Adverse Effects of Telmisartan/Hydrochlorothiazide Combination Therapy

Monitoring and Contraindications

• The European Society of Cardiology recommends monitoring kidney function and serum potassium levels, as with all RAS blockers, when using the telmisartan/hydrochlorothiazide combination 1
• The European Heart Association advises against combining telmisartan/hydrochlorothiazide with aliskiren, especially in patients with diabetes, due to increased risk of hypotension, syncope, and renal failure 1
• The American College of Cardiology recommends avoiding combination therapy with other RAS blockers, such as ACE inhibitors, as it increases adverse events 1

Electrolyte Abnormalities

• Hypokalemia (low potassium) may occur due to the hydrochlorothiazide component, with treatment-related hypokalaemia occurring in less than 0.1% of patients in large-scale studies 2, 3
• Hyponatraemia (low sodium) and hyperuricaemia (elevated uric acid) are other possible electrolyte disturbances from hydrochlorothiazide 2, 3

Pregnancy and Breastfeeding

• The European Society of Cardiology warns that telmisartan/hydrochlorothiazide can cause injury or death to the unborn baby, and alternative blood pressure medications should be discussed if planning pregnancy 2