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The drug Tolucombi is used in the treatment of hypertension with the main ingredients being Telmisartan 40mg and Hydrochlorothiazide 12.5. To ensure safety for your health and maximize the effectiveness of your treatment, you need to take Tolucombi exactly as directed by your doctor.
1. What is Tolucombi?
Tolucombi belongs to the group of cardiovascular drugs, prepared in the form of tablets, packed in boxes of 4 blisters x 7 tablets.
Tolucombi drug has ingredients:
Telmisartan 40mg; Hydrochlorothiazide 12.5; Excipients: Meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, mannitol DC, ferric oxide yellow (E172)/ferric oxide red (E172), hydroxypropylcellulose, colloidal silica anhydrous, sodium stearyl fumarate .
2. What is the effect of Tolucombi?
Tolucombi is used in combination with telmisartan and hydrochlorothiazide for the treatment of essential hypertension in adults.
Tolucombi is not indicated for initial treatment in the treatment of hypertension.
When necessary, Tolucombi can be combined with another antihypertensive drug.
3. Dosage, how to use Tolucombi
How to use:
Take Tolucombi once a day and not depend on meals. Dosage:
Adults: Take 1 Tolucombi tablet per day. If necessary, the dose of Tolucombi can be increased to 160 mg Telmisartan and 25 mg Hydrochlorothiazide. Before increasing the dose of Tolucombi, it should be noted that the maximum antihypertensive effect is usually achieved after 4 to 8 weeks of treatment. Patients with renal impairment:
Do not use Tolucombi in patients with severe renal impairment (creatinine clearance ≤ 30ml/min). Loop diuretics are preferred over thiazides in these patients. Patients with moderate to mild renal impairment do not need to adjust the dose of Tolucombi. Patients with hepatic impairment:
In patients with mild or moderate hepatic impairment, the dose of Tolucombi should not exceed 1⁄2 tablets once daily. Tolucombi is contraindicated in patients with severe hepatic impairment. Use with caution in patients with impaired liver function. Elderly patients: No dose adjustment of Tolucombi is required. Children < 18 years: The safety and effectiveness of Tolucombi have not been established. Tolucombi overdose and management:
Information on Tolucombi overdose in humans is limited. Manifestations of overdose may include bradycardia or tachycardia, excessive hypotension, dizziness, lightheadedness, fluid and electrolyte disturbances, vomiting, somnolence.
In case of overdose of Tolucombi drug, it is necessary to treat symptoms and combine support (induce vomiting, gastric lavage, use activated charcoal, rehydration, electrolyte balance, management of hepatic coma, management of hyponatremia. pressure), discontinue Tolucombi immediately and closely monitor the patient.
4. Contraindications to the use of Tolucombi
Tolucombi drug should not be used in the following cases:
Patients with hypersensitivity to Telmisartan, to Thiazides or to any of its ingredients. Women who are pregnant (first 3 months, last 3 months) or breastfeeding. Anuria person. Severe renal/liver failure, biliary obstruction. Hypokalemia, hypercalcemia. Patients with diabetes. Hypersensitivity to sulphonamide derivatives.
5. Tolucombi . drug interactions
The following are some of the reported Tolucombi drug interactions such as:
Lithium combined with Tolucombi causes increased levels and toxicity of Lithium. Potassium-depleting diuretics, laxatives, corticosteroids, Penicillin G sodium, ACTH, Amphotericin, Carbenoxolone, Salicylic acid co-administered with Tolucombi, plasma potassium concentration should be monitored. ACE inhibitors, low-potassium diuretics, potassium-containing salt substitutes, potassium supplements and cyclosporine when co-administered with Tolucombi require monitoring of plasma potassium levels. Tolucombi is used with digitalis glycosides, antiarrhythmic drugs (Quinidine, Hydroquinidine, Disopyramide, Amiodarone, Sotalol, Dofetilide, Ibutilide) and hypokalemic agents, requiring periodic monitoring of serum potassium. Sedatives such as Thioridazine, Chlorpromazine, Trifluoperazine, Levomepromazine, Cyamemazine, Sulpiride, Sultopride, Amisulpride, Haloperidol, Tiapride, Pimozide, Droperidol. Other drugs such as Bepridil, Pentamidine, Cisapride, Diphemanil, Erythromycin IV, Vincamine IV, Halofantrin, Mizolastin, Sparfloxacine, Terfenadine. Glycosidtim in combination with Tolucombi can cause hypokalemia and hypomagnesaemia. Digoxin in combination with Tolucombi increased mean peak concentration by 49% and trough concentration by 20%, plasma digoxin monitoring should be considered. Antidiabetic drugs including oral medications and insulin. Metformin in combination with Tolucombi may increase the risk of lactic acidosis and decrease in renal function that may be related to Hydrochlorothiazide. Non-steroidal anti-inflammatory drugs. Noradrenaline combined with Tolucombi reduces the effect of increasing blood pressure. Non-depolarizing skeletal muscle relaxants may be potentiated by hydrochlorothiazide when co-administered with Tolucombi. Gout medication. Calcium salts in combination with Tolucombi may increase serum calcium levels due to decreased excretion. Beta blockers and Diazoxide. Anticholinergic drugs such as Atropine, Biperiden. Amantadine Drugs Cytotoxic drugs such as Cyclophosphamide, Methotrexate in combination with Tolucombi can reduce the renal excretion of cytotoxic products and affect their myelosuppressive effects.
6. Side effects when taking Tolucombi
During the use of Tolucombi, patients may experience some unwanted side effects such as:
Fatigue, dizziness, anxiety, headache, severe hypotension, swelling of hands and feet, blurred vision. , sweating profusely... Agitation, digestive disorders (nausea, abdominal pain, indigestion, loss of appetite, diarrhea, reflux); Inflammation of the respiratory tract (cough, sore throat, sinusitis, sneezing, ...). Rare cases of visual disturbances, blurred vision, cardiac arrhythmias, anaphylaxis...
7. Precautions when using Tolucombi
Monitor blood potassium levels, especially in the elderly and people with kidney failure. Reduce the initial dose of Tolucombi in these patients. Use with caution in patients with aortic or mitral valve stenosis, hypertrophic obstructive cardiomyopathy, severe congestive heart failure. Tolucombi should be used with caution in patients with advanced gastric and duodenal ulcers or other gastrointestinal diseases because it may increase the risk of gastrointestinal bleeding. Use with caution in patients with renal artery stenosis. Tolucombi should be used with caution in patients with a history of angioedema, whether or not related to ACE inhibitors or angiotensin II receptor blockers. Tolucombi should be used with caution in patients with severe renal impairment as it may increase blood urea nitrogen and further impair renal function. Tolucombi should be used with caution in patients with liver failure due to the risk of hepatic coma. Use caution when using Tolucombi for people with Gout because the disease can be aggravated. Use caution when using Tolucombi for people with diabetes, need to adjust insulin, hypoglycemic drugs because Tolucombi can increase blood glucose. The antihypertensive effect of hydrochlorothiazide is enhanced in patients after sympathectomy. Tolucombi should be used with caution in the elderly because it is easy to lose electrolyte balance. Tolucombi is contraindicated in pregnant women because the drug can cause renal failure, hypotension, anuria, decreased skull bone production in the neonate, fetal death, low amniotic fluid, limb spasticity, and complications. craniofacial form and hypoplastic lung have been reported. It has not been accurately reported whether Telmisartan is excreted in human milk, but thiazides have been reported to pass into breast milk. Therefore, a decision should be made whether to discontinue nursing or discontinue Tolucombi as directed by the physician. Caution should be exercised if Tolucombi is used while driving or operating machinery as it can cause fatigue, headache, and dizziness. Above is important information about Tolucombi drug, patients should carefully read the instructions for use and use according to the dose prescribed by the doctor to achieve the best effect.
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