How should I take Micardis HCT hydrochlorothiazide and telmisartan? Sica DA. Angiotensin receptor blockers and the risk of malignancy: a note of caution. Drug Saf. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Dosage of Micardis is individualized. The usual starting dose is 40 mg once a day. Micardis may interact with water pills or digoxin. Tell your doctor all medications you are taking. Micardis is not recommended for use during pregnancy due to the risk for harm to a fetus. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Kidney problems, which may get worse if you already have kidney disease. You may have changes in your kidney test results, and you may need a lower dose of Micardis tablets. Angiotensin II receptor antagonists have been used in the management of heart failure. What should I discuss with my healthcare provider before taking telmisartan? Female patients of childbearing age should be told about the consequences of exposure to Micardis during pregnancy. Discuss treatment options with women planning to become pregnant. Micardis is used as safely as possible.
The population studied was 73% male, 74% Caucasian, 14% Asian, and 57% were 65 years of age or older. Baseline therapy included acetylsalicylic acid 76% lipid lowering agents 64% beta-blockers 57% calcium channel blockers 34% nitrates 29% and diuretics 28%. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. You may have very low blood pressure while taking telmisartan. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual.
It is not known if Micardis is safe and effective in children. Too much sweating, diarrhea, or vomiting may cause you to feel lightheaded. Report prolonged diarrhea or vomiting to your doctor. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee JNC 8. JAMA.
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. Pasternak B, Svanström H, Callréus T et al. Use of angiotensin receptor blockers and the risk of cancer. Circulation. Dizziness or lightheadedness may occur as your body adjusts to the medication. If either of these effects persists or worsens, tell your doctor or pharmacist promptly. Should not be used in these patients. Protect the tablets from moisture. Do not remove them from the blister pack until you are ready to take a dose. No dosage adjustment is necessary in patients with decreased renal function. Use Micardis HCT with caution in the ELDERLY; they may be more sensitive to its effects. Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is widely used in the treatment of hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction also catalyzed by ACE. Because telmisartan does not inhibit ACE kininase II it does not affect the response to bradykinin. Whether this difference has clinical relevance is not yet known. Telmisartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Three studies examined the use of CoQ10 along with conventional treatment for cancer. Carefully monitor BP during initial titration or subsequent upward adjustment in dosage. It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness; chest pain; confusion; decrease in sexual ability; decreased, difficult, or painful urination; depression; drowsiness; eye pain; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; increased or excessive sweating; muscle pain, tenderness, or cramps; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent dizziness or light-headedness; severe or persistent dry mouth, nausea, or stomach pain; shortness of breath; sluggishness; swelling of the arms or legs; unusual bruising or bleeding; unusual thirst, tiredness, or weakness; vision changes eg, decreased vision clearness; vomiting; yellowing of the skin or eyes. Boehringer Ingelheim. Micardis telmisartan tablets prescribing information. Ridgefield, CT; 2014 Dec.
Have your blood pressure checked regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor. What is the most important information I should know about Micardis tablets? It is driving me crazy! Use of telmisartan in fixed combination with hydrochlorothiazide is not recommended in patients with severe hepatic impairment. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial ALLHAT. JAMA. Appropriate studies have not been performed on the relationship of age to the effects of telmisartan in the pediatric population. Safety and efficacy have not been established. This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions. Only some of the studies of coenzyme Q10 showed that it helps heart failure symptoms. This Patient Information leaflet summarizes the most important information about Micardis tablets. If you would like more information, talk with your doctor. You can ask your pharmacist or doctor for information about Micardis tablets that is written for health professionals. Increases in BUN and S cr possible in patients with unilateral or bilateral renal artery stenosis.
Special Senses: abnormal vision, conjunctivitis, tinnitus, earache. Metabolized in liver via conjugation to inactive metabolite. Kaplan NM. Choice of initial therapy for hypertension. JAMA. If you miss a dose of Micardis HCT, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Administer orally once daily without regard to meals. Injury or death to your unborn baby. See "What is the most important information I should know about Micardis tablets? Take Micardis HCT by mouth with or without food. Plasma telmisartan concentrations may be increased in patients with obstructive biliary disease or hepatic impairment. 1 2 See Special Populations under Absorption, in Pharmacokinetics. Camargo AA, Fagundes Neto U. Intestinal transport of coconut water sodium and glucose in rats "in vivo".
Rare, serious allergic reactions may happen. TRANSCEND. For both ONTARGET and TRANSCEND trials, the primary 4-component composite endpoint was death from cardiovascular causes, myocardial infarction, stroke, and hospitalization for heart failure. The secondary 3-component composite endpoint was death from cardiovascular causes, myocardial infarction, and stroke. Micardis HCT may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of telmisartan in the elderly. Adams W, Bratt DE. Young coconut water for home rehydration in children with mild gastroenteritis. Dosage must be individualized. The usual starting dose of Micardis tablets is 40 mg once a day. Have your checked regularly while taking this medication. Learn how to monitor your own pressure at home, and share the results with your doctor. US Food and Drug Administration. FDA Drug Safety Communication: new warning and contraindication for blood pressure medicines containing aliskiren Tekturna. Rockville, MD; 2012 April 20. From FDA website.
Keep each tablet in its blister pack until you are ready to take it. Tear or cut the blister apart from the rest of the package and peel back the paper liner. There are no trials of Micardis demonstrating reductions in cardiovascular risk in patients with hypertension, but at least one pharmacologically similar drug has demonstrated such benefits. Call your doctor right away if you get any of the symptoms listed above. FDA pregnancy category D. Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Hydrochlorothiazide and telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. Can use the fixed combination as a substitute for the individually administered drugs. 132 Can switch to the fixed-combination preparation containing the corresponding individual doses of telmisartan and amlodipine; alternatively, can increase the dosage of one or both components for additional antihypertensive effects. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? II. Angiotensin II is a powerful vasoconstrictor a substance that narrows blood vessels. By blocking the receptors to which angiotensin II normally attaches, telmisartan stops the hormone having an effect, allowing the blood vessels to widen. This allows the blood pressure to drop, reducing the risks associated with high blood pressure, such as having a heart attack or stroke. It also allows the heart to pump blood more easily, which can help to reduce the risk of future cardiovascular problems. How has Micardis been studied? Micardis HCT should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. You should not use this medication if you are unable to urinate or if you are allergic to hydrochlorothiazide, telmisartan, or sulfa drugs. Hg may still be considered.
Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology ESCDeveloped with the special contribution of the Heart Failure Association HFA of the ESC. FDA pregnancy category D. Do not use if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control. Tiredness and may also occur. If any of these effects persist or worsen, tell your doctor or promptly. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. Stangier J, Su CPF, Schöndorfer G et al. Pharmacokinetics and safety of intravenous and oral telmisartan 20 mg and 120 mg in subjects with hepatic impairment compared with healthy volunteers. J Clin Pharmacol. DOQI Clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease 2002. From National Kidney Foundation website. Take Micardis tablets with or without food. Blocks the physiologic actions of angiotensin II, including vasoconstrictor and aldosterone-secreting effects. Biphasic; terminal half-life is approximately 24 hours. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. The dosage is based on your medical condition and response to treatment. There is also an AT 2 receptor found in many tissues, but AT 2 is not known to be associated with cardiovascular homeostasis.
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Studies of telmisartan in this setting do not exclude the possibility that telmisartan may not preserve a meaningful fraction of the effect of the ACE inhibitor to which it was compared. Consider using the ACE inhibitor first, and, if it is stopped for cough only, consider re-trying the ACE inhibitor after the cough resolves. Kirk JK. Therapy with angiotensin II receptor antagonists. Clin Geriatrics. Use with caution. May make these conditions worse. Danish; with English abstract. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure JNC V. Arch Intern Med.
No overall differences in effectiveness and safety were observed in these patients compared to younger patients and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Side effects with Micardis are not common. Micardis is available as white or off-white, uncoated tablets containing telmisartan 20 mg, 40 mg, or 80 mg. Tablets are marked with the BOEHRINGER INGELHEIM logo on one side, and on the other side, with either 50H, 51H, or 52H for the 20 mg, 40 mg, and 80 mg strengths, respectively.
It is not known whether telmisartan is excreted in human milk, but telmisartan was shown to be present in the milk of lactating rats. Because of the potential for adverse effects on the nursing infant, decide whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. It is also known as Q10, vitamin Q10, ubiquinone, or ubidecarenone. What is CoQ10 used for? Take Micardis one time each day at the same time. In patients with hepatic insufficiency, plasma telmisartan concentrations are increased and absolute bioavailability approaches 100%.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. One telmisartan-treated patient discontinued therapy because of increases in creatinine and blood urea nitrogen. Campbell-Falck D, Thomas T, Falck TM, et al. The intravenous use of coconut water. ACE inhibitor or angiotensin II receptor antagonist therapy. Conditions of Use and Important Information: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.