Telmisartan/hydrochlorothiazide: in the treatment of essential hypertension.
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.
Fenton
Caroline
C
Adis International Limited, Mairangi Bay, Auckland, New Zealand. demail@adis.co.nz
Keating
Gillian M
GM
Scott
Lesley J
LJ
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004232:Diuretics / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D006852:Hydrochlorothiazide / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D000077333:Telmisartan
D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D004232:Diuretics; D004338:Drug Combinations; C436283:telmisartan, hydrochlorothiazide drug combination; D006852:Hydrochlorothiazide; D000077333:Telmisartan