Telzid 40/12.5 medisun treatment for hypertension (6 blisters x 10 tablets)

Contraindicated drug combination with Aliskiren in diabetes patients and renal function impairment.

Be cautious when using

because taking the drug may experience unwanted effects such as fainting, dizziness, abnormalities, then sleep disorders, insomnia, abnormal vision, fuzzy vision, muscle weakness, leg cramps ... should be cautious for this object.

Hepatic failure

Do not use medication for patients with bile stasis, bile congestion or severe liver failure, patients with liver or liver disease are progressing, because only minor changes in water and electrolytes can lead to liver coma.

Hypertension caused by kidney artery

Has the ability to increase the risk of severe hypotension and renal failure when the patient has narrowed kidney stenosis on both sides or the kidney stenosis to the only kidney is still functioning to be treated with drugs that affect the renin-angiotensin-irtosteron system.

kidney failure and kidney transplant

Intravascular volume loss: Hypotension symptoms, especially after the first dose, can occur in patients with volume loss or sodium loss due to diuretic therapy too strong, abstain from salt too strict, diarrhea or vomiting. Such conditions should be overcome before giving medicine

Renin-Anotesin-Aldosteron dual clutches

As a consequence of the inhibition of the Renin-Anotesin-Aldosteron system, there has been a report on changing renal function (including acute renal failure) in sensitive patients, especially if used in combination with drugs that affect this system. Therefore, the Renin-Anotensin-Aldosteron double closing should be limited (for example, combining an additional enzyme inhibitor with an angiotensin II receptor inhibitors) in some cases specifically defined along with closely monitoring kidney function.

Other conditions have the stimulation of the renin-ankiotensin-aldosteron

On patients with vascular tone and renal function depend largely on the activity of the renin-angiotensin-aldosterone system (for example, patients with severe congestive heart failure or basic kidney disease, including kidney artery stenosis), the treatment with other drugs affects the renin-anidensin-krosteron system related to acute blood pressure, increased urban urinary, rarely causes acute impairment.

Increased primary aldosteron: It is not recommended to use Telzid 40/12.5.

Aortic valve stenosis and mitral valve, hypertrophic heart muscle disease

Metabolic and endocrine effects: Thiazid therapy can reduce nap glucose. In patients with diabetes may need to adjust insulin dose or oral hypoglycemic drugs. Potential diabetes can become an entity during thiazid treatment.

Increase the concentration of cholesterol and triglyerids related to thiazid diuretic therapy, but very few or almost no such effects are reported at a dose of 12.5mg contained in Telzid 40/12.5.

Hypergathomemia can occur or gout may appear in a few patients who are taking thiazid therapy.

Electrolyte balance

For any patient who uses thiazid therapy, the periodic test of electrolytes in serum must be performed according to the appropriate time. Thiazid drugs, including hydrochlorothiazid, can cause water and electrolyte imbalance (hypotension, sodium hypoglycemia and alkaline infection due to hypoglycemia). The warning signs of electrolyte imbalance are dry mouth, thirst, weakness, sleep, drowsiness, restlessness, muscle pain or cramping, muscle weakness, reducing blood pressure, urinary decrease, tachycardia and gastrointestinal disorders such as nausea or vomiting.

Although hypokalemia may appear when using thiazid diuretics, simultaneous treatment with Telmisartan can reduce the ability to lower potassium potassium due to diuretics. The risk of hypokalemia will be the highest in cirrhosis patients, on patients who are taking fast diuretics, on patients who are not compensating for enough electrolytes through oral and on patients treated simultaneously with Corficostoid or ACTH.

In contrast, due to the antagonism mechanism of the Angiotensin II receptors (ATI) by Telmisartan component of Tel/ZID 40/12.5, the condition of hyperkalemia may occur. Although clinical hyperkalemia has not been recorded with Telzid 40/12.5, risk factors leading to hyperkalemia include kidney failure or heart failure and diabetes. Potassium diuretics, potassium supplements or potassium salts should be carefully used with Telzid 40/12.5.

Thiazids can reduce the excretion of calcium in the urinary tract and cause slight increase, temporary serum calcium in the condition that no other calcium metabolic disorders. Significant hypercalcemia may be evidence of hidden parathyroid gland. Thiazids should be stopped before conducting adjacent function tests.

Thiazids have shown to increase the elimination of magnesium through the urinary tract, which can lead to lowering blood mages.

The ability to drive and operate machinery

because taking the medicine may experience unwanted effects such as fainting, dizziness, abnormalities, sleep disorders, insomnia, abnormal vision, fuzzy vision, weakness, leg cramps ... should be cautious for this object.

Pregnancy

cannot be used.

Breastfeeding period

cannot be used

Drug interaction

Telmisartan

Increased lithium and toxic lithium levels of lithium recovery have been reported during simultaneous use of lithium with enzyme inhibitors Angiotensin. In some cases, it has also been reported when used with Angiotensin II receptor antagonists including Telmisartan. Moreover, the lithium's kidney clearance rate is reduced by thiazids so the risk of lithium poisoning can increase when using Telzid 40/ 12.5. Lithium and Telzid 40/12.5 should only be used simultaneously under medical supervision and need to monitor serum lithium concentration during simultaneous use.

The effect of potassium loss of hydrochlorothiazid is reduced due to the potassium -keeping effect of Telmisartan. However, this effect of hydrochlorothiazide for serum potassium can become potential due to other drugs related to loss and hypoassia (for example, diuretics that cause potassium excretion in the urinary tract, laxatives, corticosteroids, acthoticin, amphoticin, carbenoxolone, penicillin g sodium, salicylic acid and substances).

If these drugs are prescribed with Telzid 40/12.5, plasma potassium concentration should be monitored.

In contrast, based on the experience of using other drugs that inhibit the Renin-Anotensin, simultaneous use of potassium diuretics, potassium supplements, potassium-containing salts or other drugs that increase serum potassium (for example, heparin sodium) can lead to hyperiemia.

If these drugs are prescribed with Telzid 40/12.5, plasma potassium concentration should be monitored.

Periodic monitoring of serum potassium is recommended when Telzid 40/12.5 is used with drugs affected by serum potassium balance disorders.

Patients with simultaneous use of nonsteroidal anti -inflammatory drugs and Telzid 40/12.5 must be fully rehydrated and monitor kidney function from the beginning of combined treatment.

The use in combination with nonsteroidal anti -inflammatory can reduce diuretic effect, sodium exhaust effect in urine and anti -hypertension effect of thiazid diuretics in some patients.

Telmisartan may increase the effects of other anti -hypertension drugs.

For digoxin, the average concentration of digoxin in plasma has an increase of 20% (there is a single case increased by 39%), plasma digoxin monitoring should be considered.

hydrochlorothiazide

When used simultaneously, the following drugs may interact with thiazid diuretics: