Micardis Plus – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

This is a combination product that contains two medications used to lower hypertension (high blood pressure): telmisartan and hydrochlorothiazide. It is used to treat high blood pressure for people who require treatment with both telmisartan and hydrochlorothiazide.

Telmisartan belongs to a class of medications called angiotensin II blockers, which help to lower blood pressure by relaxing blood vessels. Hydrochlorothiazide is a diuretic (water pill) that helps control blood pressure by getting rid of excess salt and water.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

80 mg/12.5 mg
Each bilayered, oblong, uncoated tablet, the telmisartan layer being white and the hydrochlorothiazide layer being red, marked “BOEHRINGER INGELHEIM” and “H8” on the white layer, contains 80 mg of telmisartan and 12.5 mg of hydrochlorothiazide. Nonmedicinal ingredients: iron oxide (red), lactose monohydrate, magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone, sodium hydroxide, sodium starch glycolate, and sorbitol.

80 mg/25 mg
Each bilayered, oblong, uncoated tablet, the telmisartan layer being white and the hydrochlorothiazide layer being yellow, marked “BOEHRINGER INGELHEIM” and “H9” on the white layer, contains 80 mg of telmisartan and 25 mg of hydrochlorothiazide. Nonmedicinal ingredients: iron oxide yellow, lactose monohydrate, magnesium stearate, maize starch, meglumine, microcrystalline cellulose, povidone, sodium hydroxide, sodium starch glycolate, and sorbitol.

How should I use this medication?

The recommended dose is 1 tablet once daily. This medication is intended to be used by people who have not had their blood pressure well-controlled with just telmisartan, or by people who have had doses of telmisartan and hydrochlorothiazide already established.

The medication can be taken with or without food, but it should be taken the same way every time (i.e., always with food or always without food).

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a 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. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. It should be left in the protective blisters until immediately before you take it.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take telmisartan – hydrochlorothiazide if you:

• are allergic to telmisartan, hydrochlorothiazide, or any ingredients of the medication
• are allergic to sulfa (sulfonamide) medications (e.g., sulfamethoxazole)
• are pregnant or breast-feeding
• have anuria (able to pass little or no urine)
• have diabetes or kidney disease and are taking aliskiren
• have fructose intolerance (a rare hereditary condition)
• have galactose intolerance (a rare hereditary condition)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• anxiety
• back or leg pain
• cold-like symptoms (e.g., runny or stuffy nose, sore throat, headache)
• constipation
• decreased appetite
• diarrhea
• dizziness or lightheadedness when rising from a lying or sitting position
• drowsiness
• dry mouth
• flu-like symptoms
• gas
• headache
• joint or muscle pain
• muscle spasms
• nausea
• pins and needles sensation
• restlessness
• sexual difficulties
• skin rash
• swollen glands (in mouth)
• tiredness
• trouble sleeping
• vomiting
• weakness

Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• pounding, rapid heartbeat
• signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of electrolyte changes (e.g., confusion, drowsiness, dry mouth, muscle fatigue, nausea, thirst, weakness)
• signs of gout (e.g., joint pain, swelling and warmth of joints)
• signs of infections (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• signs of kidney problems (e.g., decreased urination, nausea, vomiting, swelling of the feet and ankles)
• signs of liver damage (yellowing of skin or whites of eyes, abdominal pain, loss of appetite, brown urine, light-coloured stools, tiredness, or weakness)
• signs of non-melanoma skin cancer (e.g., lump or discoloured patch on skin, pink/red firm lumps, or flat and scaly patches)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• swelling legs, ankles, or hands
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness)
• symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)
• unexplained muscle tenderness or weakness
• vision changes, blurred vision, or eye pain

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain
• severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
• signs of a serious allergic reaction (e.g., swelling of face or throat, hives, difficulty breathing)
• symptoms of sepsis (blood poisoning; e.g., confusion, chills, fever or low body temperature, shakiness, irregular heartbeat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reaction: Some people who are allergic to sulfonamide medications also experience allergic reactions to hydrochlorothiazide. Before you take this medication, tell your doctor about any previous reactions you have had to medications, especially to sulfonamide antibiotics or diabetes medications. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Angioedema: This medication may cause a serious allergic reaction called angioedema, which may be fatal if not treated promptly. If you have difficulty breathing or notice hives or swelling of the face, lips, tongue, or throat, stop taking this medication and get emergency medical help immediately. Other angiotensin II receptor antagonists should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking this medication.

Cholesterol: Cholesterol and triglyceride levels may increase when taking hydrochlorothiazide. If you have increased cholesterol or triglyceride levels, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Diabetes: Hydrochlorothiazide may make it more difficult for people with diabetes to control their blood sugar levels. High blood sugar may occur, glucose tolerance may change, and diabetes may worsen. A dose adjustment of diabetes medications, including insulin, may be required. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Electrolytes: The use of hydrochlorothiazide can reduce the levels of electrolytes such as potassium, sodium, magnesium, and chloride and increase the levels of calcium. Your doctor will periodically check to see if these levels are in balance, and a potassium supplement may be recommended. Warning signs or symptoms of fluid and electrolyte imbalance include:

• confusion
• drowsiness
• dryness of mouth
• lethargy
• low blood pressure
• muscle pains or cramps
• muscular fatigue
• nausea and vomiting
• racing heartbeat
• restlessness
• seizures
• thirst
• weakness

Hereditary fructose or galactose intolerance: Due to the sorbitol and lactose content in the medication, this medication is not suitable for people with hereditary fructose or galactose intolerance.

Gout: An acute gout attack may occur in some patients taking telmisartan – hydrochlorothiazide as a result of high levels of uric acid in the blood. Symptoms of an acute gout attack include sudden pain, swelling, and stiffness in the affected joint, often the big toe. You may also experience a fever. If this is your first attack, seek medical attention as soon as possible. If you have had gout attacks before, follow your doctor’s instructions for dealing with the attack.

Kidney function: Telmisartan – hydrochlorothiazide can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems for people already at risk for this problem. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have reduced kidney function, you may require lower doses of this medication.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. This medication is not recommended for people with severe liver impairment.

This medication may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Occasionally, a greater-than-expected drop in blood pressure occurs after taking this medication. It is more likely to occur if you are taking additional diuretics (water pills) or the medication aliskiren, have reduced salt intake, are on dialysis, or are experiencing diarrhea or vomiting. Blood pressure should be monitored more often in these situations. To reduce the risk of dizziness, people with low blood pressure or who are just starting to take this medication should stand or sit up slowly when getting up from a lying down or sitting position.

If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Excessive sweating and lack of fluid intake may lead to an extreme drop in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a drop in blood pressure. Consult your doctor if you feel your blood pressure is too low.

Lupus: There have been reports of a worsening or activation of lupus in people taking hydrochlorothiazide. If you have lupus or a history of lupus, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Sensitivity to sunlight: This medication may increase the sensitivity of the skin to sunlight, increasing the risk of sunburn. Avoid exposure to sunlight for long periods of time, particularly between the hours of 10 am and 2 pm, while you are taking this medication. Wear a broad-spectrum sunscreen with an SPF of 30 or higher. If you notice any unusual skin rash or peeling, contact your doctor immediately.

Skin cancer: Recent studies of hydrochlorothiazide have suggested that long-term use of hydrochlorothiazide may be associated with an increased risk of developing non-melanoma skin cancer. Regularly check your skin for new moles or lesions or changes to any existing ones and let your doctor know if you have any concerns.

Vision changes: Hydrochlorothiazide occasionally causes vision changes, including increased eye pressure and myopia (nearsightedness). If you experience any eye symptoms, such as pain or change in vision, contact your doctor as soon as possible.

Pregnancy: Telmisartan can cause injury or death to the developing fetus if taken by a woman who is pregnant. This medication should not be taken by pregnant women. If you become pregnant while taking telmisartan – hydrochlorothiazide, consult your doctor immediately as the medication should be stopped as soon as possible.

Breast-feeding: It is not known if telmisartan passes into breast milk. Hydrochlorothiazide does pass into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children and is not recommended.

Seniors: Seniors may be more sensitive to the side effects of this medication.

What other drugs could interact with this medication?

There may be an interaction between telmisartan – hydrochlorothiazide and any of the following:

• aclidinium
• alcohol
• aldesleukin
• aliskiren
• allopurinol
• alpha-agonists (e.g., clonidine, methyldopa)
• alpha-adrenergic blocking agents (e.g., alfuzosin, doxazosin, prazosin, terazosin)
• amifostine
• amiodarone
• amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
• angiotensin-converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
• other angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
• antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• apomorphine
• atropine
• azelastine
• barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
• belladonna
• benztropine
• beta-blockers (e.g., atenolol, carvedilol, propranolol)
• beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
• bortezomib
• bromocriptine
• calcium carbonate, calcium citrate
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• carbamazepine
• cholestyramine
• colestipol resins
• conivaptan
• oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• cyclophosphamide
• cyclosporine
• darifenacin
• dexmethylphenidate
• diabetes medications (e.g., canagliflozin, glyburide, insulin, linagliptin, liraglutide, metformin,  rosiglitazone)
• digoxin
• disopyramide
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
• drospirenone
• duloxetine
• eplerenone
• flavoxate
• ginger
• ginseng
• glycopyrrolate
• guanfacine
• heparin
• hydralazine
• ipratropium
• iron sucrose
• ivabradine
• ketotifen
• levodopa
• lithium
• licorice
• low-molecular-weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
• medications that increase blood levels of potassium (e.g., potassium chloride, salt substitutes containing potassium)
• methylphenidate
• minoxidil
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• multivitamins/minerals
• muscle relaxants (e.g., baclofen, cyclobenzaprine, orphenadrine, tizanidine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine)
• nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen)
• obinutuzumab
• oxcarbazepine
• oxybutynin
• pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
• porfimer
• pramipexole
• quinidine
• quinine
• riociguat
• ropinirole
• rotigotine
• sacubitril
• scopolamine
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• sodium phosphates
• solifenacin
• sulfonamide antibiotics (“sulfas”; sulfadiazine, sulfamethoxazole)
• tacrolimus
• tamsulosin
• tiotropium
• tolcapone
• tolterodine
• tolvaptan
• topiramate
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• trimethoprim
• umeclidinium
• vitamin D analogues (e.g., alfacalcidol, calcitriol, cholecalciferol)
• warfarin
• yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Micardis-Plus

Micardis HCT | Healthgrades | (telmisartan and hydrochlorothiazide tablet)

Brand Name: Micardis HCT

Generic Name: TELMISARTAN AND HYDROCHLOROTHIAZIDE

Drug Type: HUMAN PRESCRIPTION DRUG

Route: ORAL

Dosage Form: TABLET

Data Current As Of: 2018-11-15

MICARDIS HCT (telmisartan and hydrochlorothiazide)is indicated for the treatment of hypertension, to lower blood pressure.Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascularevents, primarily strokes and myocardial infarctions. These benefitshave been seen in controlled trials of antihypertensive drugs froma wide variety of pharmacologic classes including the classes to whichthis drug principally belongs. There are no controlled trials demonstratingrisk reduction with MICARDIS HCT.

Control of high blood pressure should bepart of comprehensive cardiovascular risk management, including, asappropriate, lipid control, diabetes management, antithrombotic therapy,smoking cessation, exercise, and limited sodium intake. Many patientswill require more than one drug to achieve blood pressure goals. Forspecific advice on goals and management, see published guidelines,such as those of the National High Blood Pressure Education Program’sJoint National Committee on Prevention, Detection, Evaluation, andTreatment of High Blood Pressure (JNC).

Numerous antihypertensive drugs, from a varietyof pharmacologic classes and with different mechanisms of action,have been shown in randomized controlled trials to reduce cardiovascularmorbidity and mortality, and it can be concluded that it is bloodpressure reduction, and not some other pharmacologic property of thedrugs, that is largely responsible for those benefits. The largestand most consistent cardiovascular outcome benefit has been a reductionin the risk of stroke, but reductions in myocardial infarction andcardiovascular mortality also have been seen regularly.

Elevated systolic or diastolicpressure causes increased cardiovascular risk, and the absolute riskincrease per mmHg is greater at higher blood pressures, so that evenmodest reductions of severe hypertension can provide substantial benefit.Relative risk reduction from blood pressure reduction is similar acrosspopulations with varying absolute risk, so the absolute benefit isgreater in patients who are at higher risk independent of their hypertension(for example, patients with diabetes or hyperlipidemia), and suchpatients would be expected to benefit from more aggressive treatmentto a lower blood pressure goal.

Some antihypertensive drugs have smallerblood pressure effects (as monotherapy) in black patients, and manyantihypertensive drugs have additional approved indications and effects(e.g., on angina, heart failure, or diabetic kidney disease). Theseconsiderations may guide selection of therapy [see ClinicalStudies (14)].

MICARDIS HCT is not indicatedfor initial therapy for the treatment of hypertension [seeDosage and Administration (2.1)].

MICARDIS HCT maybe used alone or in combination with other antihypertensive agents.

patient counseling information

Advise the patient to read the FDA-approvedpatient labeling (Patient Information).

Pregnancy
Advise female patients of childbearing age aboutthe consequences of exposure to MICARDIS HCT during pregnancy. Discusstreatment options with women planning to become pregnant. Tell patientsto report pregnancies to their physicians as soon as possible [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)].

Lactation
Advise nursingwomen not to breastfeed during treatment with MICARDIS HCT [see Use in Specific Populations (8.2)].

Symptomatic Hypotension and Syncope
Advise patients that lightheadedness can occur, especiallyduring the first days of therapy, and to report it to their healthcareprovider. Inform patients that inadequate fluid intake, excessiveperspiration, diarrhea, or vomiting can lead to an excessive fallin blood pressure, with the same consequences of lightheadedness andpossible syncope. Advise patients to contact their healthcare providerif syncope occurs [see Warnings and Precautions (5.2)].

Potassium Supplements
Advise patients not to use potassium supplementsor salt substitutes that contain potassium without consulting theprescribing healthcare provider [see Warnings and Precautions(5.4) and Drug Interactions (7.1)].

Acute Myopia and SecondaryAngle-Closure Glaucoma
Advise patientsto discontinue MICARDIS HCT and seek immediate medical attention ifthey experience symptoms of Acute Myopia or Secondary Angle-ClosureGlaucoma [see Warnings and Precautions (5.6)].

Distributed by:
Boehringer Ingelheim Pharmaceuticals,Inc.
Ridgefield, CT 06877 USA

Licensed from:
Boehringer IngelheimInternational GmbH
Ingelheim, Germany

Copyright © 2018 Boehringer Ingelheim InternationalGmbH
ALL RIGHTS RESERVED

MICARDIS^® isa registered trademark of and used under license from Boehringer IngelheimInternational GmbH.
The other brands listed are trademarksof their owners.

IT5825DB092018

Patient Information

MICARDIS^® HCT (my-CAR-dis HCT)
(telmisartan and hydrochlorothiazide)
Tablets

Read this Patient Information before you start taking MICARDIS HCTtablets and each time you get a refill. There may be new information. This information does not take the place of talking to your doctorabout your medical condition or your treatment.

What is the most important informationI should know about MICARDIS HCT tablets?

MICARDIS HCT can cause harm or death toan unborn baby. Talk to your doctor about other ways to lower yourblood pressure if you plan to become pregnant. If you get pregnantwhile taking MICARDIS HCT, tell your doctor right away.

What is MICARDIS HCT?

MICARDIS HCT isa prescription medicine used to treat high blood pressure (hypertension).
MICARDIS HCT contains:

• telmisartan, an angiotensin receptor blocker (ARB)
• hydrochlorothiazide, a water pill or diuretic

Your doctor may prescribeother medicines for you to take along with MICARDIS HCT to treat yourhigh blood pressure.

It is not known if MICARDIS HCT is safe and effective in children.

Do not take MICARDIS HCT tablets if you:
• have low or no urine output
• are allergic (hypersensitive) to the active ingredients(telmisartan or hydrochlorothiazide) or any of the other ingredientslisted at the end of this leaflet

What should I tellmy doctor before using MICARDIS HCT tablets?

Before you take MICARDIS HCT tablets, tellyour doctor if you:

• are pregnant or are planning to become pregnant. See “What is the most important information I should know about MICARDISHCT tablets?”
• are breast-feeding or plan to breast-feed. MICARDIS HCTcan pass into your breast milk and may harm your baby. You and yourdoctor should decide if you will take MICARDIS HCT or breast-feed.You should not do both. Talk with your doctor about the best way tofeed your baby if you take MICARDIS HCT tablets.
• have been told that you have abnormal body salt (electrolytes)levels in your blood
• have liver problems
• have asthma or history of asthma
• have lupus
• have diabetes
• have kidney problems
• have any other medical conditions

Tell your doctorabout all the medicines you take, including prescription andnon-prescription medicines, vitamins, and herbal supplements. Also,tell your doctor if you drink alcohol.

MICARDIS HCT may affect the way other medicineswork, and other medicines may affect how MICARDIS HCT works. Especiallytell your doctor if you take:

• aliskiren
• digoxin (Lanoxin^®)
• lithium (Lithobid^®, lithium carbonate,lithium citrate)
• other medicines used to treat your high blood pressure ora heart problem
• water pills (diuretic)
• aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)
• potassium supplements or a salt substitute containing potassium
• medicine used to treat diabetes, including insulin
• narcotic pain medicines
• sleeping pills
• steroid medicine or Adrenocorticotrophic Hormone (ACTH)
• barbiturates
• certain cholesterol lowering medicines (resins that areused for cholesterol reduction, e.g., cholestyramine and colestipolresins)

Ask your doctor if youare not sure if you are taking one of the medicines listed above.

Know the medicines you take. Keep a list of them and show it to your doctor or pharmacist whenyou get a new medicine.

How should I take MICARDIS HCT tablets?

• Take MICARDIS HCT tablets exactly as your doctor tells youto take it.
• Your doctor will tell you how much MICARDIS HCT to takeand when to take it.
• Do not change your dose unless your doctor tells you to.
• Take MICARDIS HCT once each day.
• Take MICARDIS HCT tablets with or without food.
• If you take too much MICARDIS HCT, call your doctor, orgo to the nearest hospital emergency room right away.
• Read the “How to open the blister” at the endof this leaflet before you use MICARDIS HCT. Talk with your doctorif you do not understand the instructions.

What are the possibleside effects of MICARDIS HCT tablets?

MICARDIS HCT tablets may cause seriousside effects, including:

• Injury or death to your unborn baby. See “What is the most important information I should know about MICARDISHCT tablets?”
• Low blood pressure (hypotension) is most likelyto happen if you also:
  • take water pills (diuretics)
  • are on a low-salt diet
  • get dialysis treatments
  • have heart problems
  • get sick with vomiting or diarrhea
  • do not drink enough fluids
  • sweat a lot

  If you feel faint or dizzy, lie down and call your doctorright away.

• Kidney problems, which may get worse if youalready have kidney disease. You may have changes in your kidney testresults, and you may need a lower dose of MICARDIS HCT tablets. Callyour doctor if you get:
  • swelling in your feet, ankles, or hands
  • unexplained weight gain

  Call your doctor right away if you get any of the symptomslisted above.

• Liver problems, which may get worse in peoplewho already have liver problems and take MICARDIS HCT.
• Eye problems. One of the medicines in MICARDISHCT can cause eye problems that may lead to vision loss. Symptomsof eye problems can happen within hours to weeks of starting MICARDISHCT. Tell your doctor right away if you have:
• Allergic reactions. Tell your doctor rightaway if you get any of these symptoms:
  • swelling of the face, tongue, throat
  • difficulty breathing
  • Worsening of lupus. Tell your doctor if yourlupus gets worse or becomes active while taking MICARDIS HCT.
• Change in body salts (electrolytes) level in yourblood and fluid problems. Your doctor may do tests to checkyour blood. Call your doctor right away if you have:

The most common side effects of MICARDIS HCT tablets include:
• upper respiratory tract infections, including sinus pain/congestionand sore throat
• dizziness
• feeling tired
• flu-like symptoms
• back pain
• diarrhea
• nausea

These are not all the possibleside effects with MICARDIS HCT tablets. Tell your doctor if you haveany side effect that bothers you or that does not go away. Call yourdoctor for medical advice about side effects. You may report sideeffects to FDA at 1-800-FDA-1088.

How should I store MICARDIS HCT tablets?

• Store MICARDIS HCT tablets at room temperature 68°F to 77°F(20°C to 25°C).
• Do not remove MICARDIS HCT tablets from blisters until rightbefore you take them.

Keep MICARDIS HCTtablets and all medicines out of the reach of children.

General information aboutMICARDIS HCT tablets:

Medicines are sometimes prescribed for purposesother than those listed in a Patient Information leaflet. Do notuse MICARDIS HCT tablets for a condition for which it was not prescribed.Do not give MICARDIS HCT tablets to other people, even if they havethe same condition you have. It may harm them.

This Patient Information leaflet summarizesthe most important information about MICARDIS HCT tablets. If youwould like more information, talk with your doctor. You can ask yourpharmacist or doctor for information about MICARDIS HCT tablets thatis written for health professionals.

For current prescribing information, scanthe code below or call Boehringer Ingelheim Pharmaceuticals, Inc.at 1-800-542-6257 or (TTY) 1-800-459-9906.

What are the ingredients in MICARDISHCT tablets?

Active Ingredients: telmisartan and hydrochlorothiazide

Inactive Ingredients: sodiumhydroxide, meglumine, povidone, sorbitol, magnesium stearate, lactosemonohydrate, microcrystalline cellulose, maize starch, and sodiumstarch glycolate

The40 mg/12.5 mg and 80 mg/12.5 mg tablets also contain: ferric oxidered.

The 80 mg/25 mgtablets also contain: ferric oxide yellow.

What is high blood pressure (hypertension)?

Blood pressure isthe force in your blood vessels when your heart beats and when yourheart rests. You have high blood pressure when the force is too much. Medicines that lower your blood pressure lower your chance of havinga stroke or heart attack.

High blood pressure makes the heart work harder to pump blood throughthe body and causes damage to the blood vessels. MICARDIS HCT tabletscan help your blood vessels relax so your blood pressure is lower.

How to open the blister:

1. Tear (You mayalso use scissors to tear the blister apart)

2. Peel (Peel off the paper layer from thealuminum foil)

3. Push (Push the tablet through the foil)

This Patient Information has been approvedby the U.S. Food and Drug Administration.

Distributed by:
Boehringer IngelheimPharmaceuticals, Inc.
Ridgefield, CT 06877 USA

Licensed from:
BoehringerIngelheim International GmbH
Ingelheim, Germany

Copyright © 2018 Boehringer IngelheimInternational GmbH
ALL RIGHTS RESERVED

MICARDIS^® is aregistered trademark of and used under license from Boehringer IngelheimInternational GmbH.

The other brands listed are trademarks of their owners.

Revised: February 2018

IT5825DB092018

Micardis HCT

80 mg/25 mg

30 Tablets

NDC 0597-0042-37

Micardis HCT

40 mg/12.5 mg

30 Tablets

NDC 0597-0043-37

Micardis HCT

80 mg/12.5 mg

30 Tablets

NDC 0597-0044-37

Micardis | healthdirect

What it is used for

MICARDIS is indicated for: Treatment of hypertension. Prevention of cardiovascular morbidity and mortality in patients 55 years or older with coronary artery disease, peripheral artery disease, previous stroke, transient ischaemic attack or high risk diabetes with evidence of end organ damage (see CLINICAL TRIALS).

How to take it

The way to take this medicine is: Oral.
This medicine is taken by mouth.

• Store below 30 degrees Celsius
• Protect from Moisture
• Protect from Light
• Shelf lifetime is 4 Years.

You should seek medical advice in relation to medicines and use only as directed by a healthcare professional.

Always read the label. If symptoms persist see your healthcare professional.

Visual appearance

White to off-white, oblong tablet one face marked with “52H” and the other face marked with the Boehringer Ingelheim company symbol.

Images are the copyright of the Pharmacy Guild of Australia

Do I need a prescription?

What is the medicines and poisons schedule?

All medicines and poisons in Australia are categorised by how they are made available to the public. Medicines with a low safety risk are usually less tightly controlled than medicines with a higher safety risk. This system is called ‘scheduling’.

You can read more about the scheduling of medicines as well as the different scheduling categories on our Scheduling of medicines and poisons information page.

close tooltip Ok

This medicine is available from a pharmacist and requires a prescription. It is
Schedule 4 : Prescription Only Medicine.

open tool tip to find out more

Is this medicine subsidised?

This medicine was verified as being available on the PBS (Pharmaceutical Benefits Scheme) on August 1, 2021. To learn more about this subsidy, visit the Pharmaceutical Benefits Scheme (PBS) website.

Pregnant or planning a pregnancy?

For the active ingredient telmisartan

You should seek advice from your doctor or pharmacist about taking this medicine. They can help you balance the risks and the benefits of this medicine during pregnancy.

Consumer Medicines Information (CMI)

For side effects, taking other medicines and more

Print the CMI.

Listen to the CMI.

Your browser doesn’t support HTML5 audio.

Reporting side effects

You can help ensure medicines are safe by reporting the side effects you experience.

You can report side effects to your doctor, or directly at www.tga.gov.au/reporting-problems

What it is used for

MICARDIS is indicated for: Treatment of hypertension. Prevention of cardiovascular morbidity and mortality in patients 55 years or older with coronary artery disease, peripheral artery disease, previous stroke, transient ischaemic attack or high risk diabetes with evidence of end organ damage (see CLINICAL TRIALS).

How to take it

The way to take this medicine is: Oral.
This medicine is taken by mouth.

• Store below 30 degrees Celsius
• Protect from Moisture
• Protect from Light
• Shelf lifetime is 4 Years.

You should seek medical advice in relation to medicines and use only as directed by a healthcare professional.

Always read the label. If symptoms persist see your healthcare professional.

Visual appearance

White to off-white, oblong tablet one face marked with “51H” and the other face marked with the Boehringer Ingelheim company symbol.

Images are the copyright of the Pharmacy Guild of Australia

Do I need a prescription?

What is the medicines and poisons schedule?

All medicines and poisons in Australia are categorised by how they are made available to the public. Medicines with a low safety risk are usually less tightly controlled than medicines with a higher safety risk. This system is called ‘scheduling’.

You can read more about the scheduling of medicines as well as the different scheduling categories on our Scheduling of medicines and poisons information page.

close tooltip Ok

This medicine is available from a pharmacist and requires a prescription. It is
Schedule 4 : Prescription Only Medicine.

open tool tip to find out more

Is this medicine subsidised?

This medicine was verified as being available on the PBS (Pharmaceutical Benefits Scheme) on August 1, 2021. To learn more about this subsidy, visit the Pharmaceutical Benefits Scheme (PBS) website.

Pregnant or planning a pregnancy?

For the active ingredient telmisartan

You should seek advice from your doctor or pharmacist about taking this medicine. They can help you balance the risks and the benefits of this medicine during pregnancy.

Consumer Medicines Information (CMI)

For side effects, taking other medicines and more

Print the CMI.

Listen to the CMI.

Your browser doesn’t support HTML5 audio.

Reporting side effects

You can help ensure medicines are safe by reporting the side effects you experience.

You can report side effects to your doctor, or directly at www.tga.gov.au/reporting-problems

Olmesartan: medicine to treat high blood pressure

Take olmesartan tablets once a day.

Your doctor may suggest that you take your first dose before bedtime, as it can make you dizzy.

After the very first dose you can take olmesartan at any time of day.

Usually people take olmesartan in the morning, but it doesn’t really matter. Just try to take it at the same time every day.

You can take olmesartan tablets with or without food.

Swallow the tablets whole with a drink of water. Do not crush or chew the tablets.

Speak to a pharmacist if you or your child have difficulty swallowing tablets.

Dosage

Always take olmesartan as instructed by your doctor.

For adults and children aged 6 years and over, the usual dose is 10mg taken once a day to start with.

Your dose may eventually go up to 20mg or 40mg, taken once a day.

Children weighing less than 35kg (about 5.5 stone) should not take more than 20mg daily.

Your child’s doctor will calculate the right dose based on how much they weigh.

Will my dose go up or down?

After a few weeks your doctor will check your blood pressure and ask you if you’re getting any side effects.

You may also have blood tests to check how well your kidneys are working and the amount of potassium in your blood.

Your doctor will then decide whether to change your dose of olmesartan.

If olmesartan does not bring your blood pressure down, your doctor may want to increase the dose.

If your blood pressure gets too low or you get side effects, your doctor may want to lower your dose.

What if I get sick while I’m taking it?

If you get severe diarrhoea or vomiting for any reason, contact your doctor or a pharmacist. They’ll be able to advise you about what to do.

They may recommend that you stop taking olmesartan until you’re better and able to eat and drink normally again.

What if I forget to take it?

If you miss a dose of olmesartan, take it as soon as you remember if it’s on the same day.

If you don’t remember until the next day, skip the forgotten dose and take your next dose at the usual time.

Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

An overdose of olmesartan can cause low blood pressure and dizziness.

The amount of olmesartan that can lead to an overdose varies from person to person.

Telmisartan – Oral | HealthLink BC

Pronunciation: tel-mi-SAR-tan

Common Brand Name(s): Micardis

Important: How To Use This Information

This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Warning

This drug can cause serious (possibly fatal) harm to an unborn baby if used during pregnancy. Therefore, it is important to prevent pregnancy while taking this medication. Consult your doctor 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, tell your doctor right away.

Uses

This medication is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Telmisartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so blood can flow more easily.

Other Uses

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used for certain immune system diseases (such as lupus).

How To Use

Read the Patient Information Leaflet if available from your pharmacist before you start taking telmisartan and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

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. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. For the treatment of high blood pressure, it may take up to 4 weeks before you get the full benefit of this drug.

Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).

Side Effects

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.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• fainting
• symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat)

Although telmisartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking telmisartan. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine.

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/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, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking telmisartan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

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

• liver disease
• bile duct blockage
• high blood levels of potassium in the blood (hyperkalemia)
• loss of too much body water and/or minerals (dehydration)

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Too much sweating, diarrhea, or vomiting may cause you to feel lightheaded. Report prolonged diarrhea or vomiting to your doctor.

This product may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details. (See also Warning section.)

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Drug Interactions

See also Precautions section.

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 doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include:

• aliskiren
• lithium
• ramipril
• drugs that may increase the level of potassium in the blood (such as ACE inhibitors including benazepril/lisinopril, birth control pills containing drospirenone)

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/naproxen).

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast heartbeat, severe dizziness, fainting.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as kidney function, potassium levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Lifestyle changes that may help this medication work better include stress reduction programs, exercise, and dietary changes. Talk to your doctor 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 doctor.

Missed Dose

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.

Storage

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.

Telmisartan tablets

What is this medicine?

TELMISARTAN (tel mi SAR tan) is used to treat high blood pressure.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Micardis

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• if you are on a special diet, such as a low-salt diet
• kidney or liver disease
• an unusual or allergic reaction to telmisartan, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. This medicine can be taken with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

• digoxin
• potassium salts or potassium supplements
• warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Check your blood pressure as directed. Ask your doctor or health care professional what your blood pressure should be and when you should contact him or her. Call your doctor or health care professional if you notice an irregular or fast heart beat.

Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child, particularly in the second or third trimester. Talk to your health care professional or pharmacist for more information.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

Avoid salt substitutes unless you are told otherwise by your doctor or health care professional.

Do not treat yourself for coughs, colds, or pain while you are taking this medicine without asking your doctor or health care professional for advice. Some ingredients may increase your blood pressure.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• dark urine
• gout pain
• muscle pains
• slow heartbeat
• trouble passing urine or change in the amount of urine
• unusual bleeding or bruising
• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• back pain
• change in sex drive or performance
• diarrhea
• sore throat or stuffy nose

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Tablets should not be removed from the blisters until right before use. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Alzheimer’s Therapy Could Develop Out of the Blood Pressure Treatment Telmisartan

Telmisartan (Micardis) is a high blood pressure medicine that researchers are evaluating as a possible treatment for Alzheimer’s disease.

As a cardiovascular disease therapy, it works by lowering blood pressure in vessels feeding the heart. High blood pressure is also associated with the development of Alzheimer’s, studies have shown.

How Telmisartan works

Telmisartan is an angiotensin II receptor antagonist, also known as an angiotensin II receptor blocker (ARB) or a sartan. These molecules bind to the angiotensin II receptor, blocking its action. Angiotensin II receptor blockers help relax blood vessels, lowering blood pressure and making it easier for the heart to pump blood.

Studies have shown that angiotensin receptor antagonists can reduce the risk of Alzheimer’s in a rodent model.  Researchers believe telmisartan can slow the progression of Alzheimer’s by controlling blood flow, protecting capillary blood vessels, and reducing plaque formation in the brain — a hallmark of the disease.

Telmisartan in clinical trials

Two clinical trials are assessing whether telmisartan can help treat Alzheimer’s.

One is an open-label Phase 2 study (NCT02085265 nicknamed SARTAN-AD) evaluating telmisartan’s ability to treat 240 people with mild to moderate Alzheimer’s.

Some of the trial participants are taking telmisartan while others are taking another blood-pressure-lowering therapy, perindopril. Perindopril is an angiotensin-converting enzyme (ACE) inhibitor which works to prevent the creation of angiotensin II in order to keep it from narrowing blood vessels. Patients will be given either oral medication for a year.

The trial is assessing telmisartan’s safety and ability to widen blood vessels as a way of slowing the brain atrophy that characterizes Alzheimer’s. Researchers are also looking at whether telmisartan can improve patients’ cognitive and functional abilities, changes in electrolytes in the blood, its impact on the volume of a brain region called the hippocampus, and whether it changes the proportion of gray versus white matter in the brain.

The trial, being conducted in Canada, is still recruiting and is expected to be completed by March 2021.

The second trial is a Phase 1 study (NCT02471833) to see if telmisartan can help prevent Alzheimer’s in African-Americans, a group at higher risk of developing the disease than other populations.

The eight-month trial, nicknamed HEART, involves 66 middle-aged African-Americans who are susceptible to developing Alzheimer’s because they have high blood pressure and a parent with Alzheimer’s. Researchers are randomly assigning the patients to either 20 mg or 40 mg of telmisartan once a day, or a placebo.

The primary objective of the study is to see whether telmisartan can lower the level of angiotensin metabolites in the fluid surrounding the brain and spinal cord. The metabolites are associated with blood-vessel constriction.

One of the secondary objectives of the study is assessing telmisartan’s impact on patients’ cognitive abilities. Another is to see how the therapy affects biomarkers associated with Alzheimer’s, such as the level of tau protein. An accumulation of that protein is linked to brain deterioration.

The trial, being conducted at Emory University, is still recruiting and is expected to run through June of 2020.

Last updated: Sept. 5, 2019

***

Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

90,000 Hypertension tablet tested 4 in 1

Scientists from the University of Sydney have invented a combination drug for lowering blood pressure, which consists of four known drugs for hypertension in low doses and works more effectively than either drug alone. The results of a clinical trial of the combination drug are published in The Lancet and presented at the ESC Congress 2021.

High blood pressure causes heart attacks and strokes. Moreover, it is found in most people after 50 years. While not many of them measure their blood pressure on a daily basis, they are correct and know the new gold standard for normal blood pressure.

Lead author of the new study, Clara Chow of the University of Sydney, believes that hypertension control is not perfect anywhere in the world, and in Africa, hypertension is under control in less than one in ten.

“Global statistics show that over the past 30 years, the number of cases of hypertension has doubled, and hypertension has become the leading cause of death from heart attack and stroke,” says Chow.

As a result, people often go to the doctor with very high blood pressure readings. In such cases, doctors prescribe one or two drugs in high doses, from which the liver and kidneys suffer. If these drugs do not relieve blood pressure, experiment with the following. But often, such patients, experiencing the side effects of the drug – pain due to high doses of the drug, stop taking the drugs altogether and, therefore, live with a constant risk of heart attack or stroke.

“We wanted to see if people who have severe side effects from treatment would benefit from switching to a drug in the form of a combination of ultra-low doses [drugs],” explains Professor Chou.

To reduce the toxic effects of strong drugs on the body and effectively lower blood pressure, Australian scientists combined four well-known drugs in one tablet – irbesartan at a dose of 37.5 mg, amlodipine at a dose of 1.25 mg, indapamide at a dose of 0.625 mg and bisoprolol at a dose 2.5 mg. Typically, these drugs are prescribed in minimum doses of 75 mg, 5 mg, 1.5 mg, and 2.5 mg, respectively.

The combination drug was tested on two groups of 591 adults in Australia.The first group received a new 4-in-1 pill. The second group, the control group, took only one medication for hypertension, which is usually prescribed by doctors.

As a result, after 12 weeks of testing, blood pressure decreased in 80% of patients from the first group and in 60% of patients from the control group.

After 12 months, the decrease in blood pressure in the first group of patients was even more stable than in the control group of patients with a standard approach to the treatment of hypertension.However, no differences in side effects were observed.

“This was the first study to show that the benefits persisted in the long term without any decline over time,” Chou emphasizes. drugs for blood pressure, they have not caught up [in terms of effectiveness] the group with the drug 4 in 1 “.

However, it is not enough to create an effective drug.It also needs to be made affordable for the majority of patients who need it, scientists say. Only in this case will the medicine have a serious impact on the global health of the inhabitants of the planet.

“When we find such an effective, simple and safe treatment, we must do our best to deliver it to those who will benefit the most,” Chou says.

Earlier, we wrote about five-minute breathing exercises, which will lower blood pressure without pills, and exercises that will help lower blood pressure as well as medication.We also said that “high” and “low” pressure have the same effect on the risk of heart attack and stroke.

More interesting news of science and medicine can be found in the sections “Science” and “Medicine” on the media platform “Look”.

90,000 Mikardis (Telmisartan). A site about the treatment of hypertension. We learn how to reduce blood pressure to the norm of

Mikardis (Telmisartan) is available in 40 and 80 mg tablets. It is 6 times more effective than losartan. It is a fat-soluble preparation, due to which it penetrates well into tissues.It is quickly absorbed regardless of food intake. The bioavailability of telmisartan is about 50%, the time to reach the maximum concentration in the blood is 1-5 hours after administration. About 98% binds to plasma proteins. The volume of distribution (500 l) is the largest among the drugs of this class, which contributes to its wide penetration into tissues.

Mikardis (Telmisartan) does not form active metabolites. It is excreted in the bile. The patient’s gender and age do not affect the dosage of the drug.No dosage change is required in patients with renal impairment. Telmisartan (micardis) is not removed from the blood by hemodialysis.

Read the article “Pressure pills: questions and answers”.
Find out:

• How to normalize blood pressure, blood sugar and cholesterol at the same time
• The pressure pills prescribed by the doctor used to work well, but now they are weaker. Why?
• What to do if even the strongest tablets do not relieve blood pressure
• What to do if drugs for hypertension lower blood pressure too
• High blood pressure, hypertensive crisis – features of treatment in young, middle and old age

No more shortness of breath, headaches, pressure surges and other symptoms of HYPERTENSION! Our readers are already using this method to treat pressure.To learn more…

Since micardis is excreted by the liver, in patients with severe liver damage, the rate of excretion of the drug, in contrast to irbesartan, is significantly reduced. In this regard, such patients, as well as patients with obstruction of the biliary tract, should not be prescribed telmisartan (mycardis), and with moderate hepatic insufficiency, the dose should be reduced to 40 mg per day.

Telmisartan has the longest plasma half-life and therefore the longest duration of action among angiotensin II antagonists.In terms of antihypertensive efficacy, micardis (telmisartan) is not inferior to any of the modern drugs.

The effect of micardis (telmisartan) is dose-dependent. An increase in the daily dose from 20 to 80 mg is accompanied by a twofold decrease in systolic blood pressure, as well as a more significant decrease in diastolic blood pressure. Increasing the dose of micardis in excess of 80 mg per day does not lead to an additional decrease in blood pressure.

The usual maintenance dose of telmisartan is 40 mg per day, the maximum is 80 mg per day.After discontinuation of the drug, blood pressure gradually returns to its initial level within several days without manifestation of the “rebound” syndrome. Telmisartan (micardis) is well tolerated. With its use, diarrhea, back pain, myalgia are possible, but these effects are rarely observed, as with placebo.

Mikardis (Telmisartan) belongs to the group of angiotensin II receptor blockers

90,000 A new drug has been created to lower blood pressure

Hypertension is a chronic disease characterized by a persistent increase in blood pressure.It also affects such organs and systems as the heart, blood vessels, brain and kidneys. This is one of the most common human diseases. According to statistics from the World Health Organization, hypertension affects 20-30% of the adult population of the planet. The causes of hypertension are not fully understood, but smoking, excessive alcohol consumption, a sedentary lifestyle, stress and poor nutrition contribute to its development. One of the most important factors causing high blood pressure is emotional stress.

Russian scientists have developed a drug for the treatment of stress-dependent hypertension. It acts on the special beta-1-adrenergic receptors present in the cells of the heart, which are proteins built into the cell wall. When these proteins are stimulated, the strength and heart rate increase, which is one of the reasons for the development of hypertension. In medical practice, drugs that block beta-adrenergic receptors (beta-blockers) are widely used.

The receptor structure is encoded by the corresponding gene in the DNA. However, before hereditary information can be translated into protein form, it must be read in the form of mRNA, which will serve as a template for the synthesis of the amino acid sequence of the protein. It is known that stress increases the number of beta-1-adrenergic receptors and the corresponding mRNA in cells. By “blocking” the matrix for protein synthesis, receptor formation and therefore an increase in blood pressure can be prevented.Based on this principle, scientists have created a new drug. On tests it turned out that with the use of the drug, blood pressure is reduced by 10-12 mm Hg. Art. within 4-5 days.

The development of scientists surpasses traditional drugs due to an increase in its duration and, most importantly, its specificity: the key mechanism of the development of the disease is blocked, which eliminates side effects. This is the basis for the prospect of using this and other similar drugs in clinical practice.

The study was carried out by scientists from the NSU, the Institute of Cytology and Genetics of the SB RAS and the Institute of Chemical Biology and Fundamental Medicine of the SB RAS.

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