📋 Indications & Clinical Dosage
*Hypertension not adequately controlled by telmisartan alone:*
Adults: 1 tab daily using the strength as clinically appropriate. Children: Not recommended.
⛔ Contraindications
Cholestasis, biliary obstruction, severe hepatic or severe renal impairment, refractory hypokalaemia; hypercalcaemia.
⚠️ Precautions & Warnings
Mild to moderate renal or hepatic impairment, progressive liver disease, renovascular hypertension, kidney transplant, intravascular vol-ume depletion, severe congestive heart failure, renal artery stenosis, primary aldosteronism, aortic or mitral stenosis, obstructive cardiomyopathy, diabetes. Monitor serum electrolyte, creatinine and uric acid levels during therapy.
🔄 Drug Interactions
Lithium, digoxin, diuretics, corticosteroids, ACE inhibitors, K+-sparing diuretics or K+ supplements, cyclosporin, tacrolimus,
hypoglycaemic agents, anionic exchange resins, NSAIDS, pressor amines, allopurinol, probenecid, sulfnpyrazone, calcium supplements, diazoxide, beta-blockers, anticholinergics, amantadine, methotrexate, cyclophosphamide, baclofen, alcohol barbiturates, antidepressants.
⚠️ Adverse Reactions / Side Effects
Arthralgia, back pain, chest pain, eczema, GI disturbances, influenza-like symptoms, leg cramps, myalgia, pharyngitis, sinusitis, urinary-tract infection, asthenia, syncope, abnormal vision, anxiety, dry mouth, flatulence, sweating, tendinitis-like symptoms, vertigo. Rare: Blood disorders, bradycardia, depression, dyspnea, eosinophilia, increase in uric acid, insomnia, pruritus, rash, tachycardia
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.