High blood pressure can damage blood vessels in several organs, which could lead sometimes to heart attack, heart or kidney failure, stroke, or blindness. There are usually no symptoms of high blood pressure before damage occurs.
- Telmisartan belongs to a group of medicines called angiotensin II receptor antagonists. Angiotensin-II is a substance produced in your body which causes your blood vessels to narrow thus increasing your blood pressure
- Hydrochlorothiazide- belongs to a group of medicines called thiazide diuretics, which cause your urine output to increase, leading to a lowering of your blood pressure
- Amlodipine- is a calcium channel blocker. It lowers the blood pressure by relaxing the blood vessels
Theraupeutic Indication:
It is indicated for lowering high blood pressure (hypertension).
Uses:
- Myocardial Infarction
- Congestive heart failure
- diabetic kidney disease
Pharmacological Properties:
Mechanism Of Action :
Amlodipine:
Amlodipine belongs to a group of substances called "calcium channel blockers". Amlodipine stops calcium from moving into the blood vessel wall which stops the blood vessels from tightening. As a result, the blood vessels relax and blood pressure is lowered. It controls chest pain by increasing blood supply to the heart muscle.
Telmisartan:
Telmisartan is a nonpeptide AT1 angiotensin II receptor antagonist. It exerts antihypertensive activity by preventing angiotensin II from binding to AT1 receptors thus inhibiting the vasoconstricting and aldosterone-secreting effects of angiotensin II. Telmisartan relaxes blood vessels which lowers the blood pressure and also reduces the workload of the heart.
Hydrochlorthiazide:
Hydrochlorothiazide inhibits the reabsorption of Na and chloride in the distal tubules causing increased excretion of Na and water K and hydrogen ions.
Pharmacodynamics:
Telmisartan, Amlodipine and Hydrochlorothiazide lowers blood pressure by different mechanisms but through complementary mechanisms.
Hydrochlorthiazide:
Absorption: Rapidly absorbed from the GI tract. Food may slightly decrease the bioavailability. Absolute bioavailability: Dose-dependent (approx 42% after 40-mg dose; 58% after 160-mg dose). Time to peak plasma concentration: Approx 0.5-1 hr.
Distribution: Volume of distribution: 500 L. Plasma protein binding: >99%.
Metabolism: Undergoes conjugation w/ glucuronic acid to form inactive metabolites.
Excretion: Via faeces (97%, as unchanged drug). Terminal elimination half-life: Approx 24 hr.
Telmisartan:
Absorption: Rapidly absorbed from the GI tract. Food may slightly decrease the bioavailability. Absolute bioavailability: Dose-dependent (approx 42% after 40-mg dose; 58% after 160-mg dose). Time to peak plasma concentration: Approx 0.5-1 hr.
Distribution: Volume of distribution: 500 L. Plasma protein binding: >99%.
Metabolism: Undergoes conjugation w/ glucuronic acid to form inactive metabolites.
Excretion: Via faeces (97%, as unchanged drug). Terminal elimination half-life: Approx 24 hr.
Amlodipine:
Absorption: : Well absorbed from the GI tract. Bioavailability: Approx 60-65%. Time to peak plasma concentration: 6-12 hr.
Distribution: : Volume of distribution: 21 L/kg. Plasma protein binding: Approx 98%.
Metabolism: : Hepatically metabolized to inactive metabolites.
Excretion: : Via urine (mainly as metabolites, <10% as unchanged drug). Terminal elimination half-life: 35-50 hr.
Contraindications:
Hypersensitivity to the active substance or to any of the excipients in the formulation. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Drug Interaction:
- May increase plasma levels of digoxin
- May reduce plasma levels of warfarin
Side Effects:
- Headache
- Diziness
- Vomiting
Storage:
Keep this medicine out of the sight and reach of children. Store below 30° C. Store in original package in order to protect from moisture.