Product Description

Telmisartan 40 mg & Chlorthalidone 12.5 mg Tablets IP is a fixed-dose combination oral antihypertensive medication for adults with essential hypertension. 

Telmisartan, an angiotensin II receptor blocker (ARB), selectively antagonizes AT1 receptors to promote vasodilation and reduce vascular resistance.

Chlorthalidone, a thiazide-like diuretic, inhibits sodium reabsorption in the distal convoluted tubule, promoting natriuresis and diuresis to decrease plasma volume.

This dual therapy provides synergistic blood pressure (BP) reduction (typically 20–30/10–15 mmHg greater than monotherapy), ideal for patients not controlled on single agents. Hypertension is a chronic condition increasing risks of stroke, myocardial infarction, heart failure, and renal damage; this combination helps mitigate these by achieving target BP (<130/80 mmHg in most adults).

Uses

• Primary treatment of essential hypertension in adults, particularly when monotherapy is inadequate

• Adjunctive management in high-risk hypertensive patients (e.g., with diabetes, chronic kidney disease, or CV events) to reduce cardiovascular morbidity

• Not indicated for primary prevention of heart attack/stroke in normotensives, secondary hypertension, or volume overload without hypertension

How it works

This combination targets complementary pathways for enhanced BP control:

• Telmisartan (40 mg): Blocks angiotensin II from binding to AT1 receptors on vascular smooth muscle and adrenal glands, preventing vasoconstriction, aldosterone release, and sodium retention. This results in arterial/venous dilation, reduced afterload, and long-acting BP lowering (half-life ~24 hours).

• Chlorthalidone (12.5 mg): A long-acting diuretic that inhibits the Na-Cl cotransporter in the distal convoluted tubule of the kidneys, increasing excretion of sodium, chloride, and water. This reduces extracellular fluid volume and cardiac output initially, with sustained effects via vascular smooth muscle relaxation (half-life ~40–60 hours).

Synergy: ARB counters diuretic-induced renin-angiotensin activation, minimizing compensatory tachycardia/hypotension. Full effects on BP occur within 2–4 weeks.

Benefits

• Provides superior BP reduction compared to individual components, helping achieve guideline targets and improving patient adherence with once-daily dosing.

• Lowers risk of major CV events (e.g., stroke by 30–40%, heart attack by 20–25% in trials like ONTARGET and SHEP) through sustained control.

• Renoprotective effects (telmisartan reduces proteinuria; chlorthalidone aids in diabetic nephropathy).

• Minimal metabolic impact on glucose/lipids compared to other combinations; weight-neutral or slight loss from diuresis.

• Convenient for moderate hypertension, reducing pill burden and supporting long-term CV risk reduction.

How to use

Taking the tablet around the same time each day can help maintain consistent levels in the body. The tablet can be taken with or without food. It should be swallowed whole with water and not crushed, broken, or chewed. If a dose is missed, take it when remembered. Information regarding the use of Telmisartan and Chlorthalidone combination tablets should always be discussed with a healthcare provider, who can provide instructions tailored to individual needs. This medication is typically prescribed for managing blood pressure.

Side Effects

Common side effects (usually mild and transient):

• Dizziness/lightheadedness (orthostatic, especially early—~5–10%)

• Fatigue, weakness, or headache

• Gastrointestinal: nausea, diarrhea, abdominal pain

• Frequent urination (initially from a diuretic)

• Back pain or upper respiratory symptoms

Less common/rare but serious side effects (seek immediate medical attention):

• Electrolyte imbalances: Hypokalemia (low potassium—muscle cramps, arrhythmias), hyponatremia (low sodium—confusion, seizures), hyperuricemia (gout flares)

• Dehydration/hypotension: Dry mouth, thirst, fainting (risk in hot weather/exercise)

• Renal: Acute kidney injury (in dehydrated/renal-impaired patients)

• Allergic: Rash, angioedema (swelling of face/lips/tongue)

• Other: Hyperglycemia (mild, in diabetics), impotence (rare)

Report persistent symptoms; lab monitoring (electrolytes, renal function) is essential.

Safety Advice

• Contraindicated in: Hypersensitivity, severe renal impairment (eGFR <30 mL/min), anuria, severe hepatic disease, pregnancy (Category D—fetal toxicity, especially 2nd/3rd trimesters; use contraception), or breastfeeding (passes into milk).

• Use caution in: Mild-moderate renal/hepatic impairment (monitor eGFR/creatinine), elderly (start low), diabetes (may affect glucose), or gout history (hyperuricemia risk). Not for children.

• Rise slowly from sitting/lying to prevent orthostatic hypotension; avoid driving/operating machinery if dizzy. Drink adequate fluids (2–3 L/day) to counter dehydration, but monitor in heart failure.

• Electrolytes: Chlorthalidone causes potassium loss—monitor serum K+ (aim 3.5–5.0 mEq/L); eat potassium-rich foods (e.g., bananas) or supplement if low (per doctor). Avoid NSAIDs (e.g., ibuprofen—reduce efficacy, worsen kidneys) or other antihypertensives without advice.

• Lifestyle: Low-sodium diet (<2 g/day), limit alcohol (enhances hypotension), quit smoking, manage stress/exercise. Inform the doctor of all medications (e.g., lithium toxicity risk, digoxin potentiation).

• Pregnancy/breastfeeding: Discontinue immediately if pregnant; alternatives like labetalol preferred.

Storage Conditions

Store at a temperature below 86°F (30 °C). Protect from light and moisture.

FAQs

What are Telmisartan and Chlorthalidone used for?

This medication treats high blood pressure (hypertension) in adults. It is often prescribed when a single medication is not enough to control blood pressure.

How does it work?

Telmisartan relaxes blood vessels, and Chlorthalidone helps remove excess fluid and salt. Together, they lower blood pressure and reduce the risk of cardiovascular events.

Does this medication cure high blood pressure?

No, this medication helps control high blood pressure. High blood pressure is often a chronic condition, and consistent medication is necessary to prevent long-term complications.

How long does it take to work?

The medication can start working within a few hours. However, it may take a few weeks to achieve full blood pressure control.

What if a dose is missed?

If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose. Do not take a double dose, as this could cause dangerously low blood pressure.

Can this medication be stopped if blood pressure is controlled?

No, do not stop taking the medication without your doctor's advice. Blood pressure could rise again, increasing the risk of a heart attack or stroke.

Is it safe to take for a long time?

Yes, this medication is generally safe for long-term use under medical supervision.

What are the common side effects?

Common side effects include dizziness, weakness, fatigue, frequent urination, back pain, and gastrointestinal issues.

Can this medication cause dizziness?

Yes, especially when rising from a sitting or lying position. Rise slowly to avoid lightheadedness.

Can alcohol be consumed with this medication?

It is best to avoid alcohol, as it can increase the risk of dizziness and other side effects. 

What about food and drink interactions?

Avoid consuming high-potassium foods or supplements unless directed by your doctor.

Is it safe for pregnant or breastfeeding women?

No, this medication is unsafe for pregnant women, especially during the second and third trimesters. It is also not recommended for breastfeeding women.

Can it be used by people with kidney or liver issues?

Use with caution in people with kidney or liver problems, and it is contraindicated in severe cases. Always consult your doctor before taking it if you have these conditions.
 
What happens if this medication is stopped suddenly?
Stopping abruptly can cause a sudden and dangerous rise in blood pressure.

What lifestyle changes can help?

A low-salt, low-fat diet, regular exercise, managing weight and stress, and quitting smoking can support the medication.

How does it affect fertility or sex life?

Some blood pressure medications can cause erectile dysfunction, but evidence for this combination is not definitive. Discuss any concerns with your doctor.