High blood pressure, or as we all know it, "pressure," is a health problem that many people in our country are facing today. So your doctor may have prescribed you medication for this condition. One of the most commonly prescribed medications is a combination of two drugs called Telmisartan and Hydrochlorothiazide. You may be using this under the brand name Micardis HCT. Today, let's talk simply about this medication and the things you need to be careful about while using it.
What really happens with this medicine?
Simply put, this is a combination of two types of medication.
1. Telmisartan: This belongs to a class of drugs called ARB (Angiotensin II Receptor Blocker). Think of your blood vessels as a pipe that carries water. What this medicine does is widen the pipe, that is, your blood vessels, a little, and make it easier for blood to flow through. Then, the pressure inside the veins, that is, the pressure, decreases.
2. Hydrochlorothiazide: This is a diuretic. This means that it helps your kidneys remove excess water and salt from your body through urine. When your body is dehydrated, the pressure in your blood vessels also decreases.
This medicine helps control your high blood pressure in both ways.
Things you should tell your doctor before taking this medicine
Before starting this medication, it is very important to give your doctor a complete description of your health condition. Be sure to tell them about any of the conditions listed below.
| If you have these conditions... | Why should you inform? |
|---|---|
| If you are pregnant, trying to get pregnant, or breastfeeding | This medicine can cause serious harm to an unborn baby, especially during the second and third trimesters. |
| Kidney or liver disease | These diseases affect the process of removing this medication from the body, so the dosage may need to be adjusted. |
| Diabetes | This medication may affect blood sugar levels, so you may need to change your diabetes medication. |
| Immune system diseases (e.g. lupus) | Some medical conditions may be aggravated by this medication. |
| If you follow a special diet, such as a low-salt diet | The doctor should be aware of this as it affects the body's salt balance. |
| If you have allergies to other medicines, foods, dyes or preservatives | Hydrochlorothiazide can cause problems, especially if you are allergic to sulfa drugs. |
How should I use this medicine?
- Take it on time: Take this medicine at the same time every day , exactly as your doctor prescribed. This will help maintain the same level of effectiveness in your body.
- Before or after food?: This medicine can be taken before or after food. However, if you experience stomach upset, it is best to take it with food.
- Don't stop: Don't stop taking your medication until your doctor tells you to. Even if your blood pressure seems well-controlled, stopping it suddenly can cause your blood pressure to rise dangerously again.
What if I overdose?
If you accidentally take more than the prescribed dose, go to the nearest hospital Emergency Treatment Unit (ETU) immediately . Alternatively, call the National Poisons Information Centre at the Colombo National Hospital .
What if I forget to take my medicine?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at the same time.
Other medications that may interact with this medicine
Some other medications you are taking may interact with this medicine and cause unwanted effects. So tell your doctor about all the medications you are taking, including prescription medications, over-the-counter medications, pain relievers, vitamins, herbs, and even supplements.
The most important thing is that before you buy medicine from a pharmacy for a cough, cold, or pain, ask your doctor about the medicine you are taking for this blood pressure. Because some types of medicine can increase blood pressure.
Be especially careful with the following medications:
- Other blood pressure medications
- Pain and inflammation medications (e.g. NSAIDs such as Ibuprofen, Naproxen)
- Diabetes medication
- Lithium
- Digoxin
- Potassium supplements or salt substitutes
- Types of steroids (Corticosteroids)
- Some cholesterol-lowering medications (e.g., Cholestyramine)
Things you should be careful about while taking the medicine
Check the pressure regularly.
While taking this medicine, check your blood pressure regularly at home. Write down your measurements in a notebook and take them with you to your doctor. Ask your doctor what your ideal blood pressure should be and when you should tell him/her.
Be careful of dehydration.
This medicine reduces the amount of water in the body, so there is a high chance of dehydration. Ask your doctor about the amount of water you should drink per day. If you have diarrhea, vomiting, or are sweating excessively, taking this medicine can be dangerous because it can cause excessive fluid loss from the body. Seek medical advice in such cases.
Dizziness and drowsiness
This medicine may make you feel a little dizzy, light-headed, or drowsy. Therefore, avoid activities that require alertness, such as driving or operating machinery, until you know how this medicine affects you. Especially if you are an elderly person, be careful when getting up from a standing position or from a sitting position. Avoid drinking alcohol, as this dizziness and drowsiness can be made worse by drinking alcohol.
Be careful of the sun.
This medicine may make your skin more sensitive to the sun (photosensitivity). Therefore, limit your exposure to strong sunlight as much as possible. If you must go out in the sun, wear protective clothing and use sunscreen. Also talk to your doctor about your risk of skin cancer while taking this medicine.
What are the possible side effects of the medication?
Like any medicine, this one can cause side effects in some people. Some of them are serious, some of them are common.
| Serious side effects that should be reported to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| The pressure is very low. | Severe dizziness, fainting, blurred vision. |
| Kidney damage | Decreased urine output, swelling of the ankles, hands, or feet. |
| Changes in potassium levels | (If low) - Muscle twitching, pain, unusual weakness, irregular heartbeat. (If increased) - Muscle weakness, irregular heartbeat. |
| Sudden eye pain | Eye pain, blurred vision, seeing halos around lights. |
| Gout | Severe pain, redness, and swelling, especially in a joint such as the big toe. |
| Things that are usually not serious, but should be reported to the doctor if they persist | |
| Back pain | Dizziness |
| Headache | Tiredness |
| Diarrhea | Stomach ache |
Take-Home Message
- Take this medicine exactly as prescribed by the doctor, at the right time, for the right length of time. Do not stop taking it arbitrarily.
- Inform your doctor about any other illnesses you have and all medications you are taking.
- Be careful of dehydration and dizziness. Drink plenty of water.
- If you are planning to become pregnant, are pregnant, or are breastfeeding, tell your doctor right away.
- Measure your blood pressure regularly and follow your doctor's instructions.
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