Indications for MICARDIS HCT:
Hypertension (not as initial therapy).
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.
MICARDIS HCT Contraindications:
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
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.
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.
Tabs—3x10 (blister cards)