Summary

More frequently reported side effects include: dizziness. Continue reading for a comprehensive list of adverse effects.

Applies to hydrochlorothiazide / telmisartan: oral tablet.

Serious side effects

Along with its needed effects, hydrochlorothiazide/telmisartan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking hydrochlorothiazide / telmisartan:

Less common

• Bladder pain
• bloody or cloudy urine
• blurred vision
• confusion
• decreased urine
• difficult, burning, or painful urination
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
• dry mouth
• fainting
• fast, pounding, or irregular heartbeat or pulse
• frequent urge to urinate
• increased thirst
• loss of appetite
• lower back or side pain
• muscle pain or cramps
• nausea or vomiting
• numbness or tingling in the hands, feet, or lips
• seizures
• sudden sweating
• trouble breathing
• unusual tiredness or weakness

Rare

• Chills
• cold sweats

Rare

• Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

Incidence not known

• Persistent non-healing sore
• pink growth
• reddish patch or irritated area
• shiny bump
• white, yellow or waxy scar-like area

Other side effects

Some side effects of hydrochlorothiazide / telmisartan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Body aches or pain
• cough
• difficulty breathing
• dizziness
• ear congestion
• fever
• headache
• loss of voice
• runny or stuffy nose
• sneezing
• sore throat

Less common

• Acid or sour stomach
• back pain
• belching
• blistering, peeling, loosening of the skin
• cough producing mucus
• diarrhea
• heartburn
• hoarseness
• indigestion
• itching
• joint pain
• loss of appetite
• muscle aches and pains
• pain or tenderness around the eyes and cheekbones
• rash
• red irritated eyes
• red skin lesions, often with a purple center
• shivering
• sores, ulcers, or white spots in the mouth or on the lips
• stomach pain
• sweating
• tender, swollen glands in the neck
• tightness in the chest
• trouble sleeping
• trouble swallowing
• voice changes

Incidence not known

• Decreased interest in sexual intercourse
• inability to have or keep an erection
• loss in sexual ability, desire, drive, or performance

For Healthcare Professionals

Applies to hydrochlorothiazide / telmisartan: oral tablet.

General

The most common adverse effect was upper respiratory tract infection.^[Ref]

Respiratory

Common (1% to 10%): Sinusitis, upper respiratory tract infection, cough

Uncommon (0.1% to 1%): Dyspnea

Rare (less than 0.1%): Bronchitis, pharyngitis, respiratory distress, pneumonitis, pulmonary edema

Hydrochlorothiazide:

Very common (10% or more): Upper respiratory tract infection (10%)

Common (1% to 10%): Sinusitis

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema

Telmisartan:

Common (1% to 10%): Sinusitis, upper respiratory tract infection

Uncommon (0.1% to 1%): Cough

Frequency not reported: Asthma, rhinitis, dyspnea, epistaxis

Postmarketing reports: Interstitial lung disease^[Ref]

Other

Common (1% to 10%): Fatigue, influenza-like symptoms, pain

Uncommon (0.1% to 1%): Chest pain

Hydrochlorothiazide:

Common (1% to 10%): Fatigue, influenza-like symptoms

Frequency not reported: Weakness, pyrexia

Telmisartan:

Common (1% to 10%): Fatigue, influenza-like symptoms

Uncommon (0.1% to 1%): Asthenia

Frequency not reported: Earache, fever, malaise, leg edema, peripheral edema, dependent edema, chest pain

Postmarketing reports: Weakness, edema, face edema, pain^[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache

Uncommon (0.1% to 1%): Syncope, paresthesia, vertigo

Hydrochlorothiazide:

Common (1% to 10%): Dizziness

Frequency not reported: Lightheadedness

Telmisartan:

Common (1% to 10%): Dizziness

Rare (less than 0.1%): Somnolence

Frequency not reported: Tinnitus, migraine, hypoesthesia, cerebrovascular disorder, vertigo, paresthesia, hypoesthesia, involuntary muscle contraction

Postmarketing reports: Headache, syncope^[Ref]

Gastrointestinal

Common (1% to 10%): Diarrhea, nausea

Uncommon (0.1% to 1%): Dry mouth, flatulence

Rare (less than 0.1%): Abdominal pain, constipation, dyspepsia, vomiting, gastritis

Hydrochlorothiazide:

Common (1% to 10%): Diarrhea, nausea

Frequency not reported: Sialadenitis, pancreatitis, stomach discomfort, cramping, gastric irritation

Telmisartan:

Common (1% to 10%): Diarrhea, nausea

Rare (less than 0.1%): Stomach discomfort

Frequency not reported: Hemorrhoids, gastroenteritis, enteritis, gastroesophageal reflux, toothache, non-specific gastrointestinal disorder, flatulence, constipation, gastritis, dry mouth,

Postmarketing reports: Dyspepsia, abdominal pain^[Ref]

Renal

Common (1% to 10%): BUN increased 11.2 mg/dL or greater, serum creatinine increased 0.5 mg/dL or greater

Hydrochlorothiazide:

Frequency not reported: Nephritis interstitial, renal dysfunction, renal failure

Telmisartan:

Uncommon (0.1% to 1%): Renal impairment, acute renal failure^[Ref]

Genitourinary

Common (1% to 10%): Urinary tract infection

Uncommon (0.1% to 1%): Erectile dysfunction

Frequency not reported: Impotence

Hydrochlorothiazide:

Frequency not reported: Glycosuria

Telmisartan:

Uncommon (0.1% to 1%): Urinary tract infection

Frequency not reported: Micturition frequency, cystitis, impotence

Postmarketing reports: Erectile dysfunction^[Ref]

Hematologic

Common (1% to 10%): Hemoglobin decreased 2 g/dL or greater

Uncommon (0.1% to 1%): Hematocrit decreased 9% or more

Hydrochlorothiazide:

Frequency not reported: Aplastic anemia, hemolytic anemia, bone marrow depression, leukopenia, neutropenia, agranulocytosis, thrombocytopenia

Telmisartan:

Uncommon (0.1% to 1%): Anemia

Rare (less than 0.1%): Eosinophilia, thrombocytopenia, hemoglobin decreased^[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Tachycardia, arrhythmias, hypotension, orthostatic hypotension

Hydrochlorothiazide:

Frequency not reported: Vasculitis necrotizing

Telmisartan:

Uncommon (0.1% to 1%): Bradycardia

Frequency not reported: Palpitation, angina pectoris, abnormal ECG, flushing, hypertension

Postmarketing reports: Atrial fibrillation, congestive heart failure, myocardial infarction, blood pressure increased, hypertension aggravated, hypotension, postural hypotension^[Ref]

Musculoskeletal

Uncommon (0.1% to 1%): Back pain, muscle spasm, myalgia

Rare (less than 0.1%): Arthralgia, muscle cramp, pain in limb, blood creatine phosphokinase increased

Frequency not reported: Leg pain, cramps in legs

Postmarketing reports: Exacerbation or activation of systemic lupus erythematosus

Hydrochlorothiazide:

Frequency not reported: Lupus-like syndrome, muscle spasm

Telmisartan:

Rare (less than 0.1%): Arthrosis, tendon pain, tendonitis, tenosynovitis

Frequency not reported: Arthritis, arthralgia, leg pain, leg cramps, myalgia

Postmarketing reports: Back pain, muscle cramps, creatine phosphokinase increased, rhabdomyolysis^[Ref]

Metabolic

Uncommon (0.1% to 1%): Hypokalemia, blood uric acid increased

Rare (less than 0.1%): Hyperuricemia, hyponatremia

Hydrochlorothiazide:

Frequency not reported: Diabetes mellitus inadequate control, anorexia, appetite decreased, electrolyte imbalance, hypercholesterolemia, hyperglycemia, hypovolemia, triglycerides increased, hyperuricemia

Telmisartan:

Uncommon (0.1% to 1%): Hyperkalemia

Rare (less than 0.1%): Hypoglycemia in diabetic patients

Frequency not reported: Diabetes mellitus, gout, hypercholesterolemia

Postmarketing reports: Uric acid increased^[Ref]

Psychiatric

Uncommon (0.1% to 1%): Anxiety

Rare (less than 0.1%): Depression, insomnia, sleep disorder

Hydrochlorothiazide:

Frequency not reported: Restlessness

Telmisartan:

Frequency not reported: Nervousness, insomnia, anxiety, depression^[Ref]

Dermatologic

Rare (less than 0.1%): Angioedema, erythema, pruritus, rash, hyperhidrosis, urticaria

Frequency not reported: Sweating increased

Hydrochlorothiazide:

Frequency not reported: Photosensitivity reactions, skin vasculitis, toxic epidermal necrolysis, cutaneous lupus erythematosus-like reactions, reactivation of cutaneous lupus erythematosus, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, purpura, urticaria

Telmisartan:

Rare (less than 0.1%): Eczema, drug eruption, toxic skin eruption, toxicoderma, rash, angioedema

Frequency not reported: Dermatitis, sweating increased, pruritus

Postmarketing reports: Urticaria, erythema^[Ref]

Hepatic

Rare (less than 0.1%): Abnormal hepatic function/liver disorder, hepatic enzyme increased

Frequency not reported: Serum bilirubin increased

Hydrochlorothiazide:

Frequency not reported: Jaundice hepatocellular, jaundice cholestatic

Telmisartan:

Postmarketing reports: Abnormal hepatic function/liver disorder^[Ref]

Ocular

Rare (less than 0.1%): Visual disturbance, vision blurred

Hydrochlorothiazide:

Frequency not reported: Xanthopsia, acute myopia, acute angle-closure glaucoma, transient blurred vision

Telmisartan:

Frequency not reported: Conjunctivitis, abnormal vision^[Ref]

Immunologic

Hydrochlorothiazide:

Frequency not reported: Anaphylactic reactions, hypersensitivity, allergy

Telmisartan:

Rare (less than 0.1%): Sepsis, hypersensitivity, anaphylactic reactions

Frequency not reported: Allergy, infection, fungal infection, abscess, otitis media^[Ref]