ONTEL 40H
TELMISRATAN & HYDROCLORTHIAZIDE
What it does
Hydrochlorothiazide is a medication used to help lower blood pressure and reduce swelling by removing extra fluid from the body.
Commonly used for: high blood pressure (hypertension), swelling (edema)
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Source: Pharmacy and Poisons Board · fetched 2026-01-28 19:45:12 · updated 2026-08-03 02:54:15
About hydroclorthiazide
Hydrochlorothiazide is a medication used to help lower blood pressure and reduce swelling by removing extra fluid from the body.
What it treats
- high blood pressure (hypertension)
- swelling (edema)
How it works
It works by helping the kidneys get rid of excess salt and water, which lowers blood pressure and decreases swelling.
Who it's for
This medication is suitable for adults who need help managing their blood pressure or reducing swelling.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About telmisratan
Telmisartan is a medication that helps lower high blood pressure (hypertension).
What it treats
- high blood pressure (hypertension)
- heart failure
How it works
Telmisartan works by relaxing blood vessels, which helps to reduce blood pressure and improve blood flow.
Who it's for
Telmisartan is for adults who need to manage their blood pressure.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: hydroclorthiazide
Hydrochlorothiazide is a thiazide diuretic commonly used for the treatment of hypertension and edema associated with heart failure, liver cirrhosis, and renal disease. It works primarily by promoting the excretion of sodium and water from the kidneys, leading to decreased blood volume and lower blood pressure.
Indications
- Hypertension
- Edema associated with congestive heart failure
- Edema associated with hepatic cirrhosis
- Edema associated with renal disease
- Nephrolithiasis due to idiopathic hypercalciuria
Dosage
Children: Refer to BNF for Children for appropriate dosing in pediatric patients.
Adults: Dosage varies based on condition; refer to specific guidelines for hypertension and edema management.
Mechanism of action
Hydrochlorothiazide acts on the distal convoluted tubule in the nephron, where it inhibits the sodium-chloride symporter. This inhibition decreases sodium reabsorption, leading to increased excretion of sodium and water, resulting in diuresis. The reduction in blood volume contributes to its antihypertensive effects.
Pharmacodynamics
The primary pharmacodynamic effect of hydrochlorothiazide is its ability to lower blood pressure by reducing peripheral vascular resistance. Additionally, it can cause a decrease in cardiac output and total blood volume, which further aids in managing hypertension. Thiazide diuretics have a mild natriuretic effect, leading to an increase in urine output.
Pharmacokinetics
Hydrochlorothiazide is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 1 to 2 hours after oral administration. Its biological half-life is about 6 to 15 hours, depending on renal function. The drug is primarily eliminated via the kidneys, with approximately 60-80% excreted unchanged in the urine. Renal impairment can affect its clearance.
Contra-indications
- Hypersensitivity to hydrochlorothiazide or any of its components
- Anuria
- Severe renal impairment
- Electrolyte depletion
- History of hypersensitivity reactions to sulfonamide-derived drugs
Adverse effects
- Hypokalemia
- Hyponatremia
- Hypercalcemia
- Hyperuricemia
- Metabolic alkalosis
- Dizziness
- Headache
- Nausea
- Vomiting
- Rash
- Pancreatitis
- Impotence
- Photosensitivity
Interactions
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the diuretic effect
- Corticosteroids may enhance potassium loss
- Lithium levels may increase resulting in toxicity
- Digoxin toxicity may occur due to hypokalemia
- Antidiabetic agents may have reduced effectiveness
Precautions
- Monitor electrolyte levels regularly, particularly potassium and sodium
- Caution in patients with a history of gout
- Assess renal function prior to initiation and during therapy
- Use with caution in patients with diabetes due to potential hyperglycemia
- Consider risk of dehydration and hypotension in elderly patients
Pregnancy
Hydrochlorothiazide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is generally advisable to avoid thiazides during pregnancy.
Breast-feeding
Hydrochlorothiazide is excreted in breast milk. Caution should be exercised when administered to nursing mothers.
Storage
Store at room temperature, away from light and moisture. Keep out of reach of children.
Formulations
- Tablets
- Oral suspension
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: telmisratan
Telmisartan is an angiotensin II receptor blocker (ARB) used primarily for the treatment of hypertension. It works by inhibiting the action of angiotensin II, a hormone that causes blood vessels to constrict, thereby leading to increased blood pressure. By blocking this action, telmisartan promotes vasodilation and reduces blood pressure. It is also indicated for the reduction of cardiovascular morbidity in patients with cardiovascular risk factors.
Indications
- Hypertension
- Heart failure
- Reduction of cardiovascular morbidity in high-risk patients
- Diabetic nephropathy
Dosage
Children: Refer to the relevant guidelines or BNF for Children for specific dosing information.
Adults: Refer to the relevant guidelines or BNF for specific dosing information.
Mechanism of action
Telmisartan selectively blocks the binding of angiotensin II to the AT1 receptor, leading to vasodilation and a decrease in blood pressure. This action prevents the typical effects of angiotensin II such as aldosterone secretion, vasoconstriction, and sodium reabsorption in the kidneys.
Pharmacodynamics
Telmisartan exhibits antihypertensive properties by reducing systemic vascular resistance. Its blood pressure-lowering effect is dose-dependent and persists for 24 hours. Telmisartan also has a favorable effect on lipid metabolism and may improve insulin sensitivity, making it beneficial in patients with metabolic syndrome.
Pharmacokinetics
Telmisartan is well absorbed orally, with a bioavailability of approximately 50%. It has a high protein binding rate of about 99.5%, primarily to albumin. The drug undergoes minimal hepatic metabolism, with only a small fraction converted to an active metabolite. The elimination half-life of telmisartan is approximately 24 hours, allowing for once-daily dosing. It is primarily excreted unchanged in the feces, with a smaller amount eliminated via urine.
Contra-indications
- Hypersensitivity to telmisartan or any component of the formulation
- Severe renal impairment
- Pregnancy
- Biliary obstructive disorders
Adverse effects
- Dizziness
- Fatigue
- Hypotension
- Hyperkalemia
- Renal impairment
- Angioedema
Interactions
- Concurrent use with potassium-sparing diuretics may increase the risk of hyperkalemia
- NSAIDs may reduce the antihypertensive effect of telmisartan
- CYP2C19 inhibitors may increase the plasma concentration of telmisartan
Precautions
- Monitor renal function and electrolytes, especially in patients with renal artery stenosis
- Use with caution in patients with a history of angioedema
- Consider alternative therapy in patients with significant hepatic impairment
Pregnancy
Telmisartan is contraindicated in pregnancy due to potential harm to the fetus and adverse effects on fetal development.
Breast-feeding
It is not known whether telmisartan is excreted in human milk. Caution should be exercised when administering to nursing women.
Storage
Store in a cool, dry place away from light. Keep out of reach of children.
Formulations
- Tablets: 20 mg, 40 mg, 80 mg
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.