Telmisartan-Hydrochlorothiazide

• This drug can cause serious and possibly fatal harm to an unborn baby if used during pregnancy. It is important to prevent pregnancy while taking this medication.
• Consult your medical provider for more details and to discuss the use of reliable forms of birth control while taking this medication.
• If you are planning pregnancy, become pregnant or think you may be pregnant, contact your medical provider right away.

• This medication is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems.

• This product contains 2 medications—Telmisartan and Hydrochlorothiazide:

  • Telmisartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so blood can flow more easily.
  • Hydrochlorothiazide is a "water pill" (diuretic). It increases the amount of urine you produce, especially when you first start the medication. It also helps to relax the blood vessels so that blood can flow more easily.

• These medications are used together when 1 drug alone is not controlling your blood pressure. Your medical provider may direct you to start taking the individual medications first, and then switch you over to this combination product if this is the best dose combination for you.

• Take this medication by mouth with or without food as directed by your medical provider, usually once daily. It is best to avoid taking this medication within 4 hours of your bedtime to avoid having to get up to urinate. Consult your medical provider or pharmacist if you have questions about your dosing schedule.
• The dosage is based on your medical condition and response to treatment.
• Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick. It may take up to 4 weeks before you get the full benefit of this drug.
• If you also take certain drugs to lower your cholesterol—for example, bile acid-binding resins like Cholestyramine or Colestipol—take this product at least 4 hours before or at least 4 to 6 hours after these medications.
• Tell your medical provider if your condition does not improve or if it worsens—for example, your blood pressure readings remain high or increase.

• Dizziness and lightheadedness may occur as your body adjusts to the medication. Tiredness and diarrhea may also occur. If any of these effects last or get worse, tell your medical provider or pharmacist right away.
• To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
• Angioedema is a rare but potential side effect. Symptoms include swelling of the lips, tongue, throat or neck. This is not considered an allergic reaction and can occur any time during treatment. This swelling can compromise the airway and be life threatening. Patients with a personal or family history of angioedema are at higher risk. If you believe you may be at higher risk, discuss alternative treatment options with your medical provider.
• Remember that this medication has been prescribed because your medical provider has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not experience serious side effects.
• Although Telmisartan may be used to prevent kidney problems or treat people who have kidney problems, it may also cause or worsen serious kidney problems in rare cases. Your medical provider will check your kidney function while you are taking Telmisartan. Tell your medical provider right away if you have any signs of kidney problems such as a change in the amount of urine.

• This product may cause dehydration and electrolyte imbalance. Tell your medical provider right away if you have any symptoms of dehydration or electrolyte imbalance, including:

  • Extreme thirst
  • Very dry mouth
  • Muscle cramps or weakness
  • Fast, slow or irregular heartbeat
  • Confusion

• Tell your medical provider right away if you experience any serious side effects, including:

  • Fainting
  • Signs of kidney problems, such as change in amount of urine
  • Toe or joint pain
  • Symptoms of a high potassium blood level, such as muscle weakness or slow/irregular heartbeat
  • Decrease in vision
  • Eye pain

• A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • Rash
  • Itching or swelling, especially of the face/tongue/throat
  • Severe dizziness
  • Trouble breathing

• This is not a complete list of possible side effects. If you notice other effects not listed above, request a callback for medical advice. You may also report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

• Before taking this medication, tell your medical provider or pharmacist if you are allergic to Telmisartan or Hydrochlorothiazide, or if you have any other allergies, including an allergy to sulfonamides ("sulfa") because there may be cross-reactivity between the two classes of drugs. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Go to your patient dashboard and request a medical provider callback for more details.

• Before using this medication, tell your medical provider or pharmacist your medical history, especially of:

  • Glaucoma or other vision issues
  • Kidney disease like renal artery stenosis
  • Liver disease
  • Bile duct blockage
  • Dehydration
  • Untreated electrolytes imbalance, such as low or high potassium
  • Gout
  • Lupus
  • Skin cancer
• This drug may make you dizzy, which can be exacerbated by alcohol or marijuana (cannabis). Do not drive, use machinery or do anything that requires alertness until you can do it safely. Limit alcoholic beverages. Talk to your medical provider if you are using marijuana.
• Too much sweating, diarrhea or vomiting may cause dehydration and increase your risk of dizziness or lightheadedness. Report prolonged diarrhea or vomiting to your medical provider. Be sure to drink enough fluids to prevent dehydration unless your medical provider directs you otherwise.
• Before having surgery, tell your doctor or dentist about all the products you use, including prescription drugs, nonprescription drugs and herbal products.
• If you have diabetes, this medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your medical provider. Tell your medical provider right away if you have symptoms of high blood sugar like increased thirst or urination. Your medical provider may need to adjust your diabetes medication, exercise program or diet.
• This product may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your medical provider or pharmacist.
• This medication may make you more sensitive to the sun. It may also increase your risk for skin cancer, especially if you take it for a long time. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your medical provider right away if you get sunburned, have skin blisters/redness or notice new or changed moles/skin lesions.
• Older adults may be more sensitive to the side effects of this drug, especially dizziness and change in the amount of urine (kidney problems).
• Tell your medical provider if you are pregnant or plan to become pregnant. You should not become pregnant while using Telmisartan/Hydrochlorothiazide, as this medication may harm an unborn baby. If you become pregnant, talk to your medical provider right away about the risks and benefits of this medication. Consult your medical provider for more details (see also “Warnings to be aware of” section).
• This medication passes into breast milk. Consult your medical provider before breast-feeding.

• Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.
• Keep a list of all the products you use—including prescription/nonprescription drugs and herbal products—and share it with your medical provider and pharmacist.
• Do not start, stop or change the dosage of any medicines without your medical provider's approval.

• Some products that may interact with this drug include:

  • Aliskiren
  • Allopurinol
  • Certain diabetic medications
  • Certain cardiac medications
  • Dofetilide
  • Drugs that may increase the level of potassium in the blood such as ACE inhibitors including Benazepril or Lisinopril, certain antibiotics such as Bactrim or birth control pills containing Drospirenone
  • Erectile dysfunction medications
  • Licorice 
  • Lithium and certain other antidepressants and antipsychotic medications
  • Opioids
  • Ramipril
  • Some herbal supplements and vitamins
  • Steroids
• Some products have ingredients that could raise your blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely—especially cough-and-cold products, diet aids or NSAIDs such as Ibuprofen and Naproxen.
• This product may interfere with certain laboratory tests—including parathyroid and protein-bound iodide tests—possibly causing false test results. Make sure laboratory personnel and all your medical providers know you use this drug.

• Do not share this medication with others.
• Lab and/or medical tests—such as kidney function and blood mineral levels including potassium and skin exams—should be performed while you are taking this medication. Keep all medical and lab appointments. Consult your medical provider for more details.
• Lifestyle changes that may help this medication work better include stress reduction programs, exercise and dietary changes. Talk to your medical provider or pharmacist about lifestyle changes that might benefit you.
• 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 medical provider.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

• Store at room temperature away from light and moisture. Do not remove the medication from the blister pack until right before using. If the medication comes in a bottle, keep container tightly closed. Do not store in the bathroom.
• Keep all medications away from children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details.