receptor f

antagonists

lCONTRA-INDICATIONSThe combination of an angiotensin-II receptor antagonist with aliskiren is contra-indicated in patients with an eGFR less than60mL/minute/1.73m²

.

the combination of an angiotensin-II receptor antagonist with aliskiren is contra-indictated in patients with diabetes mellitus

lCAUTIONSAfro-Caribbean patients—particularly those with left ventricular hypertrophy (may not benefit from an angiotensin-II receptor antagonist)

.

aortic or mitral valve stenosis

.

elderly (lower initial doses may be appropriate)

.

hypertrophic cardiomyopathy

.

patients with a history of angioedema

.

patients with primary aldosteronism (may not benefit from an angiotensin-II receptor antagonist)

.

renal artery stenosis

lSIDE-EFFECTSHyperkalaemia

.

angioedema (may be delayed onset)

.

symptomatic hypotension including dizziness (particularly in patients with intravascular volume depletion, e.g. those taking high-dose diuretics) lPREGNANCYAngiotensin-II receptor antagonists should

be avoided in pregnancy unless essential. They may adversely affect fetal and neonatal blood pressure control and renal function; neonatal skull defects and oligohydramnios have also been reported.

lBREAST FEEDINGInformation on the use of angiotensin-II receptor antagonists in breast-feeding is limited. They are not recommended in breast-feeding and alternative treatment options, with better established safety information during breast-feeding, are available.

lRENAL IMPAIRMENTUse with caution, starting with low dose, and adjust according to response.

lMONITORING REQUIREMENTSMonitor plasma-potassium concentration, particularly in the elderly and in patients with renal impairment.

eiiiFabovei

Azilsartan medoxomil

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult 18–74 years:Initially40mg once daily, increased if necessary to80mg once daily

▶Adult 75 years and over:Initially20–40mg once daily, increased if necessary to80mg once daily Hypertension with intravascular volume depletion

▶BY MOUTH

▶Adult:Initially20–40mg daily, increased if necessary to80mg daily

lCAUTIONSHeart failure

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonDiarrhoea

.

raised creatine kinase

▶UncommonHyperuricaemia

.

peripheral oedema

.

raised creatinine

.

malaise

BNF74

Hypertension 169

Cardiovascularsystem

2

lHEPATIC IMPAIRMENTManufacturer advises to consider initial dose of20mg in mild to moderate impairment (limited information available). Manufacturer advises avoid in severe impairment (no information available).

Manufacturer advises monitor closely in mild to moderate hepatic impairment (limited information available).

lRENAL IMPAIRMENT Manufacturer advises caution in severe impairment—no information available.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Edarbi(Takeda UK Ltd)

Azilsartan medoxomil 20 mgEdarbi20mg tablets|28tabletP

£16.80DT price = £16.80

Azilsartan medoxomil 40 mgEdarbi40mg tablets|28tabletP

£16.80DT price = £16.80

Azilsartan medoxomil 80 mgEdarbi80mg tablets|28tabletP

£19.95DT price = £19.95

eiiiF169i

Candesartan cilexetil

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult:Initially8mg once daily, increased if necessary up to32mg once daily, doses to be increased at intervals of4weeks; usual dose8mg once daily Hypertension with intravascular volume depletion

▶BY MOUTH

▶Adult:Initially4mg once daily, increased if necessary up to32mg daily, doses to be increased at intervals of 4weeks; usual dose8mg once daily

Heart failure with impaired left ventricular systolic function when ACE inhibitors are not tolerated|Heart failure with impaired left ventricular systolic function in conjunction with an ACE inhibitor (under expert supervision)

▶BY MOUTH

▶Adult:Initially4mg once daily, increased at intervals of at least2weeks to’target’dose of32mg once daily or to maximum tolerated dose

lCONTRA-INDICATIONSCholestasis

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonHeadache

.

vertigo

▶Very rareArthralgia

.

back pain

.

blood disorders

.

cough

.

hepatitis

.

hyponatraemia

.

myalgia

.

nausea

.

pruritus

.

rash

.

urticaria

lHEPATIC IMPAIRMENTInitially4mg once daily in mild or moderate impairment. Avoid in severe hepatic impairment.

lRENAL IMPAIRMENT Initially4mg daily. Use with caution if eGFR less than15mL/minute/1.73m²—limited experience.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet

▶Candesartan cilexetil (Non-proprietary)

Candesartan cilexetil 2 mgCandesartan2mg tablets|7 tabletP £3.40DT price = £1.92

Candesartan cilexetil 4 mgCandesartan4mg tablets|7 tabletP £7.82DT price = £0.66|28tabletP £9.78 Candesartan cilexetil 8 mgCandesartan8mg tablets|28 tabletP £9.89DT price = £0.98

Candesartan cilexetil 16 mgCandesartan16mg tablets|28 tabletP £12.72DT price = £1.15

Candesartan cilexetil 32 mgCandesartan32mg tablets|28 tabletP £16.13DT price = £1.59

▶Amias(Takeda UK Ltd)

Candesartan cilexetil 2 mgAmias2mg tablets|7tabletP

£3.58DT price = £1.92

Candesartan cilexetil 4 mgAmias4mg tablets|7tabletP

£3.88DT price = £0.66|28tabletP £9.78

Candesartan cilexetil 8 mgAmias8mg tablets|28tabletP

£9.89DT price = £0.98

Candesartan cilexetil 16 mgAmias16mg tablets|28tabletP

£12.72DT price = £1.15

Candesartan cilexetil 32 mgAmias32mg tablets|28tabletP

£16.13DT price = £1.59

eiiiF169i

Eprosartan

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult:600mg once daily

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonHeadache

.

nausea

.

rhinitis

.

diarrhoea

.

_malaise

.

_vomiting

lHEPATIC IMPAIRMENTCaution in mild or moderate liver disease. Avoid in severe impairment.

lRENAL IMPAIRMENTCaution if eGFR less than 30mL/minute/1.73m².

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet

CAUTIONARY AND ADVISORY LABELS21

▶Eprosartan (Non-proprietary)

Eprosartan (as Eprosartan mesilate) 300 mgEprosartan300mg tablets|28tabletP £7.31DT price = £6.98

Eprosartan (as Eprosartan mesilate) 400 mgEprosartan400mg tablets|56tabletP £25.85DT price = £19.11

Eprosartan (as Eprosartan mesilate) 600 mgEprosartan600mg tablets|28tabletP £14.31DT price = £13.66

▶Teveten(Mylan Ltd)

Eprosartan (as Eprosartan mesilate) 300 mgTeveten300mg tablets|28tabletP £7.31DT price = £6.98

Eprosartan (as Eprosartan mesilate) 600 mgTeveten600mg tablets|28tabletP £14.31DT price = £13.66

eiiiF169i

Irbesartan

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult 18–74 years:Initially150mg once daily, increased if necessary to300mg once daily

▶Adult 75 years and over:Initially75–150mg once daily, increased if necessary to300mg once daily Hypertension in patients receiving haemodialysis

▶BY MOUTH

▶Adult:Initially75–150mg once daily, increased if necessary to300mg once daily

Renal disease in hypertensive type2diabetes mellitus

▶BY MOUTH

▶Adult 18–74 years:Initially150mg once daily, increased if tolerated to300mg once daily

▶Adult 75 years and over:Initially75–150mg once daily, increased if tolerated to300mg once daily

170 Blood pressure conditions

BNF74

Cardiovascularsystem

2

Renal disease in hypertensive type2diabetes mellitus in patients receiving haemodialysis

▶BY MOUTH

▶Adult:Initially75–150mg once daily, increased if tolerated to300mg once daily

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonFatigue

.

musculoskeletal pain

.

nausea

.

vomiting

▶UncommonChest pain

.

cough

.

diarrhoea

.

dyspepsia

.

flushing

.

sexual dysfunction

.

tachycardia

▶RareRash

.

urticaria

▶Very rareArthralgia

.

cutaneous vasculitis

.

headache

.

hepatitis

.

myalgia

.

renal dysfunction

.

taste disturbance

.

tinnitus lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension

Tablet

▶Irbesartan (Non-proprietary)

Irbesartan 75 mgIrbesartan75mg tablets|28tabletP £9.21 DT price = £0.97

Irbesartan 150 mgIrbesartan150mg tablets|28tabletP

£11.25DT price = £1.19

Irbesartan 300 mgIrbesartan300mg tablets|28tabletP

£15.13DT price = £1.63

▶Aprovel(Sanofi)

Irbesartan 75 mgAprovel75mg tablets|28tabletP £9.69DT price = £0.97

Irbesartan 150 mgAprovel150mg tablets|28tabletP£11.84 DT price = £1.19

Irbesartan 300 mgAprovel300mg tablets|28tabletP £15.93 DT price = £1.63

▶Ifirmasta(Consilient Health Ltd)

Irbesartan 75 mgIfirmasta75mg tablets|28tabletP £8.23DT price = £0.97

Irbesartan 150 mgIfirmasta150mg tablets|28tabletP £10.06 DT price = £1.19

Irbesartan 300 mgIfirmasta300mg tablets|28tabletP

£13.54DT price = £1.63

Irbesartan with hydrochlorothiazide

The properties listed below are those particular to the combination only. For the properties of the components please consider, irbesartan p.170, hydrochlorothiazide p.162.

lINDICATIONS AND DOSE

Hypertension not adequately controlled with irbesartan alone

▶BY MOUTH

▶Adult:(consult product literature)

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, thiazide diuretics

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Irbesartan with hydrochlorothiazide (Non-proprietary) Hydrochlorothiazide 12.5 mg, Irbesartan 150 mgIrbesartan 150mg / Hydrochlorothiazide12.5mg tablets|28tabletP £10.06 DT price = £4.65

Hydrochlorothiazide 25 mg, Irbesartan 300 mgIrbesartan300mg / Hydrochlorothiazide25mg tablets|28tabletP £13.54DT price

= £6.61

Hydrochlorothiazide 12.5 mg, Irbesartan 300 mgIrbesartan 300mg / Hydrochlorothiazide12.5mg tablets|28tabletP £13.54 DT price = £2.00

▶CoAprovel(Sanofi)

Hydrochlorothiazide 12.5 mg, Irbesartan 150 mgCoAprovel 150mg/12.5mg tablets|28tabletP £11.84DT price = £4.65 Hydrochlorothiazide 25 mg, Irbesartan 300 mgCoAprovel 300mg/25mg tablets|28tabletP£15.93DT price = £6.61 Hydrochlorothiazide 12.5 mg, Irbesartan 300 mgCoAprovel 300mg/12.5mg tablets|28tabletP £15.93DT price = £2.00

eiiiF169i

Losartan potassium

lINDICATIONS AND DOSE

Diabetic nephropathy in type2diabetes mellitus

▶BY MOUTH

▶Adult 18–75 years:Initially50mg once daily for several weeks, then increased if necessary to100mg once daily

▶Adult 76 years and over:Initially25mg once daily for several weeks, then increased if necessary to100mg once daily

Chronic heart failure when ACE inhibitors are unsuitable or contra-indicated

▶BY MOUTH

▶Adult:Initially12.5mg once daily, increased if tolerated to up to150mg once daily, doses to be increased at weekly intervals

Hypertension (including reduction of stroke risk in hypertension with left ventricular hypertrophy)

▶BY MOUTH

▶Adult 18–75 years:Initially50mg once daily for several weeks, then increased if necessary to100mg once daily

▶Adult 76 years and over:Initially25mg once daily for several weeks, then increased if necessary to100mg once daily

Hypertension with intravascular volume depletion

▶BY MOUTH

▶Adult 18–75 years:Initially25mg once daily for several weeks, then increased if necessary up to100mg once daily

lCAUTIONSSevere heart failure

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonVertigo

▶UncommonAngina

.

dyspnoea

.

gastro-intestinal disturbances

.

headache

.

malaise

.

oedema

.

palpitation

.

pruritus

.

rash

.

sleep disorders

.

urticaria

▶RareAtrialfibrillation

.

cerebrovascular accident

.

hepatitis

.

paraesthesia

.

syncope

▶Frequency not knownAnaemia

.

anaphylaxis

.

arthralgia

.

cough

.

depression

.

erectile dysfunction

.

Henoch-Schönlein purpura

.

hyponatraemia

.

myalgia

.

pancreatitis

.

photosensitivity

.

renal impairment

.

rhabdomyolysis

.

thrombocytopenia

.

tinnitus

.

vasculitis

lHEPATIC IMPAIRMENTConsider dose reduction in mild to moderate impairment. Manufacturer advises avoid in severe impairment—no information available.

lPRESCRIBING AND DISPENSING INFORMATIONFlavours of oral liquid formulations may include berry-citrus.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Oral suspension

▶Cozaar(Merck Sharp & Dohme Ltd)

Losartan potassium 2.5 mg per 1 mlCozaar2.5mg/ml oral suspension sugar-free|200mlP £53.68DT price = £53.68 Tablet

▶Losartan potassium (Non-proprietary)

Losartan potassium 12.5 mgLosartan12.5mg tablets|28 tabletP £30.00DT price = £26.66

BNF74

Hypertension 171

Cardiovascularsystem

2

Losartan potassium 25 mgLosartan25mg tablets|28tabletP

£16.18DT price = £0.80

Losartan potassium 50 mgLosartan50mg tablets|28tabletP

£12.80DT price = £0.86

Losartan potassium 100 mgLosartan100mg tablets|28 tabletP £16.18DT price = £0.99

▶Cozaar(Merck Sharp & Dohme Ltd)

Losartan potassium 12.5 mgCozaar12.5mg tablets|28 tabletP £9.70DT price = £26.66

Losartan potassium 25 mgCozaar25mg tablets|28tabletP

£16.18DT price = £0.80

Losartan potassium 50 mgCozaar50mg tablets|28tabletP

£12.80DT price = £0.86

Losartan potassium 100 mgCozaar100mg tablets|28 tabletP £16.18DT price = £0.99

Losartan with hydrochlorothiazide

The properties listed below are those particular to the combination only. For the properties of the components please consider, losartan potassium p.171,

hydrochlorothiazide p.162.

lINDICATIONS AND DOSE

Hypertension not adequately controlled with losartan alone

▶BY MOUTH

▶Adult:(consult product literature)

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, thiazide diuretics

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Losartan with hydrochlorothiazide (Non-proprietary) Hydrochlorothiazide 12.5 mg, Losartan potassium 50 mgLosartan50mg / Hydrochlorothiazide12.5mg tablets|28 tabletP £13.75DT price = £1.31

Hydrochlorothiazide 25 mg, Losartan potassium 100 mgLosartan 100mg / Hydrochlorothiazide25mg tablets|28tabletP£16.18 DT price = £1.55

Hydrochlorothiazide 12.5 mg, Losartan potassium

100 mgLosartan100mg / Hydrochlorothiazide12.5mg tablets|28 tabletP £16.18DT price = £10.12

▶Cozaar-Comp(Merck Sharp & Dohme Ltd)

Hydrochlorothiazide 12.5 mg, Losartan potassium 50 mg Cozaar-Comp50mg/12.5mg tablets|28tabletP £12.80DT price = £1.31 Hydrochlorothiazide 25 mg, Losartan potassium 100 mg Cozaar-Comp100mg/25mg tablets|28tabletP £16.18DT price = £1.55 Hydrochlorothiazide 12.5 mg, Losartan potassium

100 mgCozaar-Comp100mg/12.5mg tablets|28tabletP

£16.18DT price = £10.12

eiiiF169i

Olmesartan medoxomil

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult:Initially10mg daily, increased if necessary to 20mg daily; maximum40mg per day

lCONTRA-INDICATIONSBiliary obstruction

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonArthritis

.

chest pain

.

cough

.

fatigue

.

gastro-intestinal disturbances

.

haematuria

.

hypertriglyceridaemia

.

hyperuricaemia

.

influenza-like symptoms

.

musculoskeletal pain

.

peripheral oedema

.

pharyngitis

.

rhinitis

.

urinary-tract infection

▶UncommonAngina

.

rash

.

vertigo

▶Very rareHeadache

.

myalgia

.

pruritus

.

thrombocytopenia

.

urticaria

lHEPATIC IMPAIRMENTDose should not exceed20mg daily in moderate impairment. Manufacturer advises avoid in severe impairment—no information available.

lRENAL IMPAIRMENTMax.20mg daily if eGFR 20–60mL/minute/1.73m². Avoid if eGFR less than 20mL/minute/1.73m².

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet

▶Olmesartan medoxomil (Non-proprietary)

Olmesartan medoxomil 10 mgOlmesartan medoxomil10mg tablets

|28tabletP£2.19–£10.95DT price = £10.95

Olmesartan medoxomil 20 mgOlmesartan medoxomil20mg tablets

|28tabletP£4.53–£12.95DT price = £12.95 Olmesartan medoxomil 40 mgOlmesartan medoxomil40mg tablets|28tabletP £7.00–£17.50DT price = £17.50

▶Olmetec(Daiichi Sankyo UK Ltd)

Olmesartan medoxomil 10 mgOlmetec10mg tablets|28 tabletP £10.95DT price = £10.95

Olmesartan medoxomil 20 mgOlmetec20mg tablets|28 tabletP £12.95DT price = £12.95

Olmesartan medoxomil 40 mgOlmetec40mg tablets|28 tabletP £17.50DT price = £17.50

Olmesartan with amlodipine

The properties listed below are those particular to the combination only. For the properties of the components please consider, olmesartan medoxomil above, amlodipine p.150.

lINDICATIONS AND DOSE

Hypertension in patients stabilised on the individual components in the same proportions

▶BY MOUTH

▶Adult:(consult product literature)

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, calcium channel blockers

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Sevikar(Daiichi Sankyo UK Ltd)

Amlodipine (as Amlodipine besilate) 5 mg, Olmesartan medoxomil 20 mgSevikar20mg/5mg tablets|28tabletP

£16.95

Amlodipine (as Amlodipine besilate) 10 mg, Olmesartan medoxomil 40 mgSevikar40mg/10mg tablets|28tabletP

£16.95

Amlodipine (as Amlodipine besilate) 5 mg, Olmesartan medoxomil 40 mgSevikar40mg/5mg tablets|28tabletP

£16.95

172 Blood pressure conditions

BNF74

Cardiovascularsystem

2

Olmesartan with amlodipine and hydrochlorothiazide

The properties listed below are those particular to the combination only. For the properties of the components please consider, olmesartan medoxomil p.172, amlodipine p.150, hydrochlorothiazide p.162.

lINDICATIONS AND DOSE

Hypertension in patients stabilised on the individual components in the same proportions, or for

hypertension not adequately controlled with olmesartan and amlodipine

▶BY MOUTH

▶Adult:(consult product literature)

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, calcium channel blockers, thiazide diuretics lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Sevikar HCT(Daiichi Sankyo UK Ltd)

Amlodipine besilate 5 mg, Hydrochlorothiazide 12.5 mg, Olmesartan medoxomil 20 mgSevikar HCT20mg/5mg/12.5mg tablets|28tabletP£16.95

Amlodipine besilate 5 mg, Hydrochlorothiazide 25 mg, Olmesartan medoxomil 40 mgSevikar HCT40mg/5mg/25mg tablets|28tabletP£16.95

Amlodipine besilate 10 mg, Hydrochlorothiazide 25 mg, Olmesartan medoxomil 40 mgSevikar HCT40mg/10mg/25mg tablets|28tabletP£16.95

Amlodipine besilate 5 mg, Hydrochlorothiazide 12.5 mg, Olmesartan medoxomil 40 mgSevikar HCT40mg/5mg/12.5mg tablets|28tabletP£16.95

Amlodipine besilate 10 mg, Hydrochlorothiazide 12.5 mg, Olmesartan medoxomil 40 mgSevikar HCT40mg/10mg/12.5mg tablets|28tabletP£16.95

Olmesartan with hydrochlorothiazide

The properties listed below are those particular to the combination only. For the properties of the components please consider, olmesartan medoxomil p.172, hydrochlorothiazide p.162.

lINDICATIONS AND DOSE

Hypertension not adequately controlled with olmesartan alone

▶BY MOUTH

▶Adult:(consult product literature)

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, thiazide diuretics

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Olmetec Plus(Daiichi Sankyo UK Ltd)

Hydrochlorothiazide 12.5 mg, Olmesartan medoxomil 20 mgOlmetec Plus20mg/12.5mg tablets|28tabletP£12.95 DT price = £12.95

Olmesartan medoxomil 20 mg, Hydrochlorothiazide 25 mgOlmetec Plus20mg/25mg tablets|28tabletP £12.95DT price = £12.95

Hydrochlorothiazide 12.5 mg, Olmesartan medoxomil 40 mgOlmetec Plus40mg/12.5mg tablets|28tabletP £17.50 DT price = £17.50

eiiiF169i

Telmisartan

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult:Initially20–40mg once daily for at least 4weeks, increased if necessary up to80mg once daily Prevention of cardiovascular events in patients with established atherosclerotic cardiovascular disease, or type2diabetes mellitus with target-organ damage

▶BY MOUTH

▶Adult:80mg once daily

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists

lSIDE-EFFECTS

▶Common or very commonArthralgia

.

back pain

.

chest pain

.

eczema

.

gastro-intestinal disturbances

.

influenza-like symptoms

.

leg cramps

.

myalgia

.

pharyngitis

.

sinusitis

.

urinary-tract infection

▶UncommonAbnormal vision

.

anxiety

.

dry mouth

.

flatulence

.

increased sweating

.

tendinitis-like symptoms

.

vertigo

▶RareBlood disorders

.

bradycardia

.

depression

.

dyspnoea

.

eosinophilia

.

increase in uric acid

.

insomnia

.

pruritus

.

rash

.

tachycardia

▶Frequency not knownAsthenia

.

syncope

lHEPATIC IMPAIRMENT20–40mg once daily in mild or moderate impairment. Avoid in severe impairment or biliary obstruction.

lRENAL IMPAIRMENTManufacturer advises initial dose of 20mg once daily in severe impairment.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Telmisartan (Non-proprietary)

Telmisartan 20 mgTelmisartan20mg tablets|28tabletP

£1.01–£10.55DT price = £1.01

Telmisartan 40 mgTelmisartan40mg tablets|28tabletP

£1.07–£12.93DT price = £1.18

Telmisartan 80 mgTelmisartan80mg tablets|28tabletP

£1.46–£16.15DT price = £1.46

▶Micardis(Boehringer Ingelheim Ltd)

Telmisartan 20 mgMicardis20mg tablets|28tabletP£11.10 DT price = £1.01

Telmisartan 40 mgMicardis40mg tablets|28tabletP£13.61 DT price = £1.18

Telmisartan 80 mgMicardis80mg tablets|28tabletP £17.00 DT price = £1.46

▶Tolura(Consilient Health Ltd)

Telmisartan 20 mgTolura20mg tablets|28tabletP£11.10DT price = £1.01

Telmisartan 40 mgTolura40mg tablets|28tabletP £13.61DT price = £1.18

Telmisartan 80 mgTolura80mg tablets|28tabletP £17.00DT price = £1.46

Telmisartan with hydrochlorothiazide

The properties listed below are those particular to the combination only. For the properties of the components please consider, telmisartan above, hydrochlorothiazide p.162.

lINDICATIONS AND DOSE

Hypertension not adequately controlled by telmisartan alone

▶BY MOUTH

▶Adult:(consult product literature)

BNF74

Hypertension 173

Cardiovascularsystem

2

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, thiazide diuretics

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Telmisartan with hydrochlorothiazide (Non-proprietary) Hydrochlorothiazide 12.5 mg, Telmisartan 40 mgTelmisartan 40mg / Hydrochlorothiazide12.5mg tablets|28tabletP£13.61 DT price = £13.61

Hydrochlorothiazide 25 mg, Telmisartan 80 mgTelmisartan80mg / Hydrochlorothiazide25mg tablets|28tabletP £10.99–£17.00 DT price = £17.00

Hydrochlorothiazide 12.5 mg, Telmisartan 80 mgTelmisartan 80mg / Hydrochlorothiazide12.5mg tablets|28tabletP£9.99–

£17.00DT price = £17.00

▶Actelsar HCT(Actavis UK Ltd)

Hydrochlorothiazide 12.5 mg, Telmisartan 40 mgActelsar HCT 40mg/12.5mg tablets|28tabletP £13.61DT price = £13.61 Hydrochlorothiazide 25 mg, Telmisartan 80 mgActelsar HCT 80mg/25mg tablets|28tabletP£17.00DT price = £17.00 Hydrochlorothiazide 12.5 mg, Telmisartan 80 mgActelsar HCT 80mg/12.5mg tablets|28tabletP £17.00DT price = £17.00

▶MicardisPlus(Boehringer Ingelheim Ltd)

Hydrochlorothiazide 12.5 mg, Telmisartan 40 mgMicardisPlus 40mg/12.5mg tablets|28tabletP £13.61DT price = £13.61 Hydrochlorothiazide 25 mg, Telmisartan 80 mgMicardisPlus 80mg/25mg tablets|28tabletP£17.00DT price = £17.00 Hydrochlorothiazide 12.5 mg, Telmisartan 80 mgMicardisPlus 80mg/12.5mg tablets|28tabletP £17.00DT price = £17.00

▶Tolucombi(Consilient Health Ltd)

Hydrochlorothiazide 12.5 mg, Telmisartan 40 mgTolucombi 40mg/12.5mg tablets|28tabletP £13.61DT price = £13.61 Hydrochlorothiazide 25 mg, Telmisartan 80 mgTolucombi 80mg/25mg tablets|28tabletP£17.00DT price = £17.00 Hydrochlorothiazide 12.5 mg, Telmisartan 80 mgTolucombi 80mg/12.5mg tablets|28tabletP £17.00DT price = £17.00

eiiiF169i

Valsartan

lINDICATIONS AND DOSE Hypertension

▶BY MOUTH

▶Adult:Initially80mg once daily, increased if necessary up to320mg daily, doses to be increased at intervals of 4weeks

Hypertension with intravascular volume depletion

▶BY MOUTH

▶Adult:Initially40mg once daily, increased if necessary up to320mg daily, doses to be increased at intervals of 4weeks

Heart failure when ACE inhibitors cannot be used, or in conjunction with an ACE inhibitor when a beta-blocker cannot be used|Heart failure, in conjunction with an ACE inhibitor when a beta-blocker cannot be used (under expert supervision)

▶BY MOUTH

▶Adult:Initially40mg twice daily, increased to up to 160mg twice daily, doses to be increased at intervals of at least2weeks

Myocardial infarction with left ventricular failure or left ventricular systolic dysfunction (adjunct)

▶BY MOUTH

▶Adult:Initially20mg twice daily, increased if necessary up to160mg twice daily, doses to be increased over several weeks if tolerated

lCONTRA-INDICATIONSBiliary cirrhosis

.

cholestasis lINTERACTIONS→Appendix1: angiotensin-II receptor

antagonists lSIDE-EFFECTS

▶Common or very commonRenal impairment

▶UncommonAcute renal failure

.

cough

.

fatigue

.

gastro-intestinal disturbance

.

headache

.

syncope

▶Frequency not knownHypersensitivity reactions

.

myalgia

.

neutropenia

.

pruritus

.

rash

.

serum sickness

.

thrombocytopenia

.

vasculitis

lHEPATIC IMPAIRMENTMax. dose80mg daily in mild to moderate impairment. Avoid in severe hepatic impairment.

lRENAL IMPAIRMENTUse with caution if eGFR less than 10mL/minute/1.73m²—no information available.

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Oral solution

▶Diovan(Novartis Pharmaceuticals UK Ltd)

Valsartan 3 mg per 1 mlDiovan3mg/1ml oral solution|160 mlP£7.20

Tablet

▶Valsartan (Non-proprietary)

Valsartan 40 mgValsartan40mg tablets|7tabletP£5.00DT price = £3.11|28tabletP no price available

Valsartan 80 mgValsartan80mg tablets|28tabletP£13.69 DT price = £13.69

Valsartan 160 mgValsartan160mg tablets|28tabletP£14.69 DT price = £14.69

Valsartan 320 mgValsartan320mg tablets|28tabletP£20.23 DT price = £13.01

Capsule

▶Valsartan (Non-proprietary)

Valsartan 40 mgValsartan40mg capsules|28capsuleP

£13.97DT price = £3.31

Valsartan 80 mgValsartan80mg capsules|28capsuleP

£13.97DT price = £2.21

Valsartan 160 mgValsartan160mg capsules|28capsuleP

£18.41DT price = £4.05

Combinations available:Amlodipine with valsartan,p.151

Valsartan with hydrochlorothiazide

The properties listed below are those particular to the combination only. For the properties of the components please consider, valsartan above, hydrochlorothiazide p.162.

lINDICATIONS AND DOSE

Hypertension not adequately controlled by valsartan alone

▶BY MOUTH

▶Adult:(consult product literature)

lINTERACTIONS→Appendix1: angiotensin-II receptor antagonists, thiazide diuretics

lMEDICINAL FORMS

There can be variation in the licensing of different medicines containing the same drug.

Tablet

▶Valsartan with hydrochlorothiazide (Non-proprietary) Hydrochlorothiazide 12.5 mg, Valsartan 80 mgValsartan80mg / Hydrochlorothiazide12.5mg tablets|28tabletP£13.97DT price

= £7.74

Hydrochlorothiazide 25 mg, Valsartan 160 mgValsartan160mg / Hydrochlorothiazide25mg tablets|28tabletP £18.41DT price =

£10.41

Hydrochlorothiazide 12.5 mg, Valsartan 160 mgValsartan160mg / Hydrochlorothiazide12.5mg tablets|28tabletP £18.41DT price = £2.19

▶Co-Diovan(Novartis Pharmaceuticals UK Ltd)

Hydrochlorothiazide 12.5 mg, Valsartan 80 mgCo-Diovan 80mg/12.5mg tablets|28tabletP£16.76DT price = £7.74 Hydrochlorothiazide 25 mg, Valsartan 160 mgCo-Diovan 160mg/25mg tablets|28tabletP£22.09DT price = £10.41 Hydrochlorothiazide 12.5 mg, Valsartan 160 mgCo-Diovan 160mg/12.5mg tablets|28tabletP £22.09DT price = £2.19

174 Blood pressure conditions

BNF74

Cardiovascularsystem

2

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