Adults: MICARDIS PLUS should be taken once daily. The dose of telmisartan could be up-titrated before switching to MICARDIS PLUS. Direct change from monotherapy to the fixed combinations may be considered.
MICARDIS PLUS 40/12.5 mg may be administered in patients whose blood pressure is not adequately controlled by MICARDIS 40 mg or hydrochlorothiazide.
MICARDIS PLUS 80/12.5 mg may be administered in patients whose blood pressure is not adequately controlled by MICARDIS 80 mg or by MICARDIS PLUS 40/12.5 mg.
The maximum antihypertensive effect is generally attained with MICARDIS PLUS 4 - 8 weeks after the start of treatment.
When necessary, MICARDIS PLUS may be administered with another antihypertensive drug.
In patients with severe hypertension treatment with telmisartan at doses up to 160 mg alone and in combination with hydrochlorothiazide 12.5 - 25 mg daily was well tolerated and effective.
MICARDIS PLUS may be taken with or without food.
Renal impairment: Due to the hydrochlorothiazide component, MICARDIS PLUS should not be used in patients with severe renal dysfunction (creatinine clearance < 30 ml/min). Loop diuretics are preferred to thiazides in this population. Experience in patients with mild to moderate renal impairment is modest but has not suggested adverse renal effects and dose adjustment is not considered necessary. Periodic monitoring of renal function is advised.
Hepatic impairment: In patients with mild to moderate hepatic impairment the posology should not exceed MICARDIS PLUS 40/12.5 mg once daily. MICARDIS PLUS is not indicated in patients with severe hepatic impairment. Thiazides should be used with caution in patients with impaired hepatic function.
Elderly: No dosage adjustment is necessary.
Children and adolescents: Safety and efficacy of MICARDIS PLUS have not been established in children and in adolescents up to 18 years.