MicardisPlus

How can this medicine affect other medicines?

The blood pressure lowering effect of this medicine may be increased if it is taken with alcohol or any of the following medicines, which can also reduce blood pressure: - other medicines for high blood pressure - narcotics - barbiturates - antidepressants - baclofen. This may cause dizziness, particularly when moving from sitting or lying to a standing position. Hydrochlorothiazide can decrease blood potassium levels. The amount of potassium in your blood should be monitored if you are taking this medicine with any of the following, which can also lower blood potassium: - other diuretics, eg frusemide - amphotericin - corticosteroids, eg prednisolone - carbenoxolone - tetracosactide - laxatives - beta agonist bronchodilators, eg salbutamol. If a low blood potassium level (hypokalaemia) occurs with this medicine, it may increase the risk of adverse effects from the following medicines: - cardiac glycosides, such as digoxin - medicines for abnormal heart rhythms, such as sotalol, amiodarone, disopyramide - certain antipsychotic medicines, eg thioridazine, chlorpromazine, trifluoperazine - terfenadine - cisapride. Telmisartan may increase blood potassium levels. The amount of potassium in your blood should be monitored if you are taking this medicine with any of the following, which can also increase blood potassium: - potassium-sparing diuretics such as spironolactone - potassium supplements - potassium-containing salt substitutes - ciclosporin. Both telmisartan and hydrochlorothiazide may increase the blood levels of the medicine lithium, and this medicine is therefore not recommended for people taking lithium. If it is necessary to take both, your doctor should carefully monitor your blood level of lithium. Hydrochlorothiazide may raise blood glucose levels. People with diabetes should therefore carefully monitor their blood sugar while taking this medicine, as the effectiveness of antidiabetic medicines may be reduced and the dose of the antidiabetic medicine may need adjusting. This effect may be enhanced if diazoxide or beta-blockers are also being taken. Discuss this with your doctor. This medicine should not be taken within four hours of the following medicines, as if they are taken at the same time they may reduce the absorption of hydrochlorothiazide from the gut: - colestipol - colestyramine. Non-steroidal anti-inflammatory drugs (NSAIDs, eg indometacin, naproxen) may reduce the blood pressure lowering effect of this medicine and increase the risk of side effects on the kidney, particularly in elderly or dehydrated people. Hydrochlorothiazide may increase the risk of side effects caused by the following medicines: - amantadine - chemotherapy medicines, eg methotrexate, cyclophosphamide. Hydrochlorothiazide can increase blood calcium levels. If you take calcium or vitamin D supplements regularly with this medicine your blood calcium levels should be monitored.

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