Telvas H 40/12.5 Tablet 10'S

Introduction About TELVAS H 40MG TABLET

Telvas H 40/12.5 Tablet is a medication used to manage high blood pressure (hypertension) and certain heart conditions. This combination drug contains Telmisartan (40mg) and Hydrochlorothiazide (12.5mg) and is often prescribed to improve heart health and reduce the risk of stroke and heart attacks.

You can take Telvas H 40/12.5 Tablet with or without food. The dosage will depend on your condition and how your body responds to the medication. It is best to take it at the same time each day. Continue taking this medicine as directed by your doctor, even if you start feeling better. This medication contains a diuretic (water pill), which can cause increased urination. Therefore, it is advisable to avoid taking it within four hours of bedtime. Even if you feel fine, it is important to keep taking this medicine regularly to achieve the best results. Since high blood pressure often has no symptoms, stopping the medication could raise your risk of heart attack or stroke.

Common side effect of this medication includes headache, dizziness, fatigue, low blood pressure, electrolyte imbalances, nausea, shortness of breath, and changes in heartbeat. 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. While other side effects may occur, they are uncommon. Be sure to read the leaflet that accompanies your medication, and inform your doctor if you are concerned about any side effects or if they persist. It may be possible to adjust your dosage or switch to a different medication.

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

Uses Of TELVAS H 40MG TABLET

• High blood pressure (hypertension)
• Certain heart conditions

Benefits of TELVAS H 40MG TABLET

1. Effective Blood Pressure Control: Helps lower high blood pressure, reducing the risk of heart disease.
2. Heart Health Support: Can protect against heart failure and reduce the risk of strokes.
3. Combination of Two Active Ingredients: Combines the effects of Telmisartan and Hydrochlorothiazide for enhanced effectiveness.
4. Improved Kidney Function: May help protect the kidneys in people with high blood pressure.
5. Low Risk of Side Effects: Generally well-tolerated with fewer side effects compared to some other blood pressure medications.

How TELVAS H 40MG TABLET Works

Telvas H 40/12.5 Tablet works through a dual mechanism to lower blood pressure. It contains two active ingredients: Telmisartan and Hydrochlorothiazide. Telmisartan is an angiotensin II receptor blocker (ARB) that relaxes blood vessels by inhibiting the action of angiotensin II, a hormone that constricts blood vessels. This helps to reduce the overall resistance the heart faces when pumping blood. Hydrochlorothiazide, a thiazide diuretic, works by increasing the excretion of sodium and water through urine, which decreases blood volume and further lowers blood pressure. Together, these actions effectively reduce both the force and volume of blood flow, leading to lower blood pressure and reduced strain on the heart.

How to use TELVAS H 40MG TABLET

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

How to Take Telvas H 40/12.5 Tablet?

• Take one tablet daily, with or without food.
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication.
• For best results, take the tablet at the same time each day.

What if I forgot to take TELVAS H 40MG TABLET

• If you forget to take your dose, take it as soon as you remember.
• Do not take two doses to make up for a missed dose. This could increase your risk of side effects.
• If it is almost time for your next dose, skip the missed dose and take your regular dose at the usual time.

Side Effects Of TELVAS H 40MG TABLET

Like all medicines, Telvas H 40/12.5 Tablet may cause certain side effects in some individuals, although not everybody gets them.

The most common side effects of taking Telvas H 40/12.5 Tablet are:

• Headache
• Dizziness
• Fatigue
• Low blood pressure
• Electrolyte imbalances
• Nausea
• Shortness of breath
• Changes in heartbeat

When to consult your doctor?

• Allergic Reactions symptoms such as swelling of the face, lips, tongue, or throat (which may cause difficulty breathing or swallowing), severe rash, itching, or hives
• Heart problems symptoms such as severe dizziness or fainting, irregular heartbeat, or palpitations, chest pain
• Kidney problems symptoms such as decreased urine output or blood in the urine, swelling in the legs, ankles, or feet, unusual tiredness, or weakness
• Low potassium or sodium levels symptoms such as severe weakness or muscle cramps
• Electrolyte Imbalance symptoms such as severe weakness or muscle cramps
• Liver problems symptoms such as yellowing of the skin or eyes (jaundice), dark urine or pale stools
• Severe fatigue

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

Telvas H 40/12.5 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 Telvas H 40/12.5 Tablet if you are pregnant, think you may be pregnant or planning to have a baby. If you become pregnant while undergoing therapy with Telvas H 40/12.5 Tablet, stop taking it and consult your doctor immediately.

Breastfeeding

Contraindicated

Telvas H 40/12.5 Tablet is not recommended for use in breast-feeding women. It is important to consult your doctor before taking this medication.

Driving and Using Machines

Use with Caution

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

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking Telvas H 40/12.5 Tablet as it might make you feel dizzier and drowsier.

Kidney

Consult your doctor

Telvas H 40/12.5 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). Consult your doctor before taking it.

Liver

Consult your doctor

Telvas H 40/12.5 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. Consult your doctor before taking it.

Allergy

Contraindicated

Do not take this medication if you are allergic to Telmisartan or Hydrochlorothiazide or any other ingredients of this medicine.

Heart Disease

Use with Caution

Telvas H 40/12.5 Tablet should be used with caution in patients with heart problems (such as irregular heart rhythm, problems with heart muscle or valves). Consult your doctor before taking it.

Use In Pediatrics

Contraindicated

Telvas H 40/12.5 Tablet is not recommended for use in children and adolescents (aged below 18 years). Consult your pediatrician before giving it.

Use In Geriatrics

Use with Caution

Telvas H 40/12.5 Tablet should be used with caution in elderly patients. Consult your doctor before taking it.

Other Warnings for TELVAS H 40MG TABLET

Before taking Telvas H 40/12.5 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

Telvas H 40/12.5 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

• Follow your doctor's instructions regarding the exact dosage.
• Do not exceed the recommended daily dosage. 
• Take one tablet daily, with or without food.
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication.
• For best results, take the tablet at the same time each day.
• Consistently check your blood pressure as directed by your doctor to ensure the medication is working properly.
• Hydrochlorothiazide is a diuretic, which means it can increase urination and may cause dehydration or disrupt your electrolyte balance. It is important to stay hydrated by drinking plenty of fluids, unless your doctor advises you not to.
• Make sure to avoid excessive alcohol intake as it can also increase dehydration.
• Hydrochlorothiazide can lead to low potassium or sodium levels in the blood, resulting in an electrolyte imbalance. Your doctor may monitor your electrolyte levels throughout the management.
• Let your doctor know if you have kidney problems or liver problems
• Let your doctor know If you are pregnant or planning to become pregnant or breastfeeding women.
• If you are taking Telvas H, do not use salt substitutes containing potassium unless your doctor has approved it, as they may raise your potassium levels in the blood.

Diet and Lifestyle Advice

Drug - Drug interaction

Inform your physician if you are taking any of the following medicine before taking Telvas H 40/12.5 Tablet:

1. Other Antihypertensive Medications

• Interactions: Combining Telvas H with other antihypertensive agents, such as ACE inhibitors (e.g., enalapril), ARBs (e.g., losartan), beta-blockers (e.g., atenolol), or calcium channel blockers (e.g., amlodipine), may result in an additive effect, potentially causing excessive reduction in blood pressure.
• Effects: Severe hypotension, dizziness, fainting, fatigue, or weakness.
• Management: Close monitoring of blood pressure is essential. Dose adjustments may be necessary. Ensure gradual increases in dosages, especially in high-risk patients, and monitor regularly for any symptoms of hypotension.

2. Potassium-Sparing Diuretics and Potassium Supplements

• Interactions: Co-administration with potassium-sparing diuretics (e.g., spironolactone) or potassium supplements can increase the risk of hyperkalemia, as Telvas H can already reduce potassium excretion.
• Effects: Elevated potassium levels, which can lead to arrhythmias, muscle weakness, or cardiac arrest in severe cases.
• Management: Monitor serum potassium levels regularly. Avoid concurrent use of potassium-sparing diuretics or potassium supplements unless absolutely necessary, and adjust dosages accordingly.

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

• Interactions: NSAIDs (e.g., ibuprofen, naproxen) may reduce the antihypertensive effect of Telvas H, and long-term use can also increase the risk of kidney damage.
• Effects: Reduced effectiveness of blood pressure control, potential kidney impairment, fluid retention.
• Management: Monitor kidney function and blood pressure regularly. If an NSAID is required, use the lowest effective dose for the shortest duration and ensure adequate hydration.

4. Lithium

• Interactions: Telvas H may reduce renal clearance of lithium, leading to increased lithium levels and toxicity.
• Effects: Symptoms of lithium toxicity include nausea, vomiting, diarrhea, tremors, and confusion.
• Management: Monitor lithium levels regularly. If needed, adjust the lithium dose, and ensure proper hydration.

5. Other Diuretics

• Interactions: Concurrent use with other diuretics (e.g., furosemide, hydrochlorothiazide) can increase the risk of dehydration and electrolyte imbalances, particularly hypokalemia and hyponatremia.
• Effects: Dehydration, low blood sodium levels, dizziness, and increased risk of electrolyte imbalances.
• Management: Monitor electrolytes and fluid status closely. Adjust doses of either diuretic as needed, and ensure that the patient remains adequately hydrated.

6. Rifampicin

• Interactions: Rifampicin, a potent inducer of cytochrome P450 enzymes, can decrease the plasma concentration of Telmisartan, reducing its effectiveness in controlling blood pressure.
• Effects: Reduced antihypertensive efficacy.
• Management: Increased blood pressure monitoring. Dose adjustments of Telvas H may be necessary when starting or stopping rifampicin therapy.

7. ACE Inhibitors, ARBs, and Direct Renin Inhibitors

• Interactions: Concomitant use with Telvas H increases the risk of hyperkalemia and renal impairment due to the combined effects on the renin-angiotensin-aldosterone system.
• Effects: Hyperkalemia, renal dysfunction, hypotension.
• Management: Avoid using Telvas H with other RAAS inhibitors unless necessary. Monitor renal function, electrolytes (especially potassium), and blood pressure regularly.

8. Corticosteroids

• Interactions: Corticosteroids (e.g., prednisone) can cause fluid retention, increasing blood pressure and potentially counteracting the antihypertensive effects of Telvas H.
• Effects: Elevated blood pressure, fluid retention, edema.
• Management: Monitor blood pressure and fluid status. Dose adjustments for Telvas H or corticosteroid therapy may be required.

9. Antidiabetic Medications

• Interactions: Telvas H may enhance the blood-glucose-lowering effects of antidiabetic drugs (e.g., insulin, sulfonylureas), potentially increasing the risk of hypoglycemia.
• Effects: Symptoms of hypoglycemia, including sweating, shaking, dizziness, and confusion.
• Management: Close monitoring of blood glucose levels is necessary, particularly when initiating or adjusting Telvas H therapy. Adjust the dose of antidiabetic medications accordingly.

10. Alcohol

• Interactions: Alcohol can enhance the blood pressure-lowering effect of Telvas H, leading to an increased risk of hypotension, especially during the initiation phase of therapy.
• Effects: Dizziness, fainting, excessive drowsiness, and a sudden drop in blood pressure.
• Management: Limit alcohol intake while on Telvas H. Advise patients to avoid heavy drinking, especially when adjusting the medication dose or starting treatment.

Drug - Food interaction

Potassium-rich Foods:

• Telmisartan (the ARB in the medication) does not typically cause potassium loss but can increase potassium levels. Combining Telvas H with potassium-rich foods (such as bananas, oranges, spinach, potatoes) or potassium supplements can lead to hyperkalemia (elevated potassium levels in the blood), which may cause serious heart-related issues. It is important to monitor potassium intake and talk to your doctor about your diet.

Salt Substitutes:

• Many salt substitutes contain potassium. If you are using Telvas H, it is advisable to avoid these substitutes because they can increase potassium levels, potentially leading to hyperkalemia.

High-Salt Foods:

• Since Telvas H contains Hydrochlorothiazide (a diuretic), it can lead to an increased loss of sodium. A very high-salt diet can counteract the effect of Hydrochlorothiazide and potentially reduce its effectiveness. Maintaining a balanced, moderate intake of salt is important.

Synopsis

More Information

Product Comparison

a)Telvas H vs Prinivil

b) Telvas H vs Losar

What are some alternative medications for high blood pressure that can be considered instead of Telvas H 40/12.5 Tablet, and why might Telvas H be the preferred option for certain users?

Alternative Medications for Hypertension

1. Losartan + Hydrochlorothiazide (Cozaar HCT)
   • Why Consider It: Losartan is another ARB like telmisartan, and the combination with hydrochlorothiazide works similarly to Telvas H in lowering blood pressure by reducing fluid buildup and relaxing blood vessels.
   • Considerations: Losartan may have slightly different side effects or interactions compared to telmisartan.
2. Amlodipine + Hydrochlorothiazide (Norvasc HCT)
   • Why Consider It: Amlodipine is a calcium channel blocker, which works by relaxing the blood vessels and reducing the heart's workload. When combined with a diuretic like hydrochlorothiazide, it can effectively manage blood pressure.
   • Considerations: This combination might be preferred for individuals who have a specific need for calcium channel blockers.
3. Ramipril + Hydrochlorothiazide (Altace HCT)
   • Why Consider It: Ramipril is an ACE inhibitor, another class of medication used for high blood pressure. Combining it with hydrochlorothiazide offers a dual mechanism of action, similar to Telvas H.
   • Considerations: Some patients may prefer ACE inhibitors like ramipril over ARBs due to different side effect profiles (e.g., ACE inhibitors are known for causing a dry cough in some patients).
4. Olmesartan + Amlodipine (Azor)
   • Why Consider It: This combination pairs an ARB (Olmesartan) with a calcium channel blocker (Amlodipine). It can be particularly useful for patients with both hypertension and a risk of cardiovascular issues.
   • Considerations: Patients who do not tolerate diuretics well may find this combination appealing.
5. Bisoprolol + Hydrochlorothiazide (Ziac)
   • Why Consider It: Bisoprolol is a beta-blocker, which lowers heart rate and blood pressure by reducing the workload on the heart. Combined with hydrochlorothiazide, it may be an option for those with hypertension and heart-related issues.
   • Considerations: Beta-blockers are often used when there's a concurrent risk of heart disease or heart failure.
6. Enalapril + Hydrochlorothiazide (Vaseretic)
   • Why Consider It: Enalapril is another ACE inhibitor, and when combined with hydrochlorothiazide, it can be an effective treatment for reducing blood pressure.
   • Considerations: This option might be suitable for those who do not respond well to ARBs.
7. Indapamide (Lozol)
   • Why Consider It: Indapamide is a thiazide-like diuretic used alone or in combination with other medications to treat high blood pressure.
   • Considerations: It might be used as an alternative if the patient is specifically sensitive to ACE inhibitors or ARBs.

Why Telvas H Could Be the Preferred Choice:

1. Dual Action: The combination of Telmisartan (an ARB) and Hydrochlorothiazide (a diuretic) provides a dual mechanism that not only lowers blood pressure by relaxing blood vessels but also reduces excess fluid, making it a well-rounded option for hypertension management.
2. Well-Tolerated: ARBs like Telmisartan are generally well-tolerated and less likely to cause a dry cough, a common side effect of ACE inhibitors. This may make it a better choice for those who have experienced this side effect in the past.
3. Cardioprotective Benefits: Telmisartan has additional benefits for cardiovascular health, which may be beneficial for people with both hypertension and an increased risk of heart disease.
4. Proven Efficacy: Telvas H has been clinically proven to be effective in reducing both systolic and diastolic blood pressure, which helps in reducing the risk of stroke, heart failure, and kidney disease.
5. Once-Daily Dosing: The fixed-dose combination provides the convenience of once-daily dosing, which improves adherence to the treatment plan.
6. Diuretic Action: The inclusion of hydrochlorothiazide helps in controlling fluid retention, which can be an issue in many patients with hypertension, especially those with conditions like heart failure or kidney disease.

When to Consider Alternatives:

• Side Effects: If a patient experiences side effects from Telvas H, such as dizziness, dehydration, or electrolyte imbalances, they may need to try a different medication or combination.
• Specific Medical Conditions: For patients with a history of kidney problems, certain ACE inhibitors or diuretics might be more suitable, depending on the situation.
• Cost or Accessibility: Some patients may not have access to Telvas H due to cost or availability, and they may need to explore alternative medications.
• Contraindications: Certain medications may be contraindicated in individuals with specific conditions (e.g., pregnancy, severe renal impairment), so alternative options might be needed.

Ultimately, the choice of medication depends on individual health conditions, response to previous treatments, and physician recommendations. Always consult a doctor to determine the most suitable alternative based on personal health needs.

FAQs About TELVAS 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 1st March 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 1st March 2025]

4. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in December 2021] [Accessed on 1st March 2025]

5. Hikma Pharmaceuticals USA Inc. Telmisartan and Hydrochlorothiazide Tablet. Dailymed.com. [Revised in July 2021] [Accessed on 1st March 2025]

6. Glenmark Arzneimittel GmbH. Electronic Medicines Compendium (EMC). [Revised in November 2019] [Accessed on 1st March 2025]

7. Central Drugs Standard Control Organization. Telmisartan 40mg/80mg+ Hydrochlorthiazide 12.5mg/12.5mg tablet. August 2003. [Accessed on 1st March 2025]

User Feedback

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 01 Mar 2025 | 05:47 PM(IST)