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Telmisartan/Hydrochlorothiazide Risks

Specific Warnings and Precautions With Telmisartan/Hydrochlorothiazide

Precautions and warnings with telmisartan/hydrochlorothiazide to be aware of before starting the drug include the following:
 
  • Telmisartan/hydrochlorothiazide can interact with several different medications (see Drug Interactions With Telmisartan/Hydrochlorothiazide).
     
  • Telmisartan/hydrochlorothiazide may cause extreme low blood pressure in some people. This is more likely to occur when the medicine is first started or if the dosage is changed. It is also more likely to happen in people who are taking a diuretic, are on dialysis, have congestive heart failure, have diarrhea or vomiting, or sweat a lot. This is why it is important to drink fluids regularly while taking telmisartan/hydrochlorothiazide. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking telmisartan/hydrochlorothiazide until you have talked to your healthcare provider.
 
  • Make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how telmisartan/hydrochlorothiazide affects you.
 
  • Telmisartan/hydrochlorothiazide is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that it can present health risks to your unborn child. If you become pregnant while taking telmisartan/hydrochlorothiazide, contact your healthcare provider immediately (see Micardis HCT and Pregnancy for more information).
     
  • While taking telmisartan/hydrochlorothiazide, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your healthcare provider. In some people taking the drug, potassium in the blood can increase or decrease to dangerous levels.
     
  • Telmisartan/hydrochlorothiazide may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. Possible symptoms include:
 
    • Dry mouth
    • Increased thirst
    • Weakness
    • Tiredness
    • Restlessness
    • Confusion
    • Muscle pain or cramps
    • Decrease in urine output
    • Weak or irregular heartbeat
    • Nausea
    • Vomiting.
 
  • Medicines like telmisartan/hydrochlorothiazide have been known to cause a decrease in kidney function, especially in certain groups, such as those with severe congestive heart failure. Let your healthcare provider know if you have symptoms such as a decrease in urine output, drowsiness, headache, or back pain. He or she will also regularly check your kidney function with a blood test.
     
  • If you have moderate to severe liver disease (such as cirrhosis), gallstones, or other gallbladder problems, your body may metabolize the medication differently than intended. Therefore, your healthcare provider may start you on a lower dose of telmisartan/hydrochlorothiazide and will likely monitor your situation more closely or may recommend another blood pressure medicine.
     
  • Because of the hydrochlorothiazide, telmisartan/hydrochlorothiazide is more likely than other drugs to cause allergic reactions. This is more common in people with a history of allergies or asthma. Make sure to discuss this risk with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.
     
  • Because of the hydrochlorothiazide, telmisartan/hydrochlorothiazide is more likely to make systemic lupus erythematosus worse or, in some cases, even cause the condition. It can also make gout worse.
 
  • Telmisartan/hydrochlorothiazide may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, even cause diabetes in people without a history of the condition.
     
  • Telmisartan/hydrochlorothiazide may increase levels of cholesterol and triglycerides in the blood.
     
  • If you are nursing, it is not known whether telmisartan/hydrochlorothiazide passes through your milk. Therefore, if you are nursing, talk with your healthcare provider about whether you should stop telmisartan/hydrochlorothiazide or discontinue breastfeeding.
     
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Telmisartan and Hydrochlorothiazide

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