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Telmilok Plus 12.5/40 contains two medicines, both of which help to control high blood pressure. It is generally used when one medicine alone is not controlling the blood pressure effectively. Lowering blood pressure helps to reduce your risk of having a heart attack or a stroke in the future. You can take Telmilok Plus 12.5/40 with or without food. The dose will depend on your condition and how you respond to the medicine. Try to take it at the same time each day. It's important to keep taking this medicine until your doctor tells you not to. It contains a diuretic (water pill) and will make you urinate more, so it is best to avoid taking this medicine within four hours of going to bed. Use this medicine regularly even if you feel better to get the most from it. High blood pressure does not usually have symptoms and if you stop taking it your risk of heart attack or stroke may increase. The most common side effect is dizziness. Other side effects include feeling tired, nausea, diarrhea, flu-like symptoms, shortness of breath and changes to your heartbeat. Frequent urination is not a side effect of this medicine. It is the purpose of this medicine as frequent urination helps control your blood pressure. You may experience other possible side effects, but most are rare. Make sure you read the leaflet that comes with your medicines and tell your doctor if you are bothered by side effects or they do not go away. It may be possible to adjust your dose or try a different medicine. Do not use potassium supplements or salt substitutes unless your doctor has told you to. This medicine is not recommended during pregnancy or while breastfeeding. You should ask your doctor before taking it if you have kidney or liver disease, heart trouble or diabetes. Drinking alcohol can further lower your blood pressure and may cause side effects.
Uses of Telmilok Plus 12.5/40
Side effects of Telmilok Plus 12.5/40
Common
How to use Telmilok Plus 12.5/40
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Telmilok Plus 12.5/40 may be taken with or without food, but it is better to take it at a fixed time.
How Telmilok Plus 12.5/40 works
Telmilok Plus 12.5/40 is a combination of two medicines: Telmisartan and hydrochlorothiazide which lowers the blood pressure effectively. Telmisartan is an angiotensin receptor blocker (ARB). It works by blocking the hormone angiotensin, thereby relaxing the blood vessels. This allows the blood to flow more smoothly and the heart to pump more efficiently. Hydrochlorothiazide is a diuretic that removes extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow.
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Brief Description
Indication
Hypertension, Diabetic nephropathy
Administration
May be taken with or without food.
Adult Dose
Oral Hypertension Adult 1 tab (40-80 mg telmisartan/12.5-25 mg) once daily. Max: Telmisartan 160 mg & hydrochlorothiazide 25 mg daily. Hepatic Impairment Initiate therapy with low dose; titrate slowly; monitor
Renal Dose
Renal impairment Dose adjustment not necessary Hemodialysis patients are more susceptible to hypotension
Contraindication
Severe hepatic impairment, biliary obstructive disorders. Pregnancy. Lactation.
Mode of Action
Hydrochlorothiazide inhibits the reabsorption of Na and chloride in the distal tubules causing increased excretion of Na and water K and hydrogen ions. Telmisartan is a nonpeptide AT1 angiotensin II receptor antagonist. It exerts antihypertensive activity by preventing angiotensin II from binding to AT1 receptors thus inhibiting the vasoconstricting and aldosterone-secreting effects of angiotensin II.
Precaution
Hepatic insufficiency, biliary obstruction, renal impairment, renaly artery stenosis. Correct volume depletion before initiating treatment. Monitor serum potassium levels regularly, especially in elderly and renally-impaired patients. Lactation: discontinue drug or do not nurse
Side Effect
1-10% Telmisartan Upper respiratory infection (7%),Urinary tract infection (1%),Back pain (3%),Diarrhea (3%),Myalgia (3%),Fatigue (1%),Sinusitis (3%),Peripheral edema (1%),Chest pain (1%),Hypertension (1%),Dyspepsia (1%),Headache (1%),Dizziness (1%),Pharyngitis (1%) Frequency Not Defined Hydrochlorothiazide Anorexia,Epigastric distress,Hypotension,Orthostatic hypotension,Photosensitivity,Anaphylaxis,Anemia,Confusion,Erythema multiforme,Stevens-Johnson syndrome,Exfoliative dermatitis including toxic epidermal necrolysis,Dizziness,Hypokalemia and/or hypomagnesemia,Hyperuricemia Potentially Fatal: Rarely angioedema, rash, pruritus and urticaria.
Pregnancy Category Note
Pregnancy Category: C (1st trimester); D (2nd & 3rd trimesters)
Interaction
Lithium, kaliuretic diuretics, laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G, salicylates, K-sparing diuretics, K supplements, K salt substitutes drugs that cause hyperkalaemia, digitalis glycosides, antiarrhythmic agents, drugs known to induce torsades de pointes, alcohol, barbiturates, narcotics, oral antidiabetics, insulin, anion-exchange resins, NSAIDs, nondepolarising skeletal muscle relaxants, pressor amines, allopurinol, Ca salts, beta-blockers, diazoxide, anticholinergics, amantadine, cytotoxics.
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