Telmitan Plus
Generic Name
Telmisartan 40 mg & Hydrochlorothiazide 12.5 mg Tablet
Manufacturer
ACI Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| telmitan plus 40 mg tablet | ৳ 12.50 | ৳ 175.00 |
Description
Overview of the medicine
Telmitan Plus 40 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 relax blood vessels, lower blood pressure, and reduce the risk of heart attack and stroke.
Uses & Indications
Dosage
Adults
Usually one tablet (Telmisartan 40 mg/Hydrochlorothiazide 12.5 mg) once daily. Dosage may be adjusted based on blood pressure response.
Elderly
No initial dose adjustment is generally required, but close monitoring is advised.
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 orally once daily with or without food. Swallow the tablet whole with a glass of water. It is advisable to take it at the same time each day.
Mechanism of Action
Telmisartan blocks the effects of angiotensin II, a natural substance that constricts blood vessels, leading to vasodilation and lowered blood pressure. Hydrochlorothiazide increases the excretion of sodium and water from the body, thereby reducing blood volume and blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect observed within 3 hours, maximum effect within 4-8 weeks.
Excretion
Telmisartan is primarily excreted unchanged in feces (97%). Hydrochlorothiazide is primarily excreted renally, largely unchanged.
Half life
Telmisartan: approximately 24 hours; Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Telmisartan is rapidly but variably absorbed (bioavailability 42-58%). Hydrochlorothiazide is well absorbed (bioavailability 65-75%). Peak plasma concentrations are reached within 0.5-1 hour for HCTZ and 0.5-1 hour for Telmisartan.
Metabolism
Telmisartan is minimally metabolized via conjugation to its glucuronide. Hydrochlorothiazide is not metabolized.
Side Effects
Contraindications
- Hypersensitivity to telmisartan, hydrochlorothiazide, or any component of the formulation
- Pregnancy (especially second and third trimesters)
- Lactation
- Severe hepatic impairment
- Cholestasis and biliary obstructive disorders
- Anuria
- Refractory hypokalemia, hyponatremia, hypercalcemia
- Symptomatic hyperuricemia/gout
- Concomitant use with aliskiren in patients with diabetes or renal impairment (GFR <60 mL/min)
Drug Interactions
Digoxin
Increased risk of digoxin toxicity due to HCTZ-induced hypokalemia.
Lithium
Increased serum lithium concentrations and toxicity. Monitor lithium levels.
Corticosteroids, ACTH
Increased potassium depletion with HCTZ.
Alcohol, barbiturates, narcotics
Potentiation of orthostatic hypotension with HCTZ.
NSAIDs (e.g., ibuprofen, naproxen)
May reduce the antihypertensive effects and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium
May lead to hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include hypotension, dizziness, and tachycardia. Bradycardia may occur. Management involves symptomatic and supportive treatment. Induce vomiting or perform gastric lavage. Administer activated charcoal. Monitor electrolyte and creatinine levels.
Pregnancy & Lactation
Contraindicated during pregnancy, especially in the second and third trimesters, due to risk of fetal injury and death. Discontinue immediately if pregnancy is detected. Also contraindicated during lactation.
Side Effects
Contraindications
- Hypersensitivity to telmisartan, hydrochlorothiazide, or any component of the formulation
- Pregnancy (especially second and third trimesters)
- Lactation
- Severe hepatic impairment
- Cholestasis and biliary obstructive disorders
- Anuria
- Refractory hypokalemia, hyponatremia, hypercalcemia
- Symptomatic hyperuricemia/gout
- Concomitant use with aliskiren in patients with diabetes or renal impairment (GFR <60 mL/min)
Drug Interactions
Digoxin
Increased risk of digoxin toxicity due to HCTZ-induced hypokalemia.
Lithium
Increased serum lithium concentrations and toxicity. Monitor lithium levels.
Corticosteroids, ACTH
Increased potassium depletion with HCTZ.
Alcohol, barbiturates, narcotics
Potentiation of orthostatic hypotension with HCTZ.
NSAIDs (e.g., ibuprofen, naproxen)
May reduce the antihypertensive effects and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium
May lead to hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include hypotension, dizziness, and tachycardia. Bradycardia may occur. Management involves symptomatic and supportive treatment. Induce vomiting or perform gastric lavage. Administer activated charcoal. Monitor electrolyte and creatinine levels.
Pregnancy & Lactation
Contraindicated during pregnancy, especially in the second and third trimesters, due to risk of fetal injury and death. Discontinue immediately if pregnancy is detected. Also contraindicated during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent (for generic formulations)
WHO Essential Medicine
YesClinical Trials
Several clinical trials have demonstrated the efficacy and safety of Telmisartan and Hydrochlorothiazide combination in reducing blood pressure and cardiovascular events in hypertensive patients.
Lab Monitoring
- Blood pressure monitoring
- Serum electrolytes (potassium, sodium, magnesium, calcium)
- Renal function (BUN, creatinine, GFR)
- Liver function tests
- Serum uric acid levels
- Fasting blood glucose (in diabetic patients)
Doctor Notes
- Educate patients on the importance of adherence to therapy and lifestyle modifications.
- Monitor blood pressure, renal function, and electrolytes regularly.
- Counsel female patients of childbearing potential about the risks during pregnancy and the need for effective contraception.
Patient Guidelines
- Take medicine regularly as prescribed, even if you feel well.
- Do not stop taking the medicine without consulting your doctor.
- Inform your doctor about all other medications you are taking.
- Report any unusual symptoms or side effects immediately.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or drowsiness. Avoid driving or operating heavy machinery until you know how it affects you.
Lifestyle Advice
- Follow a low-sodium diet.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking.
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Global Brand Names
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