{"id":25204,"date":"2022-09-12T07:39:08","date_gmt":"2022-09-12T07:39:08","guid":{"rendered":"https:\/\/zeepedia.com\/?p=25204"},"modified":"2023-02-20T15:04:03","modified_gmt":"2023-02-20T15:04:03","slug":"tolucombi","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/tolucombi\/","title":{"rendered":"Tolucombi &#8211; Telmisartan\/ Hydrochlorothiazide, Uses, Dose And Side Effects"},"content":{"rendered":"\n<p><strong>Tolucombi 40 mg\/12.5 mg, 80 mg\/12.5 mg and 80 mg\/25 mg&nbsp;Telmisartan\/Hydrochlorothiazide Tablet<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Tolucombi Is And What Tolucombi Used For<\/h2>\n\n\n\n<p>Tolucombi combines two active substances, telmisartan and\u00a0hydrochlorothiazide,\u00a0in one tablet.\u00a0Both of these substances help control high\u00a0blood pressure.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Telmisartan belongs to a group of medicines called\u00a0angiotensin\u00a0-II inhibitors.\u00a0Angiotensin\u00a0II is a body substance that causes your blood vessels to become narrower, which in turn causes your\u00a0blood pressure\u00a0to rise.\u00a0Telmisartan blocks this effect of\u00a0angiotensin\u00a0II, leading to dilating blood vessels and lowering blood pressure.<\/li><li>Hydrochlorothiazide\u00a0belongs to a group of medicines called thiazide diuretics which cause increased urine output and lowers your\u00a0blood pressure.<\/li><\/ul>\n\n\n\n<p><strong>Untreated high\u00a0blood pressure\u00a0can cause vascular damage in multiple organs, sometimes leading to heart attack,\u00a0heart failure,\u00a0kidney failure,\u00a0stroke,\u00a0or blindness.\u00a0<\/strong>Most of the time, high\u00a0blood pressure\u00a0causes no symptoms before the damage occurs.\u00a0It is, therefore, important to regularly measure\u00a0blood pressure\u00a0to confirm that it is normal.<\/p>\n\n\n\n<p><strong>Tolucombi (40 mg\/12.5 mg, 80 mg\/12.5 mg)\u00a0treats high\u00a0blood pressure\u00a0(\u00a0essential\u00a0hypertension\u00a0) in adults whose\u00a0blood pressure\u00a0is not adequately controlled when telmisartan is used alone.<\/strong><\/p>\n\n\n\n<p><strong>Tolucombi (80 mg\/25 mg)<\/strong>\u00a0treats high\u00a0blood pressure\u00a0(\u00a0essential\u00a0hypertension\u00a0) in adults whose\u00a0blood pressure\u00a0is not\u00a0adequately\u00a0controlled by Tolucombi 80 mg\/12.5 mg or in patients previously stabilized with telmisartan and\u00a0hydrochlorothiazide\u00a0separately.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What You Need To Know Before Using Tolucombi:<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do Not Use Tolucombi<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>If you are allergic to telmisartan or any other ingredients of this medicine (listed in section 6).<\/li><li>If you are allergic to\u00a0hydrochlorothiazide\u00a0or any sulfonamide\u00a0derivative.<\/li><li>Pregnant women should not use Tolucombi during the last 6 months of pregnancy.\u00a0(Even earlier in pregnancy, avoid Tolucombi; see Pregnancy and breastfeeding).<\/li><li>If you have severe liver problems such as cholestasis or biliary obstruction (problems with the outflow of bile from the liver and gallbladder) or any other severe liver disease.<\/li><li>If you have severe kidney disease.<\/li><li>If your doctor determines that your blood has low potassium or high calcium levels that do not improve with treatment.<\/li><li>If you have\u00a0diabetes\u00a0or impaired kidney function and are being treated with a medicine containing aliskiren.<\/li><\/ul>\n\n\n\n<p>Tell your doctor or pharmacist before taking Tolucombi if any of the above apply.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings And Precautions:<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Talk to your doctor before taking Tolucombi if you have or have had any of the following conditions or diseases:<\/li><li>Low\u00a0blood pressure\u00a0(\u00a0hypotension\u00a0) often occurs if you are dehydrated (severe loss of body fluid) or if you have a salt deficiency due to diuretic treatment (water-reducing treatment), low-salt diet, diarrhea, vomiting, or\u00a0hemodialysis.<\/li><li>Kidney disease or if you have had a kidney transplant.<\/li><li>Renal artery stenosis (narrowing of blood vessels leading to one or both kidneys).<\/li><li>Liver disease.<\/li><li>Heart problems.<\/li><li>Diabetes.<\/li><li>Gout.<\/li><li>Increased aldosterone levels (water and salt accumulation in the body and imbalance of various minerals in the blood).<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/sle\/\">Systemic lupus erythematosus<\/a> (also called &#8220;lupus&#8221; or &#8220;SLE&#8221;) is disease in which the body&#8217;s immune system attacks the body.<\/li><li>The active substance\u00a0hydrochlorothiazide\u00a0can cause an unusual reaction that causes impaired vision and eye pain.\u00a0These may be symptoms of fluid accumulation in the eye (between the choroid and sclera) or increased pressure in your eye and may occur within hours to weeks of taking Tolucombi.\u00a0It can lead to permanent vision loss if the condition is not treated.<\/li><li>If you have had skin cancer or get an unexpected skin change during treatment.\u00a0Treatment with\u00a0hydrochlorothiazide, especially long-term use at high\u00a0doses, may increase the risk of certain types of skin and lip cancer (non-melanoma\u00a0skin cancer).\u00a0Protect your skin from exposure to sunlight and UV rays while taking Tolucombi.<\/li><li>If you have previously had breathing or lung problems (including\u00a0inflammation\u00a0or fluid in the lungs) after taking\u00a0hydrochlorothiazide.\u00a0If you experience severe shortness of breath or breathing problems after taking Tolucombi, seek medical attention immediately.<\/li><\/ul>\n\n\n\n<p>Talk to your doctor before taking Tolucombi if you are taking:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Digoxin<\/li><li>Any of the following medicines used to treat high blood pressure:<ul><li>An ACE inhibitor (eg\u00a0enalapril, lisinopril, ramipril), especially if you have diabetes-related kidney problems.<\/li><li>The aliskiren.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>If you think you are pregnant or become pregnant during treatment, contact your doctor.&nbsp;Tolucombi is not recommended during pregnancy and should not be used during the last 6 months of pregnancy as it can then cause birth defects, see Pregnancy and breastfeeding.<\/p>\n\n\n\n<p>Treatment with\u00a0hydrochlorothiazide\u00a0can cause disturbances in the electrolyte balance in your body.\u00a0Typical symptoms of disturbed fluid or electrolyte balance are:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Dry mouth<\/li><li>Weakness<\/li><li>Lack of energy<\/li><li>Sleepiness<\/li><li>Restlessness<\/li><li>Muscle pain or cramps<\/li><li>Nausea (feeling sick)<\/li><li>Vomiting<\/li><li>Muscle fatigue<\/li><li>Abnormally fast\u00a0pulse\u00a0(faster than 100 beats per minute).<\/li><\/ul>\n\n\n\n<p>If you experience any of these symptoms, tell your doctor. You should also tell your doctor if you experience that your skin is more sensitive to sunlight, with symptoms such as:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Sunburn such as:<ul><li>Redness<\/li><li>Itching<\/li><li>Swelling<\/li><li>Blisters<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>That develop faster than normal. If you are going to have surgery or be sedated, tell your doctor that you are using Tolucombi tablets.\u00a0Tolucombi may be less effective in lowering\u00a0blood pressure\u00a0et in colored patients.<\/p>\n\n\n\n<p>Your doctor may need to check kidney function,\u00a0blood pressure,\u00a0and the number of\u00a0electrolytes\u00a0(e.g.\u00a0potassium\u00a0) in the blood regularly. See also the information under the heading &#8220;Do not use Tolucombi&#8221;.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Children And Young People:<\/h2>\n\n\n\n<p>Use of Tolucombi in children and adolescents up to 18 years of age is not recommended.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other Medicines And Tolucombi:<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take other medicines.\u00a0Your doctor may need to change the\u00a0dose\u00a0of the other medicines or take other measures.\u00a0Sometimes, you may need to stop taking some of the medicines.\u00a0This applies in particular to the medicines listed below if they are taken at the same time as Tolucombi:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Lithium-containing medicines treat certain types of depression.<\/li><li>Medicines associated with low levels of potassium in the blood (\u00a0hypokalemia\u00a0), such as\u00a0diuretics\u00a0(water-reducing drugs),\u00a0laxatives\u00a0(eg castor oil),\u00a0corticosteroids\u00a0(eg prednisone), ACTH (a\u00a0hormone\u00a0), amphotericin (an antifungal agent), carbenoxolone (used in the treatment of mouth ulcers),\u00a0penicillin\u00a0-G-\u00a0sodium\u00a0(an\u00a0antibiotic\u00a0), salicylic acid and\u00a0derivatives.<\/li><li>Medicines that can increase blood potassium levels include potassium-sparing\u00a0diuretics, potassium supplements, salt substitutes containing\u00a0potassium,\u00a0ACE inhibitors, ciclosporin (a medicine that suppresses the immune system), and other medicines such as heparin sodium (an\u00a0anticoagulant\u00a0).<\/li><li>Medicines whose effect is affected by changes in the potassium value of the blood, such as heart medicines (eg\u00a0digoxin\u00a0) or medicines that control your heart rhythm (eg\u00a0quinidine,\u00a0disopyramide,\u00a0amiodarone, sotalol), medicines used in mental illnesses (eg thioridazine, chlorpromazine, levomepromazine) and other medicines such as certain\u00a0antibiotics\u00a0(sparfloxacin, pentamidine) or certain allergy medicines (terfenadine).<\/li><li>Diabetes medicines (\u00a0insulin\u00a0or tablets such as\u00a0metformin\u00a0).<\/li><li>Medicines are used to lower the level of blood fats (cholestyramine and colestipol).<\/li><li>Blood pressure-raising drugs such as\u00a0norepinephrine.<\/li><li>Muscle relaxants such as tubocurarine.<\/li><li>Calcium\u00a0or\u00a0vitamin\u00a0D supplements.<\/li><li>Anticholinergic drugs (drugs for various medical conditions, e.g. spasms in the gastrointestinal tract, muscle spasms in the bladder,\u00a0asthma, motion sickness, muscle spasms,\u00a0Parkinson&#8217;s disease,\u00a0and as support during anesthesia) such as atropine and biperiden.<\/li><li>Amantadine (medicine to treat\u00a0Parkinson&#8217;s disease\u00a0and treat or prevent certain viral diseases).<\/li><li>Other drugs to treat high\u00a0blood pressure\u00a0are corticosteroids, painkillers (NSAIDs, anti-inflammatory drugs), and drugs to treat cancer,\u00a0gout,\u00a0or\u00a0arthritis.<\/li><li>If you are taking an\u00a0ACE inhibitor\u00a0or aliskiren (see also the information under the headings &#8220;Do not take Tolucombi&#8221; and &#8220;Warnings and precautions&#8221;).<\/li><li>Digoxin<\/li><\/ul>\n\n\n\n<p>Tolucombi can increase the blood pressure-lowering effect of other medicines or medicines that can lower\u00a0blood pressure\u00a0(eg baclofen, amifostine).\u00a0In addition, low\u00a0blood pressure\u00a0can be worsened by alcohol,\u00a0barbiturates, narcotics, and antidepressants.<\/p>\n\n\n\n<p>You may notice it as dizziness when you stand up.\u00a0You should consult your doctor if you need to change the dose of any of your other medicines when taking Tolucombi. The effect of Tolucombi can be reduced when you take\u00a0NSAIDs\u00a0(non-steroidal anti-inflammatory drugs, eg\u00a0acetylsalicylic acid\u00a0or\u00a0ibuprofen\u00a0).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Tolucombi With Food, Drink, And Alcohol:<\/h2>\n\n\n\n<p>You can take Tolucombi with or without food. Avoid drinking alcohol until you have spoken to your doctor.\u00a0Alcohol can cause your\u00a0blood pressure\u00a0to drop further and increase your risk of dizziness or fainting.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, Breastfeeding, And Fertility:<\/h2>\n\n\n\n<p><strong><span style=\"text-decoration: underline;\">Pregnancy<\/span><\/strong><\/p>\n\n\n\n<p>If you think you are pregnant or become pregnant during treatment, contact your doctor.\u00a0Your doctor will usually suggest that you stop taking Tolucombi before pregnancy or as soon as you know you are pregnant and instead recommend another medicine.\u00a0<strong>Tolucombi should not be used during pregnancy or during the last 6 months of pregnancy as it may cause birth defects.<\/strong><\/p>\n\n\n\n<p><strong><span style=\"text-decoration: underline;\">Breast-feeding<\/span><\/strong><\/p>\n\n\n\n<p>Tell your doctor if you are breastfeeding or intend to start breastfeeding.\u00a0Tolucombi is not recommended during breastfeeding, and your doctor may choose another treatment for you if you wish to breastfeed your baby.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving Ability And Use Of Machinery:<\/h2>\n\n\n\n<p>Some people feel dizzy or tired after taking Tolucombi.&nbsp;If you feel dizzy or tired, do not drive or use machines.<a><\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Tolucombi Contains Lactose, Sorbitol And Sodium:<\/h2>\n\n\n\n<p>If you are intolerant to certain sugars, you should consult your doctor before taking this medication.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Tolucombi 40 mg\/12.5 mg contains 147.04 mg sorbitol per tablet, corresponding to 5 mg\/kg\/day, if the body weight is 29.8 kg.<\/li><li>Tolucombi 80 mg\/12.5 mg and Tolucombi 80 mg\/25 mg contain 294.08 mg sorbitol per tablet, corresponding to 5 mg\/kg\/day, if the body weight is 58.8 kg.<\/li><li>Patients weighing 58.8 kg or less must consider sorbitol as a source of fructose.\u00a0If you (or your child) have an intolerance to some sugars, or if you (or your child) have been diagnosed with\u00a0Hereditary\u00a0Fructose Intolerance\u00a0(HFI), a rare, inherited condition that prevents the breakdown of fructose, consult a doctor before using this drug.<\/li><li>This medicine contains less than 1 mmol (23 mg)\u00a0of sodium\u00a0per tablet, i.e. it is almost &#8220;sodium-free&#8221;.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How To Use Tolucombi?<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Always use this medicine as directed by your doctor.\u00a0Ask your doctor or pharmacist if you are unsure. The recommended\u00a0dose\u00a0of Tolucombi is one tablet per day.<\/li><li>Try to take the tablet at the same time each day.\u00a0You can take Tolucombi with or without food.<\/li><li>The tablets should be swallowed with a little water or another non-alcoholic drink.<\/li><li>It is important to continue taking Tolucombi daily until your doctor tells you otherwise. If your liver is not working properly, the normal dose should not exceed 40 mg\/12.5 mg once daily.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">If You Have Used Too Much Tolucombi:<\/h2>\n\n\n\n<p>If you accidentally take too many tablets, you may experience symptoms such as low\u00a0blood pressure\u00a0and heart palpitations.\u00a0Symptoms such as:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Low\u00a0heart rate<\/li><li>Dizziness<\/li><li>Vomiting<\/li><li>Impaired kidney function, including\u00a0kidney failure,\u00a0have also been reported.<\/li><\/ul>\n\n\n\n<p>Due to the content of\u00a0hydrochlorothiazide, markedly low\u00a0blood pressure\u00a0and low potassium levels in the blood may occur, which may cause:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Nausea<\/li><li>Sleepiness<\/li><li>Muscle cramps<\/li><li>Irregular heartbeats in connection with the simultaneous use of\u00a0digitalis\u00a0or certain antiarrhythmic drugs.<\/li><\/ul>\n\n\n\n<p>Contact your doctor, pharmacist, or nearest emergency department immediately.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If You Forget To Use Tolucombi:<\/h2>\n\n\n\n<p>Do not worry if you forget to take a\u00a0dose.\u00a0Take\u00a0dose\u00a0one as soon as you remember and then continue as before.\u00a0If you forget the medicine one day, take the usual\u00a0dose\u00a0the next day.<\/p>\n\n\n\n<p>Do not take a\u00a0double\u00a0dose\u00a0to make up for missed\u00a0doses. Contact your doctor or pharmacist if you have further questions about this medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible Tolucombi Side Effects<\/h2>\n\n\n\n<p>This medicine can cause side effects like all medicines, although not everybody gets them.<\/p>\n\n\n\n<p><strong>Some&nbsp;side effects&nbsp;can be serious and require immediate medical treatment.<\/strong><\/p>\n\n\n\n<p>Contact your doctor immediately if you experience any of the following symptoms:<\/p>\n\n\n\n<p><strong>Sepsis* (which is often called &#8220;blood poisoning&#8221;) is a severe\u00a0infection\u00a0with inflammatory reactions throughout the body, rapid swelling of the skin and mucous membranes (\u00a0angioedema\u00a0), blisters, and peeling of the outermost layer of the skin (\u00a0toxic epidermal necrolysis\u00a0);\u00a0<\/strong><\/p>\n\n\n\n<p>These\u00a0side effects\u00a0are rare (may occur in up to 1 in 1,000 users) or have an unknown frequency (\u00a0toxic epidermal necrolysis\u00a0) but are extremely serious. Patients should stop taking medicine and see a doctor immediately.<\/p>\n\n\n\n<p>The conditions can be fatal if left untreated. An increased incidence of\u00a0sepsis\u00a0has been observed with telmisartan alone but cannot be excluded for Tolucombi.<\/p>\n\n\n\n<p><strong>Possible&nbsp;side effects&nbsp;of Tolucombi:<\/strong><\/p>\n\n\n\n<p><strong><em>Common\u00a0tolucombi side effects\u00a0(<\/em>\u00a0may affect up to 1 in 10 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Dizziness<\/li><\/ul>\n\n\n\n<p><strong><em>Uncommon\u00a0side effects\u00a0(<\/em>\u00a0may affect up to 1 in 100 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Decreased potassium levels<\/li><li>Restlessness<\/li><li>Fainting (\u00a0syncope\u00a0)<\/li><li>Experiencing numbness<\/li><li>Tingling (paraesthesia)<\/li><li>Dizziness (\u00a0vertigo\u00a0)<\/li><li>Fast heart rate (\u00a0tachycardia\u00a0)<\/li><li>Heart rhythm disturbances<\/li><li>Low\u00a0blood pressure<\/li><li>Sudden drop in blood pressure when standing up<\/li><li>Shortness of breath (\u00a0dyspnoea\u00a0)<\/li><li>Diarrhea<\/li><li>Dry mouth<\/li><li>Whether tension<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/back-hurts\/\">Back pain<\/a><\/li><li>Muscle spasms<\/li><li>Muscle pain<\/li><li>Erectile dysfunction\u00a0(inability to get or maintain\u00a0an erection\u00a0)<\/li><li>Chest pain<\/li><li>The increased uric acid level in the blood<\/li><\/ul>\n\n\n\n<p><strong><em>Rare\u00a0side effects\u00a0(<\/em>\u00a0may affect up to 1 in 1,000 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Inflammation\u00a0of the lungs (\u00a0bronchitis\u00a0)<\/li><li>Activation or worsening of systemic lupus erythematosus (a disease in which the body&#8217;s immune system attacks its own body, causing <a href=\"https:\/\/zeepedia.com\/medical\/diseases\/joint-pain\/\">joint pain<\/a>, skin rash, and fever)<\/li><li><a href=\"https:\/\/zeepedia.com\/medical\/diseases\/sore-throat\/\">Sore throat<\/a><\/li><li>Inflamed sinuses<\/li><li>Depression<\/li><li>Insomnia<\/li><li>Impaired vision<\/li><li>Difficulty breathing<\/li><li>Stomach pain<\/li><li>Constipation<\/li><li>Belching (\u00a0dyspepsia\u00a0)<\/li><li>Nausea (vomiting)<\/li><li>Inflammation\u00a0of the stomach (\u00a0gastritis\u00a0)<\/li><li>Abnormal liver function (Japanese patients are more likely to have this side effect)<\/li><li>Reddening\u00a0of the skin (\u00a0erythema\u00a0)<\/li><li>Allergic reactions such as\u00a0itching\u00a0or rash;<ul><li>Increased sweating<\/li><\/ul><\/li><li>Hives\u00a0(\u00a0urticaria\u00a0)<\/li><li>Joint pain (\u00a0arthralgia\u00a0) and pain in the arms and legs<\/li><li>Muscle cramps<\/li><li>Flu-like illness<\/li><li>Pain<\/li><li>Low levels of\u00a0sodium\u00a0in the blood<\/li><li>Increased levels of\u00a0creatinine<\/li><li>Liver enzymes or creatine phosphokinase in the blood<\/li><\/ul>\n\n\n\n<p>Side effects&nbsp;reported for one of the individual components may be a possible side effect with Tolucombi, even if they were not observed in&nbsp;clinical studies&nbsp;with this drug.<\/p>\n\n\n\n<p><strong><em>Telmisartan<\/em><\/strong><\/p>\n\n\n\n<p>In patients using only telmisartan, the following&nbsp;side effects&nbsp;have also been reported:<\/p>\n\n\n\n<p><strong><em>Uncommon\u00a0side effects\u00a0(<\/em>\u00a0may affect up to 1 in 100 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Upper respiratory infection (for example, sore throat)<\/li><li>Inflamed sinuses (The common cold)<\/li><li>Urinary tract infections<\/li><li>Lack red blood cells\u00a0(\u00a0anemia\u00a0)<\/li><li>High potassium levels<\/li><li>Slow heart rate (\u00a0bradycardia\u00a0)<\/li><li>Impaired kidney function, including\u00a0acute\u00a0kidney failure<\/li><li>Weakness,<\/li><li>Cough<\/li><\/ul>\n\n\n\n<p><strong><em>Rare\u00a0side effects\u00a0(<\/em>\u00a0may affect up to 1 in 1,000 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Low\u00a0platelet count\u00a0(\u00a0thrombocytopenia\u00a0)<\/li><li>Increase in certain\u00a0white blood cells\u00a0(\u00a0eosinophilia\u00a0)<\/li><li>Severe allergic reactions (for example, hypersensitivity,\u00a0anaphylactic reaction, drug rash)<\/li><li>Low blood sugar (in patients with\u00a0diabetes\u00a0)<\/li><li>Upset stomach<\/li><li>Eczema\u00a0(a skin disease)<\/li><li>Osteoarthritis<\/li><li>Tendonitis<\/li><li>Decreased hemoglobin levels (a\u00a0protein\u00a0in the blood),\u00a0tiredness<\/li><\/ul>\n\n\n\n<p><strong><em>Very rare\u00a0side effects\u00a0(<\/em>\u00a0may affect up to 1 in 10,000 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Progressive\u00a0scarring of lung tissue (interstitial lung disease)**<\/li><\/ul>\n\n\n\n<p>* These\u00a0side effects\u00a0may be coincidental or related to a currently unknown mechanism.<\/p>\n\n\n\n<p>** Cases of&nbsp;progressive&nbsp;scarring of lung tissue have been reported with treatment with telmisartan.&nbsp;However, it is not known whether telmisartan is the cause.<\/p>\n\n\n\n<p><em><span style=\"text-decoration: underline;\">Hydrochlorothiazide<\/span><\/em><\/p>\n\n\n\n<p>In patients using only&nbsp;hydrochlorothiazide, the following&nbsp;side effects&nbsp;have also been reported:<\/p>\n\n\n\n<p><em><strong>Common\u00a0side effects\u00a0(may affect up to 1 in 10 users):<\/strong><\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Nausea<\/li><li>Low levels of\u00a0magnesium\u00a0in the blood<\/li><\/ul>\n\n\n\n<p><em><strong>Rare\u00a0side effects\u00a0(may affect up to 1 in 1,000 users):<\/strong><\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Decreased number of\u00a0blood platelets increases the risk of bleeding or bruising (small purple-red dots in the skin or other\u00a0tissue\u00a0caused by bleeding)<\/li><li>High levels of\u00a0calcium\u00a0in the blood<\/li><li>Headache<\/li><\/ul>\n\n\n\n<p><strong>Very rare\u00a0side effects\u00a0(may affect up to 1 in 10,000 users):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Increased\u00a0pH\u00a0(disturbed acid-base balance) due to low chloride levels in the blood,\u00a0acute\u00a0respiratory distress syndrome signs of this are:<ul><li>Severe shortness of breath<\/li><li>Fever<\/li><li>Weakness<\/li><li>Confusion<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong><em>Side effects\u00a0with no known frequency (frequency cannot be calculated from available data)<\/em>:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Salivary\u00a0gland inflammation<\/li><li>Skin and lip cancer (Non-\u00a0melanoma\u00a0skin cancer)<\/li><li>Decreased number (or even lack of)\u00a0blood cells, including low red and\u00a0white blood cell counts<\/li><li>Severe allergic reactions eg:<ul><li>Hypersensitivity<\/li><li>Anaphylactic reactions<\/li><\/ul><\/li><li>Decreased appetite or loss of appetite<\/li><li>Restlessness<\/li><li>Dizziness<\/li><li>Blurred vision or yellow-colored field of\u00a0vision<\/li><li>Impaired vision and eye pain (possible sign of fluid accumulation in the eye (between the choroid and the sclera) or\u00a0acute\u00a0narrow-angle glaucoma\u00a0)<\/li><li>Inflammation\u00a0of blood vessels (\u00a0necrotizing\u00a0vasculitis\u00a0)<\/li><li>Inflamed\u00a0pancreas<\/li><li>Upset stomach<\/li><li>Yellowed skin or yellowed eyes (jaundice)<\/li><li>Lupus-like syndrome (a condition similar to a disease called systemic lupus erythematosus in which the body&#8217;s immune system attacks its own body)<\/li><li>Skin diseases such as:<ul><li>Inflamed blood vessels in the skin<\/li><li>Increased sensitivity to sunlight<\/li><li>Rash<\/li><li>Redness of the skin<\/li><li>Blisters on the lips, eyes or mouth<\/li><li>Scaly skin<\/li><\/ul><\/li><li>Fever (possible signs of erythema multiforme)<\/li><li>Weakness, inflammation of the kidneys or impaired kidney function<\/li><li>Glucose in the urine (glycosuria)<\/li><li>Fever<\/li><li>Impaired salt balance (electrolyte balance)<\/li><li>High blood cholesterol levels<\/li><li>Decreased blood volume<\/li><li>Increased blood glucose levels<\/li><li>Difficulty controlling blood\/urine glucose levels in patients with\u00a0diabetes\u00a0or fat in the blood<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Should Tolucombi Be Stored?<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Keep this medicine out of sight and reach of children.<\/li><li>Use before the expiry date stated on the carton, and blister after EXP.\u00a0The expiration date is the last day of the specified month.<\/li><li>No special temperature instructions.\u00a0Store in the original packaging to protect against<\/li><li>Medicines must not be thrown into the drain or among the household waste.\u00a0Ask the pharmacist how to dispose of medicines that are no longer used.\u00a0These measures will help to protect the environment.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Contents Of The Packaging And Other Information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Contents Declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li><em>The active ingredients are telmisartan and\u00a0hydrochlorothiazide.<\/em><\/li><li>Each tablet contains 40 mg telmisartan and 12.5 mg\u00a0hydrochlorothiazide.<\/li><li>Each tablet contains 80 mg telmisartan and 12.5 mg\u00a0hydrochlorothiazide.<\/li><li>Each tablet contains 80 mg telmisartan and 25 mg\u00a0hydrochlorothiazide.<\/li><li>Other ingredients are hydroxypropyl cellulose,\u00a0lactose monohydrate, magnesium stearate, meglumine, povidone (K30), red iron oxide (E172) \u2013 only in the 40 mg\/12.5 mg and 80 mg\/12.5 mg tablets, anhydrous\u00a0colloidal\u00a0silicon, sodium hydroxide (E524), sodium stearyl fumarate, sorbitol (E420) and yellow iron oxide (E172) \u2013 only in the 80 mg\/25 mg tablets.\u00a0See section 2, &#8220;Tolucombi contains\u00a0lactose, sorbitol, and sodium&#8221;.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Appearance And Package Sizes Of The Medicine:<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>40 mg\/12.5 mg tablets: white to off-white or pinkish white on one side and pink marbled on the other of the bi-layer biconvex, oval tablet, tablet dimensions 15 mm x 7 mm.<\/li><li>80 mg\/12.5 mg tablets: white to off-white or pinkish white on one side and pink marble on the other of the bi-layered biconvex, oval tablet, tablet dimensions 18 mm x 9 mm.<\/li><li>80 mg\/25 mg tablets: white to yellowish white on one side and yellow marbled on the other of the bilayer biconvex, oval tablet, tablet dimensions 18 mm x 9 mm.<\/li><li>Blister (OPA\/Al\/PVC foil\/\/Al foil): 14 x 1, 28 x 1, 30 x 1, 56 x 1, 60 x 1, 84 x 1, 90 x 1, 98 x 1 and 100 x 1 tablet in a carton.<\/li><li>Blister (OPA\/Al\/PE foil with desiccant\/\/Al foil): 14 x 1 and 98 x 1 tablets in a carton.<\/li><li>Not all pack sizes may be marketed<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorization Holder And Manufacturer:<\/h2>\n\n\n\n<p><strong>Marketing Authorisation Holder<\/strong><\/p>\n\n\n\n<p>KRKA, dd, Novo mesto, \u0160marje\u0161ka cesta 6, 8501 Novo mesto, Slovenia<\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>KRKA, dd, Novo mesto, \u0160marje\u0161ka cesta 6, 8501 Novo mesto, Slovenia<\/p>\n\n\n\n<p>KRKA-POLSKA Sp.&nbsp;z o. o., ul.&nbsp;R\u00f3wnoleg\u0142a 5, 02-235 Warsaw, Poland<\/p>\n\n\n\n<p>TAD Pharma GmbH, Heinz-Lohmann-Stra\u00dfe 5, 27472 Cuxhaven, Germany<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tolucombi is used for persons with hypertension not managed sufficiently by telmisartan alone. <\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,22500],"tags":[3664,4301,17468,17471,26067,26070,7947,4300,17469,26068,17470,26069],"class_list":["post-25204","post","type-post","status-publish","format-standard","hentry","category-medicines","category-t","tag-hydrochlorothiazide","tag-hydrochlorothiazide-tablet","tag-telmisartan","tag-telmisartan-tablet","tag-tolucombi","tag-tolucombi-tablet","tag-what-hydrochlorothiazide-is-used-for","tag-what-is-hydrochlorothiazide","tag-what-is-telmisartan","tag-what-is-tolucombi","tag-what-telmisartan-is-used-for","tag-what-tolucombi-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25204","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=25204"}],"version-history":[{"count":76,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25204\/revisions"}],"predecessor-version":[{"id":50022,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/25204\/revisions\/50022"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=25204"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=25204"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=25204"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}