Telmitan Plus
Generic Name
Telmisartan + Hydrochlorothiazide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| telmitan plus 80 mg tablet | ৳ 22.00 | ৳ 308.00 |
Description
Overview of the medicine
Telmitan Plus 80 mg Tablet is a combination medicine containing Telmisartan and Hydrochlorothiazide. It is primarily used to treat high blood pressure (hypertension). Telmisartan is an Angiotensin II Receptor Blocker (ARB) that relaxes blood vessels, while Hydrochlorothiazide is a diuretic that helps the body get rid of excess salt and water, thereby lowering blood pressure.
Uses & Indications
Dosage
Adults
Usually one Telmitan Plus 80 mg tablet once daily. The dose can be adjusted by a physician based on blood pressure response.
Elderly
No specific dose adjustment is usually required for elderly patients with normal renal function, but caution is advised.
Renal_impairment
Caution is advised in patients with mild to moderate renal impairment; it is contraindicated in severe renal impairment (creatinine clearance < 30 mL/min).
How to Take
Take one tablet orally once daily with or without food. Swallow the tablet whole with water. Do not chew or crush.
Mechanism of Action
Telmisartan works by blocking the binding of angiotensin II to the AT1 receptor, preventing vasoconstriction and aldosterone secretion, leading to vasodilation and reduced blood pressure. Hydrochlorothiazide works by inhibiting sodium and chloride reabsorption in the distal convoluted tubule of the kidneys, increasing the excretion of sodium, chloride, and water, which reduces blood volume and lowers blood pressure.
Pharmacokinetics
Onset
Telmisartan: Onset within 3 hours; maximum effect within 4-8 weeks. Hydrochlorothiazide: Onset within 2 hours; peak effect in 4 hours.
Excretion
Telmisartan is primarily excreted unchanged in feces via bile. Hydrochlorothiazide is primarily excreted by the kidneys.
Half life
Telmisartan: Approximately 24 hours. Hydrochlorothiazide: 6-15 hours.
Absorption
Telmisartan is rapidly but incompletely absorbed from the GI tract (bioavailability ~42% for 40 mg, ~58% for 80 mg). Hydrochlorothiazide is readily absorbed from the GI tract.
Metabolism
Telmisartan is metabolized by conjugation to glucuronide in the liver. Hydrochlorothiazide is not metabolized and excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to Telmisartan, Hydrochlorothiazide, or any sulfonamide-derived drugs.
- Severe hepatic impairment, cholestasis, and biliary obstructive disorders.
- Severe renal impairment (creatinine clearance < 30 mL/min) and anuria.
- Pregnancy (especially second and third trimesters) and lactation.
- Concomitant use with aliskiren in patients with diabetes or renal impairment.
Drug Interactions
Digoxin
Increased risk of digoxin toxicity due to hypokalemia caused by HCTZ.
Lithium
Increased serum lithium concentrations and toxicity.
Corticosteroids
Increased risk of hypokalemia.
Other Antihypertensives
Additive hypotensive effects.
Insulin/Oral Hypoglycemics
HCTZ may decrease glucose tolerance, requiring adjustment of antidiabetic medications.
Cholestyramine and Colestipol resins
Impaired absorption of HCTZ.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
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 hypotension, dizziness, palpitation, and electrolyte disturbances (due to HCTZ). Treatment is symptomatic and supportive. Induce emesis or perform gastric lavage. Administer activated charcoal. Monitor blood pressure and electrolytes and provide supportive care.
Pregnancy & Lactation
Contraindicated in pregnancy, especially during the second and third trimesters, due to risk of fetal injury or death. Discontinue immediately if pregnancy is detected. Not recommended during lactation as both components are excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to Telmisartan, Hydrochlorothiazide, or any sulfonamide-derived drugs.
- Severe hepatic impairment, cholestasis, and biliary obstructive disorders.
- Severe renal impairment (creatinine clearance < 30 mL/min) and anuria.
- Pregnancy (especially second and third trimesters) and lactation.
- Concomitant use with aliskiren in patients with diabetes or renal impairment.
Drug Interactions
Digoxin
Increased risk of digoxin toxicity due to hypokalemia caused by HCTZ.
Lithium
Increased serum lithium concentrations and toxicity.
Corticosteroids
Increased risk of hypokalemia.
Other Antihypertensives
Additive hypotensive effects.
Insulin/Oral Hypoglycemics
HCTZ may decrease glucose tolerance, requiring adjustment of antidiabetic medications.
Cholestyramine and Colestipol resins
Impaired absorption of HCTZ.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
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 hypotension, dizziness, palpitation, and electrolyte disturbances (due to HCTZ). Treatment is symptomatic and supportive. Induce emesis or perform gastric lavage. Administer activated charcoal. Monitor blood pressure and electrolytes and provide supportive care.
Pregnancy & Lactation
Contraindicated in pregnancy, especially during the second and third trimesters, due to risk of fetal injury or death. Discontinue immediately if pregnancy is detected. 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
Available in pharmacies
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available
Clinical Trials
Numerous clinical trials have demonstrated the efficacy and safety of Telmisartan/Hydrochlorothiazide combinations in reducing blood pressure and cardiovascular risk in hypertensive patients.
Lab Monitoring
- Blood pressure
- Serum electrolytes (potassium, sodium, magnesium, calcium)
- Renal function (BUN, creatinine, eGFR)
- Liver function tests (LFTs)
- Blood glucose (especially in diabetic patients)
- Uric acid levels
Doctor Notes
- Counsel patients on lifestyle modifications (diet, exercise, smoking cessation).
- Emphasize the importance of consistent medication adherence.
- Monitor renal function and serum electrolytes periodically.
- Caution against use in patients with severe hepatic or renal impairment.
- Advise patients to report symptoms of angioedema or severe allergic reactions immediately.
Patient Guidelines
- Take medicine regularly as prescribed by the doctor.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Monitor your blood pressure regularly at home.
- Report any unusual symptoms or side effects to your doctor.
- Avoid excessive alcohol consumption.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If a dose is missed, 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
This medicine may cause dizziness or drowsiness, especially at the start of treatment or when changing dosage. If affected, avoid driving or operating heavy machinery.
Lifestyle Advice
- Adopt a healthy diet low in sodium and high in fruits, vegetables, and whole grains.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Quit smoking and limit alcohol intake.
- Manage stress effectively.
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