Indications for: MICARDIS HCT

Hypertension (not as initial therapy).

Adult Dosage:

Not for initial therapy. May be substituted for titrated components. BP not controlled on telmisartan 80mg/day: 80mg/12.5mg once daily. BP not controlled on HCTZ 25mg/day or BP controlled but hypokalemic: 80mg/12.5mg once daily. Both: may titrate up to 160mg/25mg after 2–4 weeks. Hepatic insufficiency or biliary obstruction: initially 40mg/12.5mg once daily; monitor closely. Severe renal (CrCl ≤30mL/min) or hepatic impairment: not recommended.

Children Dosage:

Not established.

MICARDIS HCT Contraindications:

Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.

Boxed Warning:

Fetal toxicity.

MICARDIS HCT Warnings/Precautions:

Fetal toxicity may develop; discontinue if pregnancy is detected. Salt/volume depletion; correct hypovolemia prior to initiation. Severe CHF. Renal or hepatic impairment. Renal artery stenosis. Asthma. Diabetes. Postsympathectomy. SLE. Gout. Acute myopia. Secondary angle-closure glaucoma. Monitor BP, electrolytes, and renal function. Elderly. Neonates. Pregnancy: avoid. Nursing mothers: not recommended.

MICARDIS HCT Classification:

Angiotensin II receptor blocker (ARB) + thiazide diuretic.

MICARDIS HCT Interactions:

See Contraindications. Concomitant ACE inhibitors (eg, ramipril): not recommended. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Digoxin, lithium toxicity. Adjust antidiabetic medications. Hyperkalemia with K+ supplements, K+ sparing diuretics, K+ containing salt substitutes. Hypokalemia with corticosteroids, ACTH. Orthostatic hypotension potentiated by alcohol, CNS depressants. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume-depleted). Potentiates other antihypertensives. May potentiate nondepolarizing muscle relaxants. May antagonize pressor amines. Reduced absorption with bile acid resins (eg, cholestyramine, colestipol). May interfere with parathyroid test.

Adverse Reactions:

Upper respiratory tract infection, dizziness, sinusitis, diarrhea, fatigue, flu-like symptoms, back or abdominal pain, dyspepsia, erythema, vomiting, bronchitis, pharyngitis; electrolyte disturbances, orthostatic hypotension, hyperglycemia, hyperuricemia, adverse lipid values, angioedema, rhabdomyolysis (rare); HCTZ: increased risk for non-melanoma skin cancer.

How Supplied:

Tabs—3x10 (blister cards)