen - MBBS, MD (General Medicine)

Last updated on 20 Feb 2025 | 10:30 AM(IST)