Telmivas HZ 12.5/40 Tablet 1 Strip

✔️ Side Effects

Common side effects include:

• Dizziness, drowsiness, tiredness
• Flushing, nausea, diarrhea, stomach pain
• Leg pain, chest pain, back pain
• Insomnia, dry mouth

Rare but serious adverse effects may include:

• Allergic reactions, fever, photosensitivity
• Myalgia, muscle spasms, gastric irritation
• Elevations in liver enzymes or bilirubin levels

✔️ Dosage & Administration

• Patients are uncontrolled with Telmisartan 80 mg monotherapy: Start with Telmisartan & Hydrochlorothiazide 80 mg/12.5 mg once daily. If necessary, the dose may be increased to 160 mg/25 mg after 2 to 4 weeks.
• Patients on Hydrochlorothiazide 25 mg experiencing hypokalemia: Start with Telmisartan & Hydrochlorothiazide 80 mg/12.5 mg once daily, with the possibility of titrating up to 160 mg/25 mg.
• Combination with other antihypertensive drugs: Telmisartan and Hydrochlorothiazide can be used alongside other antihypertensive agents for better blood pressure control.

✔️ Pediatric Use:

Safety and effectiveness in children have not been established.

✔️ Geriatric Use:

Older patients should start with the lowest effective dose due to possible decreased kidney, liver, or heart function.

✔️ Hepatic Impairment:

Patients with liver disease should take this medication under close medical supervision.

✔️ Renal Impairment:

• Not recommended for patients with severe renal impairment (CrCl <30 ml/min).
• No dose adjustment is needed for mild to moderate renal impairment.

✔️ Caution should be exercised if taking Telmivas HZ alongside:

• Aliskiren (especially in diabetic patients)
• Digoxin, lithium, NSAIDs (aspirin, ibuprofen, naproxen)
• Corticosteroids (prednisone, hydrocortisone)
• ACE inhibitors (benazepril, enalapril, lisinopril)
• Other angiotensin II receptor blockers (losartan, olmesartan, valsartan)

This medication may interfere with certain lab tests (e.g., parathyroid test, protein-bound iodide test), causing false results.

✔️ Contraindications

• Patients with hypersensitivity to Telmisartan, Hydrochlorothiazide, or any component of the formulation.
• Diabetic patients should not take this medication with Aliskiren.

✔️ Pregnancy (Category D):

• This medication can harm fetal renal function if used during the second and third trimesters, leading to complications such as lung hypoplasia and skeletal deformities.
• If pregnancy is detected, discontinue use immediately.

✔️ Lactation:

• It is unknown whether telmisartan is excreted in human milk.
• Thiazides do pass into breast milk and may affect the nursing infant.
• A decision should be made to either discontinue nursing or the medication, based on the mother's needs.

✔️ Symptoms of overdose may include:

• Hypotension, dizziness, tachycardia, bradycardia
• Electrolyte imbalances (hypokalemia, hyponatremia)
• Dehydration

Telmisartan is not removed by hemodialysis, and the extent to which Hydrochlorothiazide is removed is unknown.

✔️ Before taking Telmivas HZ, inform your doctor if you have:

• Kidney or liver disease, bile duct blockage
• Dehydration or mineral imbalances (e.g., potassium levels)
• Gout or lupus
• Diabetes (as it may affect blood sugar levels)

✔️ Precautions & Warnings

• Avoid potassium supplements or salt substitutes containing potassium without consulting a doctor.
• This medication may cause dizziness. Avoid driving or using heavy machinery until you know how it affects you.
• Drink enough fluids to prevent dehydration.

✔️ Storage Conditions

• Store in a cool and dry place, away from light.
• Keep out of reach of children.