Arbitel Plus
Generic Name
Telmisartan 80 mg + Hydrochlorothiazide 12.5 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| arbitel plus 80 mg tablet | ৳ 20.00 | ৳ 200.00 |
Description
Overview of the medicine
Arbitel Plus 80 mg tablet is a combination medicine used to treat high blood pressure (hypertension). It contains Telmisartan, an angiotensin II receptor blocker (ARB), and Hydrochlorothiazide, a thiazide diuretic. This combination helps to lower blood pressure by relaxing blood vessels and increasing the excretion of salt and water from the body.
Uses & Indications
Dosage
Adults
The usual recommended dose is one Arbitel Plus 80 mg tablet once daily. The maximum recommended dose is Telmisartan 80 mg / Hydrochlorothiazide 25 mg once daily.
Elderly
No dose adjustment is generally required for elderly patients, but caution is advised due to potential for reduced renal function.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). For moderate impairment, careful monitoring is needed.
How to Take
Take Arbitel Plus 80 mg tablet orally once daily, with or without food. Swallow the tablet whole with water.
Mechanism of Action
Telmisartan blocks the action of angiotensin II, a substance in the body that constricts blood vessels, thereby relaxing blood vessels and lowering blood pressure. Hydrochlorothiazide is a diuretic that increases the excretion of sodium and water from the body through the kidneys, which also helps to lower blood pressure.
Pharmacokinetics
Onset
Blood pressure reduction is noticeable within 3 hours, with peak effects within 4-8 weeks of consistent dosing.
Excretion
Telmisartan is almost exclusively excreted in feces via bile. Hydrochlorothiazide is primarily eliminated unchanged by renal excretion.
Half life
Telmisartan has a prolonged elimination half-life of approximately 24 hours. Hydrochlorothiazide has an elimination half-life ranging from 5.6 to 14.8 hours.
Absorption
Telmisartan is well absorbed from the gastrointestinal tract, with a bioavailability of about 42-58%. Hydrochlorothiazide is rapidly absorbed with a bioavailability of 65-75%.
Metabolism
Telmisartan is metabolized by conjugation to form a pharmacologically inactive acylglucuronide. Hydrochlorothiazide is not metabolized.
Side Effects
Contraindications
- Hypersensitivity to telmisartan, hydrochlorothiazide, or any sulfonamide-derived drugs.
- Pregnancy (second and third trimesters).
- Severe hepatic impairment or biliary obstructive disorders.
- Severe renal impairment (creatinine clearance <30 mL/min) or anuria.
- Refractory hypokalemia, hyponatremia, hypercalcemia, and symptomatic hyperuricemia.
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 m²).
Drug Interactions
Digoxin
Diuretic-induced hypokalemia may increase digoxin toxicity.
Lithium
Increased serum lithium concentrations and toxicity have been reported. Monitor lithium levels.
Corticosteroids
May enhance potassium depletion caused by hydrochlorothiazide.
Antidiabetic drugs
Dose adjustment of antidiabetic drugs may be required.
Other antihypertensive agents
Additive hypotensive effect.
Alcohol, barbiturates, or narcotics
May potentiate orthostatic hypotension.
NSAIDs (Non-steroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Telmisartan/HCTZ and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or other agents that may increase potassium levels
May lead to hyperkalemia. Monitor serum potassium.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include profound hypotension, tachycardia or bradycardia, dizziness, and electrolyte disturbances (e.g., hypokalemia, hypochloremia). Management involves symptomatic and supportive therapy, including correction of fluid and electrolyte balance.
Pregnancy & Lactation
Arbitel Plus is contraindicated in the second and third trimesters of pregnancy and not recommended during the first trimester. It is also not recommended during lactation, as both components are excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to telmisartan, hydrochlorothiazide, or any sulfonamide-derived drugs.
- Pregnancy (second and third trimesters).
- Severe hepatic impairment or biliary obstructive disorders.
- Severe renal impairment (creatinine clearance <30 mL/min) or anuria.
- Refractory hypokalemia, hyponatremia, hypercalcemia, and symptomatic hyperuricemia.
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 m²).
Drug Interactions
Digoxin
Diuretic-induced hypokalemia may increase digoxin toxicity.
Lithium
Increased serum lithium concentrations and toxicity have been reported. Monitor lithium levels.
Corticosteroids
May enhance potassium depletion caused by hydrochlorothiazide.
Antidiabetic drugs
Dose adjustment of antidiabetic drugs may be required.
Other antihypertensive agents
Additive hypotensive effect.
Alcohol, barbiturates, or narcotics
May potentiate orthostatic hypotension.
NSAIDs (Non-steroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect of Telmisartan/HCTZ and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or other agents that may increase potassium levels
May lead to hyperkalemia. Monitor serum potassium.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include profound hypotension, tachycardia or bradycardia, dizziness, and electrolyte disturbances (e.g., hypokalemia, hypochloremia). Management involves symptomatic and supportive therapy, including correction of fluid and electrolyte balance.
Pregnancy & Lactation
Arbitel Plus is contraindicated in the second and third trimesters of pregnancy and not recommended during the first trimester. It is also not recommended during lactation, as both components are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Off-patent
Clinical Trials
Clinical trials have demonstrated the efficacy and safety of Telmisartan/Hydrochlorothiazide combination in reducing blood pressure in patients with essential hypertension.
Lab Monitoring
- Serum electrolytes (especially potassium, sodium, magnesium, calcium)
- Renal function (creatinine, BUN, GFR)
- Liver function tests
- Uric acid levels
- Blood glucose levels (especially in diabetic patients)
Doctor Notes
- Emphasize regular monitoring of serum electrolytes (especially potassium) and renal function, particularly in elderly patients or those with pre-existing renal impairment or diabetes.
- Advise patients on lifestyle modifications to enhance therapeutic outcomes.
- Caution against abrupt discontinuation due to potential rebound hypertension.
Patient Guidelines
- Take the medicine regularly as prescribed by your doctor, even if you feel well.
- Do not stop taking Arbitel Plus without consulting your doctor.
- Report any unusual side effects or worsening conditions to your healthcare provider.
- Maintain a healthy lifestyle alongside medication for optimal blood pressure control.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Arbitel Plus may cause dizziness or lightheadedness, especially at the beginning of treatment or when changing dose. Exercise caution when driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Follow a low-salt diet.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Avoid smoking and limit alcohol consumption.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.