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▴ Oral telmisartan/hydrochlorothiazide (HCTZ) combines two antihypertensive agents, a selective angiotensin II receptor antagonist with a long half-life and once-daily administration, and a thiazide diuretic.
▴ In two large, 8-week, double-blind trials, patients with hypertension unresponsive to monotherapy who received combined telmisartan/HCTZ 80/12.5 or 40/12.5 mg/day, achieved significantly larger reductions in diastolic and systolic blood pressure (BP), than recipients of continued telmisartan monotherapy (p < 0.05 for all). Compliance with telmisartan/HCTZ 80/12.5 mg/day was 98.9%.
▴ In patients with hypertension, telmisartan/HCTZ resulted in similar BP reductions to oral enalapril/ HCTZ and atenolol/HCTZ in 26-week double-blind trials and greater reductions than oral losartan/ HCTZ 50/12.5 mg/day in a 6-week randomised open-label trial (p < 0.001).
▴ Up to one-third of patients with hypertension initially responsive to telmisartan 40 or 80 mg/day in a 4-year study required the eventual addition of HCTZ 12.5 or 25 mg/day and/or another agent to maintain BP control. BP was controlled in about 75% of these by adding only HCTZ.
▴ In clinical trials of up to 4 years, including elderly patients, telmisartan/HCTZ had similar tolerability to placebo, with few reports of hypokalaemia. Most adverse events were mild to moderate.
KeywordsEnalapril Atenolol Losartan Telmisartan HCTZ
- 1.McGill JB, Reilly PA. Telmisartan plus hydrochlorothiazide versus telmisartan or hydrochlorothiazide monotherapy in patients with mild to moderate hypertension: a multicenter, randomized, double-blind, placebo-controlled, parallel-group trial. Clin Ther 2001 Jun; 23(6): 833–50PubMedCrossRefGoogle Scholar
- 11.Burgess ED, Buckley S. Acute natriuretic effect of telmisartan in hypertensive patients [abstract no. 1025]. Am J Hypertens 2000 Apr; 13 (Pt 2): 183Google Scholar
- 12.Burgess ED, Buckley S. Long-term effect of telmisartan on sodium excretion in hypertensive patients [abstract no. 58]. Can J Cardiol 2000 Sep; 16 Suppl. F: 106Google Scholar
- 13.Weber M. The telmisartan programme of research to show telmisartan end-organ protection (PROTECTION) programme. J Hypertens 2003; 21 Suppl. 6: S37–46Google Scholar
- 20.Yong CL, Dias VC, Stangier J. Multiple-dose pharmacokinetics of telmisartan and of hydrochlorothiazide following concurrent administration in healthy subjects. J Clin Pharmacol 2000 Dec; 40 (12 Pt 1): 1323–30Google Scholar
- 21.Stangier J, Schmid J, Turck D, et al. Absorption, metabolism, and excretion of intravenously and orally administered [14C]telmisartan in healthy volunteers. J Clin Pharmacol 2000 Dec; 40 Pt 1: 1312–22Google Scholar
- 23.Neutel JM, Smith DHG, Telmisartan US Study Group. Dose response and antihypertensive efficacy of the AT1receptor antagonist telmisartan in patients with mild to moderate hypertension. Adv Ther 1998 Jul–Aug; 15: 206–17Google Scholar
- 25.Stangier J, Heinzel G, Su C-A, et al. Clinical pharmacokinetics of telmisartan [abstract no. P.49]. J Hum Hypertens 1999 May; 13 Suppl. 3: 13Google Scholar
- 30.Boehringer Ingelheim. Telmisartan prescribing information. 2000Google Scholar
- 32.Hannedouche T, Chanard J, Baumelou B. Evaluation of the safety and efficacy of telmisartan and enalapril, with the potential addition of frusemide, in moderate-renal failure patients with mild-to-moderate hypertension. J Renin Angiotensin Aldosterone Syst 2001 Dec; 2(4): 246–54PubMedCrossRefGoogle Scholar
- 34.Lacourcière Y, Gil-Extremera B, Mueller O, et al. Efficacy and tolerability of fixed-dose combinations of telmisartan plus HCTZ compared with losartan plus HCTZ in patients with essential hypertension. Int J Clin Pract 2003 May; 57: 237–79Google Scholar
- 36.Freytag F, Schelling A, Meinicke T, et al. Comparison of 26-week efficacy and tolerability of telmisartan and atenolol, in combination with hydrochlorothiazide as required, in the treatment of mild to moderate hypertension: a randomized, multicenter study. Clin Ther 2001 Jan; 23(1): 108–23PubMedCrossRefGoogle Scholar
- 39.Boehringer-Ingelheim. Data on file. 2003Google Scholar
- 40.Lacourcière Y, Poirier L, Extremera BG, et al. Telmisartan in combination with hydrochlorothiazide or losartan in combination with hydrochlorothiazide; ABPM assessment of blood pressure lowering. Am J Hypertens 2002 Apr; 15 (Pt 2): 113Google Scholar
- 41.Mancia G. Tolerability and safety of telmisartan as monotherapy or combined with hydrochlorothiazide compared with placebo [abstract no. R194]. J Hypertens 2002 Jun; 20 (4 Suppl.): 377Google Scholar
- 42.European Agency for the Evaluation of Medicinal Products. Summary of product characteristics for telmisartan/hydrochlorothiazide [online]. Available from URL: http://www.emea.eu.int [Accessed 2003 May 20]