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Actelsar HCT (telmisartan / hydrochlorothiazide) – Package leaflet - C09DA07

Updated on site: 11-Jul-2017

Medication nameActelsar HCT
ATC CodeC09DA07
Substancetelmisartan / hydrochlorothiazide
ManufacturerActavis Group hf

Package leaflet: Information for the user

Actelsar HCT 40 mg/12.5 mg tablets telmisartan/hydrochlorothiazide

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

-Keep this leaflet. You may need to read it again.

-If you have any further questions, ask your doctor or pharmacist.

-This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1.What Actelsar HCT is and what it is used for

2.What you need to know before you take Actelsar HCT

3.How to take Actelsar HCT

4.Possible side effects

5.How to store Actelsar HCT

6.Contents of the pack and other information

1.What Actelsar HCT is and what it is used for

Actelsar HCT is a combination of two active substances, telmisartan and hydrochlorothiazide in one tablet. Both of these substances help to control high blood pressure.

-Telmisartan belongs to a group of medicines called angiotensin II receptor antagonists. Angiotensin-II is a substance produced in your body which causes your blood vessels to narrow thus increasing your blood pressure. Telmisartan blocks the effect of angiotensin II so that the blood vessels relax, and your blood pressure is lowered.

-Hydrochlorothiazide belongs to a group of medicines called thiazide diuretics, which cause your urine output to increase, leading to a lowering of your blood pressure.

High blood pressure, if not treated, can damage blood vessels in several organs, which could lead sometimes to heart attack, heart or kidney failure, stroke, or blindness. There are usually no symptoms of high blood pressure before damage occurs. Thus it is important to regularly measure blood pressure to verify if it is within the normal range.

Actelsar HCT is used to treat high blood pressure (essential hypertension) in adults whose blood pressure is not controlled enough when telmisartan is used alone.

2. What you need to know before you take Actelsar HCT

Do not take Actelsar HCT

-if you are allergic to telmisartan or any of the other ingredients of this medicine (listed in section 6).

-if you are allergic to hydrochlorothiazide or to any other sulfonamide-derived medicines.

-if you are more than 3 months pregnant. (It is also better to avoid Actelsar HCT in early pregnancy – see pregnancy section).

-if you have severe liver problems such as cholestasis or biliary obstruction (problems with drainage of the bile from the liver and gall bladder) or any other severe liver disease.

-if you have severe kidney disease.

-if your doctor determines that you have low potassium levels or high calcium levels in your blood that do not get better with treatment.

-if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, tell your doctor or pharmacist before taking Actelsar HCT.

Warnings and precautions

Talk to your doctor if you are suffering or have ever suffered from any of the following conditions or illnesses:

-Low blood pressure (hypotension), likely to occur if you are dehydrated (excessive loss of body water) or have salt deficiency due to diuretic therapy (water tablets), low-salt diet, diarrhoea, vomiting, or haemodialysis.

-Kidney disease or kidney transplant.

-Renal artery stenosis (narrowing of the blood vessels to one or both kidneys).

-Liver disease.

-Heart trouble.

-Diabetes.

-Gout.

-Raised aldosterone levels (water and salt retention in the body along with imbalance of various blood minerals).

-Systemic lupus erythematosus (also called “lupus” or “SLE”) a disease where the body’s immune system attacks the body.

-The active ingredient hydrochlorothiazide can cause an unusual reaction, resulting in a decrease in vision and eye pain. These could be symptoms of an increase of pressure in your eye and can happen within hours to weeks of taking Actelsar HCT. This can lead to permanent vision impairment, if not treated.

Talk to your doctor before taking Actelsar HCT:

-if you are taking digoxin.

-if you are taking any of the following medicines used to treat high blood pressure:

-an ACE-inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

-aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Actelsar HCT”.

You must tell your doctor if you think you are (or might become) pregnant. Actelsar HCT is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see pregnancy section).

Treatment with hydrochlorothiazide may cause electrolyte imbalance in your body. Typical symptoms of fluid or electrolyte imbalance include dry mouth, weakness, lethargy, drowsiness, restlessness, muscle pain or cramps, nausea (feeling sick), vomiting, tired muscles, and an abnormally fast heart rate (faster than 100 beats per minute). If you experience any of these you should tell your doctor.

You should also tell your doctor if you experience an increased sensitivity of the skin to the sun with symptoms of sunburn (such as redness, itching, swelling, blistering) occurring more quickly than normal.

In case of surgery or anaesthetics, you should tell your doctor that you are taking Actelsar HCT. Actelsar HCT may be less effective in lowering the blood pressure in black patients.

Children and adolescents

The use of Actelsar HCT in children and adolescents up to the age of 18 years is not recommended.

Other medicines and Actelsar HCT

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Your doctor may need to change the dose of these other medications or take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below taken at the same time with Actelsar HCT:

-Lithium containing medicines to treat some types of depression.

-Medicines associated with low blood potassium (hypokalaemia) such as other diuretics, (“water tablets”), laxatives (e.g. castor oil), corticosteroids (e.g. prednisone), ACTH (a hormone), amphotericin (an antifungal medicine), carbenoxolone (used to treat mouth ulcers), penicillin G sodium (an antibiotic), and salicylic acid and derivatives.

-Potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, ACE inhibitors that may increase blood potassium levels.

-Heart medicines (e.g. digoxin) or medicines to control the rhythm of your heart (e.g. quinidine, disopyramide).

-Medicines used for mental disorders (e.g. thioridazine, chlorpromazine, levomepromazine).

-Other medicines used to treat high blood pressure, steroids, painkillers, medicines to treat cancer, gout, or arthritis, and vitamin D supplements.

-If you are taking an ACE-inhibitor or aliskiren (see also information under the headings “Do not take Actelsar HCT” and “Warnings and precautions”).

-Digoxin.

Actelsar HCT may increase the blood pressure lowering effect of other medicines used to treat high blood pressure or of medicines with blood pressure lowering potential (e.g. baclofen, amifostine). Furthermore, low blood pressure may be aggravated by alcohol, barbiturates, narcotics or antidepressants. You may notice this as dizziness when standing up. You should consult with your doctor if you need to adjust the dose of your other medicine while taking Actelsar HCT.

The effect of Actelsar HCT may be reduced when you take NSAIDs (non steroidal anti-inflammatory medicines, e.g. aspirin or ibuprofen).

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Actelsar HCT before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Actelsar HCT. Actelsar HCT is not recommended during pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Actelsar HCT is not recommended for mothers who are breast-feeding and your doctor may choose another treatment for you if you wish to breast-feed.

Driving and using machines

Some people feel dizzy or tired when taking Actelsar HCT. If you feel dizzy or tired, do not drive or operate machinery.

3.How to take Actelsar HCT

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose of Actelsar HCT is one tablet a day. Try to take the tablet at the same time each day. You can take Actelsar HCT with or without food. The tablets should be swallowed with some water or other non-alcoholic drink. It is important that you take Actelsar HCT every day until your doctor tells you otherwise.

If your liver is not working properly, the usual dose should not exceed 40 mg/12.5 mg once a day.

If you take more Actelsar HCT than you should

If you accidentally take too many tablets contact your doctor, pharmacist, or your nearest hospital emergency department immediately.

If you forget to take Actelsar HCT

If you forget to take a dose, do not worry. Take it as soon as you remember, then carry on as before. If you do not take your tablet on one day, take your normal dose on the next day. Do not take a double dose to make up for a forgotten dose.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4.Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some side effects can be serious and need immediate medical attention:

You should see your doctor immediately if you experience any of the following symptoms:

Sepsis* (often called “blood poisoning”), is a severe infection with whole-body inflammatory response, rapid swelling of the skin and mucosa (angioedema); these side effects are rare (may affect up to 1 in 1,000 people) but are extremely serious and patients should stop taking the medicine and see their doctor immediately. If these effects are not treated they could be fatal. Increased incidence of sepsis has been observed with telmisartan only, however it can not be ruled out for Actelsar HCT.

Possible side effects of Actelsar HCT:

Common side effects (may affect up to 1 to 10 people):

Dizziness

Uncommon side effects (may affect up to 1 to 100 people):

Decreased blood potassium levels, anxiety, fainting (syncope), sensation of tingling, pins and needles (paraesthesia), feeling of spinning (vertigo), fast heart beat (tachycardia), heart rhythm disorders, low blood pressure, a sudden fall in blood pressure when you stand up, shortness of breath (dyspnoea), diarrhoea, dry mouth, flatulence, back pain, muscle spasm, muscle pain, erectile dysfunction (inability to get or keep an erection), chest pain, increased blood uric acid levels.

Rare side effects (may affect up to 1 to 1000 people):

Inflammation of the lungs (bronchitis), activation or worsening of systemic lupus erythematosus (a disease where the body’s immune system attacks the body, which causes joint pain, skin rashes and fever); sore throat, inflamed sinuses, feeling sad (depression), difficulty falling asleep (insomnia), impaired vision, difficulty breathing, abdominal pain, constipation, bloating (dyspepsia), feeling sick, inflammation of the stomach (gastritis), abnormal liver function (Japanese patients are more likely to experience this side effect), rapid swelling of the skin and mucosa which can also lead to death

(angioedema also with fatal outcome), redness of the skin (erythema), allergic reactions such as itching or rash, increased sweating, hives (urticaria), joint pain (arthralgia) and pain in extremities, muscle cramps, flu-like-illness, pain, increased levels of uric acid, low levels of sodium, increased levels of creatinine, hepatic enzymes or creatine phosphokinase in the blood.

Adverse reactions reported with one of the individual components may be potential adverse reactions with Actelsar HCT, even if not observed in clinical trials with this product.

Telmisartan

In patients taking telmisartan alone the following additional side effects have been reported:

Uncommon side effects (may affect up to 1 to 100 people):

Upper respiratory tract infection (e.g. sore throat, inflamed sinuses, common cold), urinary tract infections, deficiency in red blood cells (anaemia), high potassium levels, slow heart rate (bradycardia), kidney impairment including acute kidney failure, weakness, cough.

Rare side effects (may affect up to 1 to 1000 people):

Sepsis* (often called “blood poisoning”, is a severe infection with whole-body inflammatory response which can lead to death), low platelet count (thrombocytopenia), increase in certain white blood cells (eosinophilia), serious allergic reaction (e.g. hypersensitivity, anaphylactic reaction, drug rash), low blood sugar levels (in diabetic patients), upset stomach, eczema (a skin disorder), arthrosis, inflammation of the tendons, decreased haemoglobin (a blood protein), somnolence.

Very rare side effects (may affect up to 1 in 10,000 people):

Progressive scarring of lung tissue (interstitial lung disease)**

*The event may have happened by chance or could be related to a mechanism currently not known.

**Cases of progressive scarring of lung tissue have been reported during intake of telmisartan. However, it is not known whether telmisartan was the cause.

Hydrochlorothiazide

In patients taking hydrochlorothiazide alone the following additional side effects have been reported:

Side effects of unknown frequency (frequency cannot be estimated from the available data) Inflammation of the salivary gland, decreases in the number of cells in the blood, including low red and white blood cell count, low platelet count (thrombocytopenia), serious allergic reactions (e.g. hypersensitivity, anaphylactic reaction), decreased or loss of appetite, restlessness, light-headedness, blurred or yellowing of vision, decrease in vision and eye pain (possible signs of acute myopia or acute-angle closure glaucoma), inflammation of blood vessels (vasculitis necrotising), inflamed pancreas, upset stomach, yellowing of the skin or eyes (jaundice), lupus-like syndrome (a condition mimicking a disease called systemic lupus erythematosus where the body’s immune system attacks the body); skin disorders such as inflamed blood vessels in the skin, increased sensitivity to sunlight, or blistering and peeling of the top layer of skin (toxic epidermal necrolysis), weakness, kidney inflammation or impaired kidney function, glucose in the urine (glycosuria), fever, impaired electrolyte balance, high blood cholesterol levels, decreased blood volume, increased levels of glucose, or fat in the blood.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

5.How to store Actelsar HCT

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton, blister or bottle label after “EXP”. The expiry date refers to the last day of that month.

For Al/Al blisters and HDPE tablet container

This medicine does not require any special storage conditions.

For Al/PVC/PVDC blister

Do not store above 30ºC.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Actelsar HCT contains

-The active substances are telmisartan and hydrochlorothiazide. Each tablet contains 40 mg telmisartan and 12.5 mg hydrochlorothiazide.

-The other ingredients are magnesium stearate (E470b), potassium hydroxide, meglumine, povidone, sodium starch glycolate (type A), microcrystalline cellulose, mannitol (E421).

What Actelsar HCT looks like and contents of the pack

Actelsar HCT 40 mg/12.5 mg tablets are white or almost white, 6.55 x 13.6 mm oval-shaped and biconvex tablets marked with “TH” on one side.

Pack sizes

Al/Al blister packs: 14, 28, 30, 56, 84, 90 and 98 tablets

Al/PVC/PVDC blister packs: 28, 56, 84, 90 and 98 tablets

Tablet containers: 30, 90 and 250 tablets

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Actavis Group PTC ehf.

Reykjavíkurvegur 76-78, 220 Hafnarfjörður, Iceland

Manufacturer

Actavis hf.

Reykjavíkurvegur 78, 220 Hafnarfjörður, Iceland

Actavis Ltd.

BLB016, Bulebel Industrial Estate, Zejtun ZTN 3000, Malta

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgique/Belgien

Lietuva

Aurobindo Pharma B.V.

UAB “Actavis Baltics”

Nederland / Pays-Bas / Niederlande

Tel: +370 5 260 9615

Tél/Tel: +31 (0)35 542 99 33

 

 

България

Luxembourg/Luxemburg

Актавис ЕАД

Aurobindo Pharma B.V.

Teл.: +359 2 9321 861

Pays-Bas / Niederlande

 

Tél/Tel: +31 (0)35 542 99 33

Česká republika

Magyarország

Actavis CZ a.s.

Actavis Hungary Kft.

Tel: +420 251 113 002

Tel.: +36 1 501 7001

Danmark

Malta

Actavis A/S

Actavis Ltd.

Tlf: +45 72 22 30 00

Tel: +35621693533

Deutschland

Nederland

PUREN Pharma GmbH & Co. KG

Aurobindo Pharma B.V.

Tel.: +49-89-558-9090

Tel: +31 (0)35 542 99 33

Eesti

Norge

UAB “Actavis Baltics” Eesti Filiaal

Actavis Norway AS

Tel: +372 6100 565

Tlf: +47 815 22 099

Ελλάδα

Österreich

Specifar ABEE

Actavis GmbH

Τηλ: +30 210 5401500

Tel: +43 (0)662 435 235 00

España

Polska

Aurovitas Spain, S.A.U.

Actavis Export Int. Ltd., Malta

Tfno.: +34 91 630 86 45

Kontakt w Polsce:

 

Tel.: (+48 22) 512 29 00

France

Portugal

Arrow Génériques

Aurovitas, Unipessoal, Lda

Tél: +33 4 72 72 60 72

Tel: +351 214 185 104

Hrvatska

România

PharmaVigil d.o.o.

Actavis SRL

Tel: +385(1)3890676

Tel: +40 21 318 17 77

Ireland

Slovenija

Actavis Ireland Limited

Apta Medica Internacional d.o.o.

Tel: +353 (0)21 4619040

Tel: +386 51 615 015

Ísland

Slovenská republika

Actavis Group PTC ehf.

Actavis s.r.o.

Sími: +354 550 3300

Tel: +421 2 3255 3800

Italia

Suomi/Finland

Aurobindo Pharma (Italia) s.r.l.

Actavis Oy

Tel: +39 0296392601

Puh/Tel: +358 (0)9 348 233

Κύπρος

Sverige

A. Potamitis Medicare Ltd

Actavis AB

Τηλ: +357 22583333

Tel: +46 8 13 63 70

Latvija

United Kingdom

UAB “Actavis Baltics” Latvijas filiāle

Actavis UK Limited

Tel: +371 67304300

Tel: +44 1271 385257

België/Belgique/Belgien

Lietuva

Aurobindo Pharma B.V.

UAB “Actavis Baltics”

Nederland / Pays-Bas / Niederlande

Tel: +370 5 260 9615

Tél/Tel: +31 (0)35 542 99 33

 

България

Luxembourg/Luxemburg

Актавис ЕАД

Aurobindo Pharma B.V.

Teл.: +359 2 9321 680

Pays-Bas / Niederlande

 

Tél/Tel: +31 (0)35 542 99 33

Česká republika

Magyarország

Actavis CZ a.s.

Actavis Hungary Kft.

Tel: +420 251 113 002

Tel.: +36 1 501 7001

Danmark

Malta

Actavis A/S

Actavis Ltd.

Tlf: +45 72 22 30 00

Tel: +35621693533

Deutschland

Nederland

Actavis Deutschland GmbH & Co. KG

Aurobindo Pharma B.V.

Telefon: +49 (0)89 558909 0

Tel: +31 (0)35 542 99 33

Eesti

Norge

UAB “Actavis Baltics” Eesti Filiaal

Actavis Norway AS

Tel: +372 6100 565

Tlf: +47 815 22 099

Ελλάδα

Österreich

Specifar ABEE

Actavis GmbH

Τηλ: +30 210 5401500

Tel: +43 (0)662 435 235 00

España

Polska

Aurovitas Spain, S.A.U.

Actavis Export Int. Ltd., Malta

Tfno.: +34 91 630 86 45

Kontakt w Polsce:

 

Tel.: (+48 22) 512 29 00

France

Portugal

Arrow Génériques

Aurovitas, Unipessoal, Lda

Tél: +33 4 72 72 60 72

Tel: +351 214 185 104

Hrvatska

România

Phoenix Farmacija d.d.

Actavis SRL

Tel: +385(1) 6370-400

Tel: +40 21 318 17 77

Ireland

Slovenija

Actavis Ireland Limited

Apta Medica Internacional d.o.o.

Tel: +353 (0)21 4619040

Tel: +386 51 615 015

Ísland

Slovenská republika

Actavis Group PTC ehf.

Actavis s.r.o.

Sími: +354 550 3300

Tel: +421 2 3255 3800

Italia

Suomi/Finland

Aurobindo Pharma (Italia) s.r.l.

Actavis Oy

Tel: +39 0296392601

Puh/Tel: +358 (0)9 348 233

Κύπρος

Sverige

A. Potamitis Medicare Ltd

Actavis AB

Τηλ: +357 22583333

Tel: +46 8 13 63 70

Latvija

United Kingdom

UAB “Actavis Baltics” Latvijas filiāle

Actavis UK Limited

Tel: +371 67304300

Tel: +44 1271 385257

This leaflet was last revised in

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.

Package leaflet: Information for the user

Actelsar HCT 80 mg/12.5 mg tablets telmisartan/hydrochlorothiazide

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

-Keep this leaflet. You may need to read it again.

-If you have any further questions, ask your doctor or pharmacist.

-This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1.What Actelsar HCT is and what it is used for

2.What you need to know before you take Actelsar HCT

3.How to take Actelsar HCT

4.Possible side effects

5.How to store Actelsar HCT

6.Contents of the pack and other information

1. What Actelsar HCT is and what it is used for

Actelsar HCT is a combination of two active substances, telmisartan and hydrochlorothiazide in one tablet. Both of these substances help to control high blood pressure.

-Telmisartan belongs to a group of medicines called angiotensin II receptor antagonists. Angiotensin-II is a substance produced in your body which causes your blood vessels to narrow thus increasing your blood pressure. Telmisartan blocks the effect of angiotensin II so that the blood vessels relax, and your blood pressure is lowered.

-Hydrochlorothiazide belongs to a group of medicines called thiazide diuretics, which cause your urine output to increase, leading to a lowering of your blood pressure.

High blood pressure, if not treated, can damage blood vessels in several organs, which could lead sometimes to heart attack, heart or kidney failure, stroke, or blindness. There are usually no symptoms of high blood pressure before damage occurs. Thus it is important to regularly measure blood pressure to verify if it is within the normal range.

Actelsar HCT is used to treat high blood pressure (essential hypertension) in adults whose blood pressure is not controlled enough when telmisartan is used alone.

2. What you need to know before you take Actelsar HCT

Do not take Actelsar HCT

-if you are allergic to telmisartan or any of the other ingredients of this medicine (listed in section 6).

-if you are allergic to hydrochlorothiazide or to any other sulfonamide-derived medicines.

-if you are more than 3 months pregnant. (It is also better to avoid Actelsar HCT in early pregnancy – see pregnancy section).

-if you have severe liver problems such as cholestasis or biliary obstruction (problems with drainage of the bile from the liver and gall bladder) or any other severe liver disease.

-if you have severe kidney disease.

-if your doctor determines that you have low potassium levels or high calcium levels in your blood that do not get better with treatment.

-if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, tell your doctor or pharmacist before taking Actelsar HCT.

Warnings and precautions

Talk to your doctor if you are suffering or have ever suffered from any of the following conditions or illnesses:

-Low blood pressure (hypotension), likely to occur if you are dehydrated (excessive loss of body water) or have salt deficiency due to diuretic therapy (water tablets), low-salt diet, diarrhoea, vomiting, or haemodialysis.

-Kidney disease or kidney transplant.

-Renal artery stenosis (narrowing of the blood vessels to one or both kidneys).

-Liver disease.

-Heart trouble.

-Diabetes.

-Gout.

-Raised aldosterone levels (water and salt retention in the body along with imbalance of various blood minerals).

-Systemic lupus erythematosus (also called “lupus” or “SLE”) a disease where the body’s immune system attacks the body.

-The active ingredient hydrochlorothiazide can cause an unusual reaction, resulting in a decrease in vision and eye pain. These could be symptoms of an increase of pressure in your eye and can happen within hours to weeks of taking Actelsar HCT. This can lead to permanent vision impairment, if not treated.

Talk to your doctor before taking Actelsar HCT:

-if you are taking digoxin.

-if you are taking any of the following medicines used to treat high blood pressure:

-an ACE-inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

-aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Actelsar HCT”.

You must tell your doctor if you think you are (or might become) pregnant. Actelsar HCT is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see pregnancy section).

Treatment with hydrochlorothiazide may cause electrolyte imbalance in your body. Typical symptoms of fluid or electrolyte imbalance include dry mouth, weakness, lethargy, drowsiness, restlessness, muscle pain or cramps, nausea (feeling sick), vomiting, tired muscles, and an abnormally fast heart rate (faster than 100 beats per minute). If you experience any of these you should tell your doctor.

You should also tell your doctor if you experience an increased sensitivity of the skin to the sun with symptoms of sunburn (such as redness, itching, swelling, blistering) occurring more quickly than normal.

In case of surgery or anaesthetics, you should tell your doctor that you are taking Actelsar HCT.

Actelsar HCT may be less effective in lowering the blood pressure in black patients.

Children and adolescents

The use of Actelsar HCT in children and adolescents up to the age of 18 years is not recommended.

Other medicines and Actelsar HCT

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Your doctor may need to change the dose of these other medications or take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below taken at the same time with Actelsar HCT:

-Lithium containing medicines to treat some types of depression.

-Medicines associated with low blood potassium (hypokalaemia) such as other diuretics, (“water tablets”), laxatives (e.g. castor oil), corticosteroids (e.g. prednisone), ACTH (a hormone), amphotericin (an antifungal medicine), carbenoxolone (used to treat mouth ulcers), penicillin G sodium (an antibiotic), and salicylic acid and derivatives.

-Potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, ACE inhibitors that may increase blood potassium levels.

-Heart medicines (e.g. digoxin) or medicines to control the rhythm of your heart (e.g. quinidine, disopyramide).

-Medicines used for mental disorders (e.g. thioridazine, chlorpromazine, levomepromazine).

-Other medicines used to treat high blood pressure, steroids, painkillers, medicines to treat cancer, gout, or arthritis, and vitamin D supplements.

-If you are taking an ACE-inhibitor or aliskiren (see also information under the headings “Do not take Actelsar HCT” and “Warnings and precautions”).

-Digoxin.

Actelsar HCT may increase the blood pressure lowering effect of other medicines used to treat high blood pressure or of medicines with blood pressure lowering potential (e.g. baclofen, amifostine). Furthermore, low blood pressure may be aggravated by alcohol, barbiturates, narcotics or antidepressants. You may notice this as dizziness when standing up. You should consult with your doctor if you need to adjust the dose of your other medicine while taking Actelsar HCT.

The effect of Actelsar HCT may be reduced when you take NSAIDs (non steroidal anti-inflammatory medicines, e.g. aspirin or ibuprofen).

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Actelsar HCT before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Actelsar HCT. Actelsar HCT is not recommended during pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Actelsar HCT is not recommended for mothers who are breast-feeding and your doctor may choose another treatment for you if you wish to breast-feed.

Driving and using machines

Some people feel dizzy or tired when taking Actelsar HCT. If you feel dizzy or tired, do not drive or operate machinery.

3. How to take Actelsar HCT

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose of Actelsar HCT is one tablet a day. Try to take the tablet at the same time each day. You can take Actelsar HCT with or without food. The tablets should be swallowed with some water or other non-alcoholic drink. It is important that you take Actelsar HCT every day until your doctor tells you otherwise.

If your liver is not working properly, the usual dose should not exceed 40 mg/12.5 mg once a day.

If you take more Actelsar HCT than you should

If you accidentally take too many tablets contact your doctor, pharmacist, or your nearest hospital emergency department immediately.

If you forget to take Actelsar HCT

If you forget to take a dose, do not worry. Take it as soon as you remember, then carry on as before. If you do not take your tablet on one day, take your normal dose on the next day. Do not take a double dose to make up for a forgotten dose.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some side effects can be serious and need immediate medical attention:

You should see your doctor immediately if you experience any of the following symptoms:

Sepsis* (often called “blood poisoning”), is a severe infection with whole-body inflammatory response, rapid swelling of the skin and mucosa (angioedema); these side effects are rare (may affect up to 1 in 1,000 people) but are extremely serious and patients should stop taking the medicine and see their doctor immediately. If these effects are not treated they could be fatal. Increased incidence of sepsis has been observed with telmisartan only, however it can not be ruled out for Actelsar HCT.

Possible side effects of Actelsar HCT:

Common side effects (may affect up to 1 to 10 people):

Dizziness

Uncommon side effects (may affect up to 1 to 100 people):

Decreased blood potassium levels, anxiety, fainting (syncope), sensation of tingling, pins and needles (paraesthesia), feeling of spinning (vertigo), fast heart beat (tachycardia), heart rhythm disorders, low blood pressure, a sudden fall in blood pressure when you stand up, shortness of breath (dyspnoea), diarrhoea, dry mouth, flatulence, back pain, muscle spasm, muscle pain, erectile dysfunction (inability to get or keep an erection), chest pain, increased blood uric acid levels.

Rare side effects (may affect up to 1 to 1000 people):

Inflammation of the lungs (bronchitis), activation or worsening of systemic lupus erythematosus (a disease where the body’s immune system attacks the body, which causes joint pain, skin rashes and fever); sore throat, inflamed sinuses, feeling sad (depression), difficulty falling asleep (insomnia), impaired vision, difficulty breathing, abdominal pain, constipation, bloating (dyspepsia), feeling sick, inflammation of the stomach (gastritis), abnormal liver function (Japanese patients are more likely to experience this side effect), rapid swelling of the skin and mucosa which can also lead to death (angioedema also with fatal outcome), redness of the skin (erythema), allergic reactions such as

itching or rash, increased sweating, hives (urticaria), joint pain (arthralgia) and pain in extremities, muscle cramps, flu-like-illness, pain, increased levels of uric acid, low levels of sodium, increased levels of creatinine, hepatic enzymes or creatine phosphokinase in the blood.

Adverse reactions reported with one of the individual components may be potential adverse reactions with Actelsar HCT, even if not observed in clinical trials with this product.

Telmisartan

In patients taking telmisartan alone the following additional side effects have been reported:

Uncommon side effects (may affect up to 1 to 100 people):

Upper respiratory tract infection (e.g. sore throat, inflamed sinuses, common cold), urinary tract infections, deficiency in red blood cells (anaemia), high potassium levels, slow heart rate (bradycardia), kidney impairment including acute kidney failure, weakness, cough.

Rare side effects (may affect up to 1 to 1000 people):

Sepsis* (often called “blood poisoning”, is a severe infection with whole-body inflammatory response which can lead to death), low platelet count (thrombocytopenia), increase in certain white blood cells (eosinophilia), serious allergic reaction (e.g. hypersensitivity, anaphylactic reaction, drug rash), low blood sugar levels (in diabetic patients), upset stomach, eczema (a skin disorder), arthrosis, inflammation of the tendons, decreased haemoglobin (a blood protein), somnolence.

Very rare side effects (may affect up to 1 in 10,000 people):

Progressive scarring of lung tissue (interstitial lung disease)**

*The event may have happened by chance or could be related to a mechanism currently not known.

**Cases of progressive scarring of lung tissue have been reported during intake of telmisartan. However, it is not known whether telmisartan was the cause.

Hydrochlorothiazide

In patients taking hydrochlorothiazide alone the following additional side effects have been reported:

Side effects of unknown frequency (frequency cannot be estimated from the available data) Inflammation of the salivary gland, decreases in the number of cells in the blood, including low red and white blood cell count, low platelet count (thrombocytopenia), serious allergic reactions (e.g. hypersensitivity, anaphylactic reaction), decreased or loss of appetite, restlessness, light-headedness, blurred or yellowing of vision, decrease in vision and eye pain (possible signs of acute myopia or acute-angle closure glaucoma), inflammation of blood vessels (vasculitis necrotising), inflamed pancreas, upset stomach, yellowing of the skin or eyes (jaundice), lupus-like syndrome (a condition mimicking a disease called systemic lupus erythematosus where the body’s immune system attacks the body); skin disorders such as inflamed blood vessels in the skin, increased sensitivity to sunlight, or blistering and peeling of the top layer of skin (toxic epidermal necrolysis), weakness, kidney inflammation or impaired kidney function, glucose in the urine (glycosuria), fever, impaired electrolyte balance, high blood cholesterol levels, decreased blood volume, increased levels of glucose, or fat in the blood.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Actelsar HCT

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton, blister or bottle label after “EXP”. The expiry date refers to the last day of that month.

For Al/Al blisters and HDPE tablet container

This medicine does not require any special storage conditions.

For Al/PVC/PVDC blister

Do not store above 30ºC.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Actelsar HCT contains

-The active substances are telmisartan and hydrochlorothiazide. Each tablet contains 80 mg telmisartan and 12.5 mg hydrochlorothiazide.

-The other ingredients are magnesium stearate (E470b), potassium hydroxide, meglumine, povidone, sodium starch glycolate (type A), microcrystalline cellulose, mannitol (E421).

What Actelsar HCT looks like and contents of the pack

Actelsar HCT 80 mg/12.5 mg tablets are white or almost white, 9.0 x 17.0 mm capsule-shaped tablets marked with “TH 12.5” on both sides.

Pack sizes

Al/Al blister packs: 14, 30, 28, 56, 84, 90 and 98 tablets

Al/PVC/PVDC blister packs: 14, 28, 56, 84, 90 and 98 tablets

Tablet containers: 30, 90 and 250 tablets

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Actavis Group PTC ehf.

Reykjavíkurvegur 76-78, 220 Hafnarfjörður, Iceland

Manufacturer

Actavis hf.

Reykjavíkurvegur 78, 220 Hafnarfjörður, Iceland

Actavis Ltd.

BLB016, Bulebel Industrial Estate, Zejtun ZTN 3000, Malta

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgique/Belgien

Lietuva

Aurobindo Pharma B.V.

UAB “Actavis Baltics”

Nederland / Pays-Bas / Niederlande

Tel: +370 5 260 9615

Tél/Tel: +31 (0)35 542 99 33

 

 

България

Luxembourg/Luxemburg

Актавис ЕАД

Aurobindo Pharma B.V.

Teл.: +359 2 9321 861

Pays-Bas / Niederlande

 

Tél/Tel: +31 (0)35 542 99 33

Česká republika

Magyarország

Actavis CZ a.s.

Actavis Hungary Kft.

Tel: +420 251 113 002

Tel.: +36 1 501 7001

Danmark

Malta

Actavis A/S

Actavis Ltd.

Tlf: +45 72 22 30 00

Tel: +35621693533

Deutschland

Nederland

PUREN Pharma GmbH & Co. KG

Aurobindo Pharma B.V.

Tel.: +49-89-558-9090

Tel: +31 (0)35 542 99 33

Eesti

Norge

UAB “Actavis Baltics” Eesti Filiaal

Actavis Norway AS

Tel: +372 6100 565

Tlf: +47 815 22 099

Ελλάδα

Österreich

Specifar ABEE

Actavis GmbH

Τηλ: +30 210 5401500

Tel: +43 (0)662 435 235 00

España

Polska

Aurovitas Spain, S.A.U.

Actavis Export Int. Ltd., Malta

Tfno.: +34 91 630 86 45

Kontakt w Polsce:

 

Tel.: (+48 22) 512 29 00

France

Portugal

Arrow Génériques

Aurovitas, Unipessoal, Lda

Tél: +33 4 72 72 60 72

Tel: +351 214 185 104

Hrvatska

România

PharmaVigil d.o.o.

Actavis SRL

Tel: +385(1)3890676

Tel: +40 21 318 17 77

Ireland

Slovenija

Actavis Ireland Limited

Apta Medica Internacional d.o.o.

Tel: +353 (0)21 4619040

Tel: +386 51 615 015

Ísland

Slovenská republika

Actavis Group PTC ehf.

Actavis s.r.o.

Sími: +354 550 3300

Tel: +421 2 3255 3800

Italia

Suomi/Finland

Aurobindo Pharma (Italia) s.r.l.

Actavis Oy

Tel: +39 0296392601

Puh/Tel: +358 (0)9 348 233

Κύπρος

Sverige

A. Potamitis Medicare Ltd

Actavis AB

Τηλ: +357 22583333

Tel: +46 8 13 63 70

Latvija

United Kingdom

UAB “Actavis Baltics” Latvijas filiāle

Actavis UK Limited

Tel: +371 67304300

Tel: +44 1271 385257

België/Belgique/Belgien

Lietuva

Aurobindo Pharma B.V.

UAB “Actavis Baltics”

Nederland / Pays-Bas / Niederlande

Tel: +370 5 260 9615

Tél/Tel: +31 (0)35 542 99 33

 

България

Luxembourg/Luxemburg

Актавис ЕАД

Aurobindo Pharma B.V.

Teл.: +359 2 9321 680

Pays-Bas / Niederlande

 

Tél/Tel: +31 (0)35 542 99 33

Česká republika

Magyarország

Actavis CZ a.s.

Actavis Hungary Kft.

Tel: +420 251 113 002

Tel.: +36 1 501 7001

Danmark

Malta

Actavis A/S

Actavis Ltd.

Tlf: +45 72 22 30 00

Tel: +35621693533

Deutschland

Nederland

Actavis Deutschland GmbH & Co. KG

Aurobindo Pharma B.V.

Telefon: +49 (0)89 558909 0

Tel: +31 (0)35 542 99 33

Eesti

Norge

UAB “Actavis Baltics” Eesti Filiaal

Actavis Norway AS

Tel: +372 6100 565

Tlf: +47 815 22 099

Ελλάδα

Österreich

Specifar ABEE

Actavis GmbH

Τηλ: +30 210 5401500

Tel: +43 (0)662 435 235 00

España

Polska

Aurovitas Spain, S.A.U.

Actavis Export Int. Ltd., Malta

Tfno.: +34 91 630 86 45

Kontakt w Polsce:

 

Tel.: (+48 22) 512 29 00

France

Portugal

Arrow Génériques

Aurovitas, Unipessoal, Lda

Tél: +33 4 72 72 60 72

Tel: +351 214 185 104

Hrvatska

România

Phoenix Farmacija d.d.

Actavis SRL

Tel: +385(1) 6370-400

Tel: +40 21 318 17 77

Ireland

Slovenija

Actavis Ireland Limited

Apta Medica Internacional d.o.o.

Tel: +353 (0)21 4619040

Tel: +386 51 615 015

Ísland

Slovenská republika

Actavis Group PTC ehf.

Actavis s.r.o.

Sími: +354 550 3300

Tel: +421 2 3255 3800

Italia

Suomi/Finland

Aurobindo Pharma (Italia) s.r.l.

Actavis Oy

Tel: +39 0296392601

Puh/Tel: +358 (0)9 348 233

Κύπρος

Sverige

A. Potamitis Medicare Ltd

Actavis AB

Τηλ: +357 22583333

Tel: +46 8 13 63 70

Latvija

United Kingdom

UAB “Actavis Baltics” Latvijas filiāle

Actavis UK Limited

Tel: +371 67304300

Tel: +44 1271 385257

This leaflet was last revised in

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.

Package leaflet: Information for the user

Actelsar HCT 80 mg/25 mg tablets telmisartan/hydrochlorothiazide

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

-Keep this leaflet. You may need to read it again.

-If you have any further questions, ask your doctor or pharmacist.

-This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1.What Actelsar HCT is and what it is used for

2.What you need to know before you take Actelsar HCT

3.How to take Actelsar HCT

4.Possible side effects

5.How to store Actelsar HCT

6.Contents of the pack and other information

1. What Actelsar HCT is and what it is used for

Actelsar HCT is a combination of two active substances, telmisartan and hydrochlorothiazide in one tablet. Both of these substances help to control high blood pressure.

-Telmisartan belongs to a group of medicines called angiotensin II receptor antagonists. Angiotensin-II is a substance produced in your body which causes your blood vessels to narrow thus increasing your blood pressure. Telmisartan blocks the effect of angiotensin II so that the blood vessels relax, and your blood pressure is lowered.

-Hydrochlorothiazide belongs to a group of medicines called thiazide diuretics, which cause your urine output to increase, leading to a lowering of your blood pressure.

High blood pressure, if not treated, can damage blood vessels in several organs, which could lead sometimes to heart attack, heart or kidney failure, stroke, or blindness. There are usually no symptoms of high blood pressure before damage occurs. Thus it is important to regularly measure blood pressure to verify if it is within the normal range.

Actelsar HCT is used to treat high blood pressure (essential hypertension) in adults whose blood pressure is not controlled enough when telmisartan is used alone.

2. What you need to know before you take Actelsar HCT

Do not take Actelsar HCT

-if you are allergic to telmisartan or any of the other ingredients of this medicine (listed in section 6).

-if you are allergic to hydrochlorothiazide or to any other sulfonamide-derived medicines.

-if you are more than 3 months pregnant. (It is also better to avoid Actelsar HCT in early pregnancy – see pregnancy section).

-if you have severe liver problems such as cholestasis or biliary obstruction (problems with drainage of the bile from the liver and gall bladder) or any other severe liver disease.

-if you have severe kidney disease.

-if your doctor determines that you have low potassium levels or high calcium levels in your blood that do not get better with treatment.

-if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, tell your doctor or pharmacist before taking Actelsar HCT.

Warnings and precautions

Talk to your doctor if you are suffering or have ever suffered from any of the following conditions or illnesses:

-Low blood pressure (hypotension), likely to occur if you are dehydrated (excessive loss of body water) or have salt deficiency due to diuretic therapy (water tablets), low-salt diet, diarrhoea, vomiting, or haemodialysis.

-Kidney disease or kidney transplant.

-Renal artery stenosis (narrowing of the blood vessels to one or both kidneys).

-Liver disease.

-Heart trouble.

-Diabetes.

-Gout.

-Raised aldosterone levels (water and salt retention in the body along with imbalance of various blood minerals).

-Systemic lupus erythematosus (also called “lupus” or “SLE”) a disease where the body’s immune system attacks the body.

-The active ingredient hydrochlorothiazide can cause an unusual reaction, resulting in a decrease in vision and eye pain. These could be symptoms of an increase of pressure in your eye and can happen within hours to weeks of taking Actelsar HCT. This can lead to permanent vision impairment, if not treated.

Talk to your doctor before taking Actelsar HCT:

-if you are taking digoxin.

-if you are taking any of the following medicines used to treat high blood pressure:

-an ACE-inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

-aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Actelsar HCT”.

You must tell your doctor if you think you are (or might become) pregnant. Actelsar HCT is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see pregnancy section).

Treatment with hydrochlorothiazide may cause electrolyte imbalance in your body. Typical symptoms of fluid or electrolyte imbalance include dry mouth, weakness, lethargy, drowsiness, restlessness, muscle pain or cramps, nausea (feeling sick), vomiting, tired muscles, and an abnormally fast heart rate (faster than 100 beats per minute). If you experience any of these you should tell your doctor.

You should also tell your doctor if you experience an increased sensitivity of the skin to the sun with symptoms of sunburn (such as redness, itching, swelling, blistering) occurring more quickly than normal.

In case of surgery or anaesthetics, you should tell your doctor that you are taking Actelsar HCT.

Actelsar HCT may be less effective in lowering the blood pressure in black patients.

Children and adolescents

The use of Actelsar HCT in children and adolescents up to the age of 18 years is not recommended.

Other medicines and Actelsar HCT

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Your doctor may need to change the dose of these other medications or take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below taken at the same time with Actelsar HCT:

-Lithium containing medicines to treat some types of depression.

-Medicines associated with low blood potassium (hypokalaemia) such as other diuretics, (“water tablets”), laxatives (e.g. castor oil), corticosteroids (e.g. prednisone), ACTH (a hormone), amphotericin (an antifungal medicine), carbenoxolone (used to treat mouth ulcers), penicillin G sodium (an antibiotic), and salicylic acid and derivatives.

-Potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, ACE inhibitors that may increase blood potassium levels.

-Heart medicines (e.g. digoxin) or medicines to control the rhythm of your heart (e.g. quinidine, disopyramide).

-Medicines used for mental disorders (e.g. thioridazine, chlorpromazine, levomepromazine).

-Other medicines used to treat high blood pressure, steroids, painkillers, medicines to treat cancer, gout, or arthritis, and vitamin D supplements.

-If you are taking an ACE-inhibitor or aliskiren (see also information under the headings “Do not take Actelsar HCT” and “Warnings and precautions”).

-Digoxin.

Actelsar HCT may increase the blood pressure lowering effect of other medicines used to treat high blood pressure or of medicines with blood pressure lowering potential (e.g. baclofen, amifostine). Furthermore, low blood pressure may be aggravated by alcohol, barbiturates, narcotics or antidepressants. You may notice this as dizziness when standing up. You should consult with your doctor if you need to adjust the dose of your other medicine while taking Actelsar HCT.

The effect of Actelsar HCT may be reduced when you take NSAIDs (non steroidal anti-inflammatory medicines, e.g. aspirin or ibuprofen).

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Actelsar HCT before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Actelsar HCT. Actelsar HCT is not recommended during pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Actelsar HCT is not recommended for mothers who are breast-feeding and your doctor may choose another treatment for you if you wish to breast-feed.

Driving and using machines

Some people feel dizzy or tired when taking Actelsar HCT. If you feel dizzy or tired, do not drive or operate machinery.

3. How to take Actelsar HCT

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose of Actelsar HCT is one tablet a day. Try to take the tablet at the same time each day. You can take Actelsar HCT with or without food. The tablets should be swallowed with some water or other non-alcoholic drink. It is important that you take Actelsar HCT every day until your doctor tells you otherwise.

If your liver is not working properly, the usual dose should not exceed 40 mg/12.5 mg once a day.

If you take more Actelsar HCT than you should

If you accidentally take too many tablets contact your doctor, pharmacist, or your nearest hospital emergency department immediately.

If you forget to take Actelsar HCT

If you forget to take a dose, do not worry. Take it as soon as you remember, then carry on as before. If you do not take your tablet on one day, take your normal dose on the next day. Do not take a double dose to make up for a forgotten dose.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some side effects can be serious and need immediate medical attention:

You should see your doctor immediately if you experience any of the following symptoms:

Sepsis* (often called “blood poisoning”), is a severe infection with whole-body inflammatory response, rapid swelling of the skin and mucosa (angioedema); these side effects are rare (may affect up to 1 in 1,000 people) but are extremely serious and patients should stop taking the medicine and see their doctor immediately. If these effects are not treated they could be fatal. Increased incidence of sepsis has been observed with telmisartan only, however it can not be ruled out for Actelsar HCT.

Possible side effects of Actelsar HCT:

Common side effects (may affect up to 1 to 10 people):

Dizziness

Uncommon side effects (may affect up to 1 to 100 people):

Decreased blood potassium levels, anxiety, fainting (syncope), sensation of tingling, pins and needles (paraesthesia), feeling of spinning (vertigo), fast heart beat (tachycardia), heart rhythm disorders, low blood pressure, a sudden fall in blood pressure when you stand up, shortness of breath (dyspnoea), diarrhoea, dry mouth, flatulence, back pain, muscle spasm, muscle pain, erectile dysfunction (inability to get or keep an erection), chest pain, increased blood uric acid levels.

Rare side effects (may affect up to 1 to 1000 people):

Inflammation of the lungs (bronchitis), activation or worsening of systemic lupus erythematosus (a disease where the body’s immune system attacks the body, which causes joint pain, skin rashes and fever); sore throat, inflamed sinuses, feeling sad (depression), difficulty falling asleep (insomnia), impaired vision, difficulty breathing, abdominal pain, constipation, bloating (dyspepsia), feeling sick, inflammation of the stomach (gastritis), abnormal liver function (Japanese patients are more likely to experience this side effect), rapid swelling of the skin and mucosa which can also lead to death (angioedema also with fatal outcome), redness of the skin (erythema), allergic reactions such as

itching or rash, increased sweating, hives (urticaria), joint pain (arthralgia) and pain in extremities, muscle cramps, flu-like-illness, pain, increased levels of uric acid, low levels of sodium, increased levels of creatinine, hepatic enzymes or creatine phosphokinase in the blood.

Adverse reactions reported with one of the individual components may be potential adverse reactions with Actelsar HCT, even if not observed in clinical trials with this product.

Telmisartan

In patients taking telmisartan alone the following additional side effects have been reported:

Uncommon side effects (may affect up to 1 to 100 people):

Upper respiratory tract infection (e.g. sore throat, inflamed sinuses, common cold), urinary tract infections, deficiency in red blood cells (anaemia), high potassium levels, slow heart rate (bradycardia), kidney impairment including acute kidney failure, weakness, cough.

Rare side effects (may affect up to 1 to 1000 people):

Sepsis* (often called “blood poisoning”, is a severe infection with whole-body inflammatory response which can lead to death), low platelet count (thrombocytopenia), increase in certain white blood cells (eosinophilia), serious allergic reaction (e.g. hypersensitivity, anaphylactic reaction, drug rash), low blood sugar levels (in diabetic patients), upset stomach, eczema (a skin disorder), arthrosis, inflammation of the tendons, decreased haemoglobin (a blood protein), somnolence.

Very rare side effects (may affect up to 1 in 10,000 people):

Progressive scarring of lung tissue (interstitial lung disease)**

*The event may have happened by chance or could be related to a mechanism currently not known.

**Cases of progressive scarring of lung tissue have been reported during intake of telmisartan. However, it is not known whether telmisartan was the cause.

Hydrochlorothiazide

In patients taking hydrochlorothiazide alone the following additional side effects have been reported:

Side effects of unknown frequency (frequency cannot be estimated from the available data) Inflammation of the salivary gland, decreases in the number of cells in the blood, including low red and white blood cell count, low platelet count (thrombocytopenia), serious allergic reactions (e.g. hypersensitivity, anaphylactic reaction), decreased or loss of appetite, restlessness, light-headedness, blurred or yellowing of vision, decrease in vision and eye pain (possible signs of acute myopia or acute-angle closure glaucoma), inflammation of blood vessels (vasculitis necrotising), inflamed pancreas, upset stomach, yellowing of the skin or eyes (jaundice), lupus-like syndrome (a condition mimicking a disease called systemic lupus erythematosus where the body’s immune system attacks the body); skin disorders such as inflamed blood vessels in the skin, increased sensitivity to sunlight, or blistering and peeling of the top layer of skin (toxic epidermal necrolysis), weakness, kidney inflammation or impaired kidney function, glucose in the urine (glycosuria), fever, impaired electrolyte balance, high blood cholesterol levels, decreased blood volume, increased levels of glucose, or fat in the blood.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Actelsar HCT

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton, blister or bottle label after “EXP”. The expiry date refers to the last day of that month.

For Al/Al blisters and HDPE tablet container

This medicine does not require any special storage conditions.

For Al/PVC/PVDC blister

Do not store above 30ºC.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Actelsar HCT contains

-The active substances are telmisartan and hydrochlorothiazide. Each tablet contains 80 mg telmisartan and 25 mg hydrochlorothiazide.

-The other ingredients are magnesium stearate (E470b), potassium hydroxide, meglumine, povidone, sodium starch glycolate (type A), microcrystalline cellulose, mannitol (E421).

What Actelsar HCT looks like and contents of the pack

Actelsar HCT 80 mg/25 mg tablets are white or almost white, 9.0 x 17.0 mm oval-shaped and biconvex tablets marked with “TH” on one side and “25” on the other side.

Pack sizes

Al/Al blister packs: 14, 28, 30, 56, 84, 90 and 98 tablets

Al/PVC/PVDC blister packs: 28, 56, 84, 90 and 98 tablets

Tablet containers: 30, 90 and 250 tablets

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Actavis Group PTC ehf.

Reykjavíkurvegur 76-78, 220 Hafnarfjörður, Iceland

Manufacturer

Actavis hf.

Reykjavíkurvegur 78, 220 Hafnarfjörður, Iceland

Actavis Ltd.

BLB016, Bulebel Industrial Estate, Zejtun ZTN 3000, Malta

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgique/Belgien

Lietuva

Aurobindo Pharma B.V.

UAB “Actavis Baltics”

Nederland / Pays-Bas / Niederlande

Tel: +370 5 260 9615

Tél/Tel: +31 (0)35 542 99 33

 

 

България

Luxembourg/Luxemburg

Актавис ЕАД

Aurobindo Pharma B.V.

Teл.: +359 2 9321 861

Pays-Bas / Niederlande

 

Tél/Tel: +31 (0)35 542 99 33

Česká republika

Magyarország

Actavis CZ a.s.

Actavis Hungary Kft.

Tel: +420 251 113 002

Tel.: +36 1 501 7001

Danmark

Malta

Actavis A/S

Actavis Ltd.

Tlf: +45 72 22 30 00

Tel: +35621693533

Deutschland

Nederland

PUREN Pharma GmbH & Co. KG

Aurobindo Pharma B.V.

Tel.: +49-89-558-9090

Tel: +31 (0)35 542 99 33

Eesti

Norge

UAB “Actavis Baltics” Eesti Filiaal

Actavis Norway AS

Tel: +372 6100 565

Tlf: +47 815 22 099

Ελλάδα

Österreich

Specifar ABEE

Actavis GmbH

Τηλ: +30 210 5401500

Tel: +43 (0)662 435 235 00

España

Polska

Aurovitas Spain, S.A.U.

Actavis Export Int. Ltd., Malta

Tfno.: +34 91 630 86 45

Kontakt w Polsce:

 

Tel.: (+48 22) 512 29 00

France

Portugal

Arrow Génériques

Aurovitas, Unipessoal, Lda

Tél: +33 4 72 72 60 72

Tel: +351 214 185 104

Hrvatska

România

PharmaVigil d.o.o.

Actavis SRL

Tel: +385(1)3890676

Tel: +40 21 318 17 77

Ireland

Slovenija

Actavis Ireland Limited

Apta Medica Internacional d.o.o.

Tel: +353 (0)21 4619040

Tel: +386 51 615 015

Ísland

Slovenská republika

Actavis Group PTC ehf.

Actavis s.r.o.

Sími: +354 550 3300

Tel: +421 2 3255 3800

Italia

Suomi/Finland

Aurobindo Pharma (Italia) s.r.l.

Actavis Oy

Tel: +39 0296392601

Puh/Tel: +358 (0)9 348 233

Κύπρος

Sverige

A. Potamitis Medicare Ltd

Actavis AB

Τηλ: +357 22583333

Tel: +46 8 13 63 70

Latvija

United Kingdom

UAB “Actavis Baltics” Latvijas filiāle

Actavis UK Limited

Tel: +371 67304300

Tel: +44 1271 385257

België/Belgique/Belgien

Lietuva

Aurobindo Pharma B.V.

UAB “Actavis Baltics”

Nederland / Pays-Bas / Niederlande

Tel: +370 5 260 9615

Tél/Tel: +31 (0)35 542 99 33

 

България

Luxembourg/Luxemburg

Актавис ЕАД

Aurobindo Pharma B.V.

Teл.: +359 2 9321 680

Pays-Bas / Niederlande

 

Tél/Tel: +31 (0)35 542 99 33

Česká republika

Magyarország

Actavis CZ a.s.

Actavis Hungary Kft.

Tel: +420 251 113 002

Tel.: +36 1 501 7001

Danmark

Malta

Actavis A/S

Actavis Ltd.

Tlf: +45 72 22 30 00

Tel: +35621693533

Deutschland

Nederland

Actavis Deutschland GmbH & Co. KG

Aurobindo Pharma B.V.

Telefon: +49 (0)89 558909 0

Tel: +31 (0)35 542 99 33

Eesti

Norge

UAB “Actavis Baltics” Eesti Filiaal

Actavis Norway AS

Tel: +372 6100 565

Tlf: +47 815 22 099

Ελλάδα

Österreich

Specifar ABEE

Actavis GmbH

Τηλ: +30 210 5401500

Tel: +43 (0)662 435 235 00

España

Polska

Aurovitas Spain, S.A.U.

Actavis Export Int. Ltd., Malta

Tfno.: +34 91 630 86 45

Kontakt w Polsce:

 

Tel.: (+48 22) 512 29 00

France

Portugal

Arrow Génériques

Aurovitas, Unipessoal, Lda

Tél: +33 4 72 72 60 72

Tel: +351 214 185 104

Hrvatska

România

Phoenix Farmacija d.d.

Actavis SRL

Tel: +385(1) 6370-400

Tel: +40 21 318 17 77

Ireland

Slovenija

Actavis Ireland Limited

Apta Medica Internacional d.o.o.

Tel: +353 (0)21 4619040

Tel: +386 51 615 015

Ísland

Slovenská republika

Actavis Group PTC ehf.

Actavis s.r.o.

Sími: +354 550 3300

Tel: +421 2 3255 3800

Italia

Suomi/Finland

Aurobindo Pharma (Italia) s.r.l.

Actavis Oy

Tel: +39 0296392601

Puh/Tel: +358 (0)9 348 233

Κύπρος

Sverige

A. Potamitis Medicare Ltd

Actavis AB

Τηλ: +357 22583333

Tel: +46 8 13 63 70

Latvija

United Kingdom

UAB “Actavis Baltics” Latvijas filiāle

Actavis UK Limited

Tel: +371 67304300

Tel: +44 1271 385257

This leaflet was last revised in

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.

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