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Generic Name:

hydrochlorothiazide-telmisartan, Oral tablet

All Brands

  • Micardis HCT
SECTION 1 of 4

Highlights for hydrochlorothiazide-telmisartan

Oral tablet
1

Telmisartan/hydrochlorothiazide is a combination of two drugs in a single form. These drugs work in different ways to lower your high blood pressure. Lowering your blood pressure will reduce your risk of stroke or heart attack.

2

This drug shouldn’t be the first medication you take for high blood pressure. If your blood pressure isn’t controlled with telmisartan or hydrochlorothiazide alone, you can try this combination tablet.

3

You shouldn’t take this medication if you’re pregnant or plan to become pregnant. Telmisartan/hydrochlorothiazide can cause serious harm to your fetus.

4

Telmisartan/hydrochlorothiazide is available as a brand-name drug called Micardis HCT. It’s also available as a generic drug.

5

Common side effects can include tiredness, dizziness, diarrhea, or nausea. They can also include stuffy nose, flu-like symptoms, or upper respiratory infections, such as the common cold.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to effects that may be dangerous.

Use during pregnancy warning. Telmisartan, a component of this medication, acts directly on your renin-angiotensin system. This helps control your body’s blood pressure. If this drug is taken during pregnancy, it can harm and be fatal to your developing fetus. Don’t take this drug if you’re pregnant or plan to become pregnant. If you get pregnant, call your doctor and stop taking this medication right away.

Low blood pressure (hypotension)

This drug can cause low blood pressure, especially during the first few days of taking it. Tell your doctor if you feel lightheaded, dizzy, or like you’re going to faint. You may be more likely to have low blood pressure if you:

  • aren’t drinking enough fluids
  • are sweating heavily
  • have diarrhea or are vomiting

Kidney problems

Some people with certain conditions, such as congestive heart failure or renal artery stenosis, may develop kidney problems. If this happens, you may need to stop taking this drug. Call your doctor if you have the following symptoms:

  • changes in the amount that you urinate
  • swelling in your feet or ankles
  • confusion

Eye problems

This drug can cause vision problems, such as changes in vision or eye pain. These symptoms can occur within hours to weeks after starting this medication. Call your doctor or get emergency medical help right away if you have any eye problems.

What is telmisartan/hydrochlorothiazide?

This drug is a prescription drug. It’s available as a tablet you take by mouth.

This drug is available as a brand-name drug called Micardis HCT. It’s also available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug is a combination of two drugs in a single form. It’s important to know about both drugs in the combination because each drug may affect you in a different way.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications to treat high blood pressure.

Why it's used

This drug is used to treat high blood pressure. Lowering your blood pressure will help reduce your risk of stroke or heart attack.

How it works

Telmisartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs). Hydrochlorothiazide belongs to a class of drugs called thiazide diuretics.

More Details

How it works

Telmisartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs). Hydrochlorothiazide belongs to a class of drugs called thiazide diuretics. A class of drugs is a group of medications that work in a similar way. They are often used to treat similar conditions.

Telmisartan blocks the action of angiotensin II, a chemical in your body that causes blood vessels to tighten and narrow. Telmisartan helps your blood vessels to relax and widen. This lowers your blood pressure.

Hydrochlorothiazide works in your kidneys to remove sodium (salt) and water from your body. This also helps reduce your blood pressure. 

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SECTION 2 of 4

hydrochlorothiazide-telmisartan Side Effects

Oral tablet

Most Common Side Effects

The more common side effects that can occur with telmisartan/hydrochlorothiazide include:

  • tiredness

  • dizziness

  • diarrhea

  • nausea

  • stuffy nose

  • flu-like symptoms, such as fever and body aches

  • upper respiratory infections, such as the common cold

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Allergic reactions. You shouldn’t use this drug if you’re allergic to sulfonamide (sulfa) drugs. Symptoms can include:

    • swelling of your skin, the layers under your skin, and your mucous membranes (inside your mouth) 
    • itching and hives
    • reddening and warming of your face (flushing) 
    • a feeling of warmth throughout the body
    • swelling of your throat or tongue
    • wheezing or trouble breathing
    • a fast, irregular heartbeat
    • nausea, vomiting, or diarrhea
    • dizziness or fainting
  • Skin reactions. Symptoms can include:

    • painful rash
    • blistering or peeling skin
  • Low blood pressure (hypotension). This is more likely to occur if you’re dehydrated, or if you stand up after sitting or lying down. Symptoms can include:

    • lightheadedness
    • dizziness
  • Heart problems. Symptoms can include:

    • chest pain
    • irregular or pounding heart rate
  • Fluid and electrolyte imbalance: Telmisartan/hydrochlorothiazide may cause an imbalance in the amount of electrolytes in your body. You need the right balance of electrolytes for your body to work properly. Symptoms can include:

    • dry mouth
    • feeling thirsty
    • weakness
    • tiredness
    • drowsiness
    • restlessness
    • confusion
    • seizures
    • muscle pains or cramps
    • low blood pressure (hypotension), which may make you feel dizzy or lightheaded
    • producing less urine than normal (oliguria)
    • a fast heart rate (tachycardia)
    • nausea and vomiting 
  • Kidney problems. Symptoms can include:

    • changes in the amount you urinate
    • swelling in your feet or ankles
    • confusion
  • Liver problems. Symptoms can include:

    • yellowing of your skin and whites of your eyes
    • nausea
    • loss of appetite
    • dark-colored urine
    • tiredness
  • Muscle pain or muscle breakdown (rhabdomyolysis). Symptoms can include:

    • muscle aches throughout your body
    • dark-colored urine
  • Blood disorders. This drug may decrease your body’s red blood cells, white blood cells, and platelets.

    • low red blood cells. Symptoms can include:
      • extreme tiredness
      • lightheadedness
      • shortness of breath
      • pale-colored skin
    • low white blood cells. This can cause symptoms of infection such as:
      • fever
      • cold symptoms that don’t go away, such as a running nose or sore throat
      • flu symptoms, such as body aches and tiredness
    • low platelets. Symptoms can include: 
      • cuts or wounds that don’t stop bleeding
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may make you drowsy, dizzy, and tired. You shouldn’t drive, use machinery, or do other tasks that require alertness until you know how this drug affects you.

This drug may also cause lightheadedness, especially during the first few days when you start taking it. If this happens, let your doctor know. If you faint while taking this medication, stop taking it and tell your doctor right away.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

hydrochlorothiazide-telmisartan May Interact with Other Medications

Oral tablet

Telmisartan/hydrochlorothiazide can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Telmisartan/hydrochlorothiazide may cause a sudden drop in blood pressure. You may feel dizzy, lightheaded, or faint, especially when you stand up after sitting or lying down. Drinking alcohol while taking this medication can worsen these effects.

Medications that might interact with this drug

Blood thinners

The levels in your body of drugs used to thin the blood, such as warfarin, may slightly decrease when taken with telmisartan/hydrochlorothiazide. Your doctor will do a blood test called an INR to make sure you’re receiving the right dose of your blood thinner.

Cholesterol drugs

Certain drugs used to treat cholesterol problems may reduce the amount of telmisartan/hydrochlorothiazide that’s absorbed from your stomach. This means that telmisartan/hydrochlorothiazide may not work as well to lower your blood pressure levels. This effect may be more likely to occur if you take these drugs within four hours of each other. These cholesterol drugs include:

  • cholestyramine
  • colestipol

Diabetes drugs

Telmisartan/hydrochlorothiazide may raise your blood sugar level. If you have diabetes, you may need to test your blood sugar more often. Also, your doctor may adjust the medications you take to control your diabetes. These drugs include:

  • glimepiride
  • glipizide
  • glyburide
  • nateglinide
  • repaglinide
  • insulin

Heart drugs

Digoxin is used to treat heart problems such as irregular heart rhythm. When it’s used with telmisartan/hydrochlorothiazide, you may have a higher level of digoxin in your body. Your doctor will monitor you closely when you’re starting or stopping treatment with telmisartan/hydrochlorothiazide, or when your dose is adjusted.

Pain drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat pain and inflammation. When taken with telmisartan/hydrochlorothiazide, these drugs can cause kidney problems, including kidney failure. They can also reduce the effects of telmisartan/hydrochlorothiazide. This means that it may not work as well to lower your blood pressure. NSAIDs include:

  • celecoxib
  • diclofenac
  • etodolac
  • fenoprofen
  • flurbiprofen
  • ibuprofen
  • indomethacin
  • ketoprofen
  • ketorolac
  • meclofenamate
  • mefenamic acid
  • meloxicam
  • nabumetone
  • naproxen
  • oxaprozin
  • piroxicam
  • sulindac
  • tolmetin

Narcotics are used to treat severe pain. When used with telmisartan/hydrochlorothiazide, these drugs can cause a sudden drop in blood pressure. This is more likely to occur when you stand up after sitting or lying down. This low blood pressure can cause dizziness and result in a fall or serious injury. Narcotics include:

  • codeine
  • hydrocodone
  • morphine
  • oxycodone

Mental health drugs

Lithium is used to treat bipolar disorder. When it’s taken with telmisartan/hydrochlorothiazide, you may have a higher level of lithium in your body. This raises your risk of side effects from lithium.

Muscle relaxants

Tubocurarine can be used to relax the muscles during surgery. You may be more sensitive to the effects of tubocurarine when you take it with telmisartan/hydrochlorothiazide.

Other drugs

Barbiturates can be used to treat seizures, anxiety, or other conditions. When used with telmisartan/hydrochlorothiazide, these drugs can cause a sudden drop in your blood pressure. This is more likely to occur when you stand up after sitting or lying down. This low blood pressure can cause dizziness and result in a fall or serious injury. Barbiturates include:

  • amobarbital
  • butabarbital
  • pentobarbital
  • phenobarbital
  • secobarbital

Corticosteroids can be used to treat many conditions, including arthritis, allergies, or lupus. When used with telmisartan/hydrochlorothiazide, these drugs can decrease the levels of potassium in your body (hypokalemia). Corticosteroids include:

  • betamethasone
  • budesonide
  • dexamethasone
  • hydrocortisone
  • methylprednisolone
  • prednisolone
  • prednisone 

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
sulfa allergy
People with a sulfa allergy

Hydrochlorothiazide, a component of this medication, is similar to a class of medications called sulfonamides (sulfa drugs). If you’re allergic to sulfa medications, you may be allergic to hydrochlorothiazide. If you have a sulfa allergy, don’t take this drug.

breathing problems
People with breathing problems

If you have breathing problems such as asthma, you’re more likely to have an allergic reaction when taking this drug. Tell your doctor about your breathing problems before you start this medication.

lupus
People with lupus

This drug may worsen or activate lupus.

eye or vision problems
People with eye or vision problems

This drug can cause sudden vision problems, such as trouble seeing objects that are far away, and increased pressure inside your eyes. This may cause changes in your vision and eye pain. Tell your doctor about any eye problems you have before starting this medication.

kidney problems
People with kidney problems

Before taking this medication, be sure your doctor knows you have kidney problems. Your doctor will monitor you closely because this drug can make your condition worse. If you have severe kidney disease, you shouldn’t take this drug. Your doctor will likely give you a different medication.

urination problems
People with urination problems

If you don’t make any urine (anuria), you shouldn’t take this drug. This drug doesn’t work well in people with this condition.

liver problems
People with liver problems

You shouldn’t use this drug if you have severe liver disease. This drug may cause a fluid and electrolyte imbalance in your body. This can lead to other severe liver problems that need immediate medical care. Let your doctor know if you have any liver problems.

diabetes
People with diabetes

This drug may raise your blood sugar (hyperglycemia). You may need to test your blood sugar more often. Your doctor may adjust the medications you take to control your diabetes.

gout
People with gout

This drug may increase uric acid levels and cause a gout attack. Tell your doctor if you have a history of gout. They will monitor your uric acid levels.

anemia
People with anemia

Talk to your doctor if you are anemic or have problems with anemia. This drug may decrease hemoglobin (a red blood cell protein that carries and transports oxygen to the rest of your body) and worsen anemia.

blood disorders
People with blood disorders

If you have a history of low neutrophils, leukocytes, or platelet counts, tell your doctor. This drug may decrease these levels even further. This puts you at risk of infections or bleeding.

Pregnant women
Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breast-feeding
Women who are breast-feeding

This drug may pass into breast milk and cause serious effects in a child who is breast-fed.

You and your doctor may need to decide if you’ll take this drug or breast-feed.

seniors
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

children
For children

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

allergies
Allergies

This drug may cause a serious allergic reaction. Symptoms can include:

  • swelling of the skin, the layers under the skin, and your mucous membranes (inside your mouth)
  • itching and hives
  • reddening and warmth to your skin (flushing) 
  • a feeling of warmth throughout the body
  • swelling of your throat or tongue
  • wheezing or trouble breathing
  • a fast, irregular heartbeat
  • nausea, vomiting, or diarrhea
  • dizziness or fainting

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it, its individual components, or other sulfa medications before. Taking it a second time after an allergic reaction could be fatal (cause death).

SECTION 4 of 4

How to Take hydrochlorothiazide-telmisartan (Dosage)

Oral tablet

What are you taking this medication for?

High blood pressure (hypertension)

Brand: Micardis HCT

Form: Oral tablet
Strengths:
  • 40 mg telmisartan/12.5 mg hydrochlorothiazide
  • 80 mg telmisartan/12.5 mg hydrochlorothiazide
  • 80 mg telmisartan/25 mg hydrochlorothiazide

Generic: telmisartan/hydrochlorothiazide

Form: Oral tablet
Strengths:
  • 40 mg telmisartan/12.5 mg hydrochlorothiazide
  • 80 mg telmisartan/12.5 mg hydrochlorothiazide
  • 80 mg telmisartan/25 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)
  • Typical starting dose: 80 mg telmisartan/12.5 mg hydrochlorothiazide or 80 mg telmisartan/25 mg hydrochlorothiazide, taken by mouth once per day
  • Dose increases: If your blood pressure is still high after 2–4 weeks, your doctor may increase your daily dose up to a maximum of 160 mg telmisartan/25 mg hydrochlorothiazide. Your doctor may further adjust your dose based on your response to the drug, side effects, and the fluid electrolyte levels in your blood.
Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Special considerations

Liver problems: Your doctor may give you a lower dose of 40 mg telmisartan/12.5 mg hydrochlorothiazide and monitor you carefully. If your liver problems are severe, you shouldn’t take this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don't take it at all

Your blood pressure won’t be controlled. This will raise your risk of a heart attack or stroke.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • low blood pressure, which may cause dizziness, lightheadedness, fainting, or a fast heart rate
  • urinating more often than normal. This can make you dehydrated.
  • dry mouth
  • muscle cramps
  • dizziness
  • an irregular heart rate

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. 

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could cause dangerous side effects.

How to tell if the drug is working

Your blood pressure should go down. You won’t be able to feel if this medication is working. You can check your blood pressure at home using a blood pressure monitor. Your doctor will also check your blood pressure regularly.

This drug is a long-term treatment.

Important considerations for taking this drug
timing
Take this tablet once per day
do not cut or crush
Don’t cut or crush the tablet
Store this drug carefully
See Details
refillable
Prescription is refillable
Travel
Travel
See Details
Self-management
Self-management
See Details
Clinical monitoring
Clinical monitoring
See Details
Sun sensitivity
Sun sensitivity
See Details
not usually stocked
Not every pharmacy stocks this drug. When refilling your prescription, be sure to call ahead
Hidden costs
Hidden costs
See Details
prior authorization
Insurance
See Details

Store this drug carefully

  • Keep this drug at room temperature, between 59°F (15°C) and 86°F (30°C).
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Do not put this medication in your glove compartment or leave it in the car, especially when the temperature is hot or freezing.

Self-management

You may need to check your blood pressure at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this log with you to your doctor appointments.

You may also need to buy a blood pressure monitor. You can use this device to check your blood pressure at home. Blood pressure monitors are available at most pharmacies.

Clinical monitoring

Your doctor will monitor you. During treatment with this drug, your doctor may check your:

  • blood pressure
  • kidney function
  • electrolyte levels, such as your blood potassium levels

Sun sensitivity

This drug can make you more sensitive to the sun’s effects. You should:

  • Avoid being in direct sunlight for long periods of time.
  • Wear protective clothing that covers most areas of the body when you’re in the sun.
  • Use sunscreen whenever you’re outdoors.

Hidden costs

You may need to buy a home blood pressure monitor. This will help you track your blood pressure.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other options that may work for you.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 11, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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