What happens if I overdose Temisartan Diur?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; fast or slow heartbeat; severe or unusual dizziness or light-headedness; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, decreased urination; dry mouth or eyes; fast heartbeat; unusual thirst, tiredness, or weakness).
Proper storage of Temisartan Diur:
Store Temisartan Diur at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Temisartan Diur out of the reach of children and away from pets.
Overdose of Temisartan Diur in details
No specific information is available on the treatment of overdosage with Temisartan Diur. Treatment is symptomatic and supportive. Therapy with Temisartan Diur should be discontinued and the patient observed closely. Suggested measures include induction of emesis if ingestion is recent, and correction of dehydration, electrolyte imbalance, hepatic coma and hypotension by established procedures.
Losartan (Temisartan Diur): Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. If symptomatic hypotension should occur, supportive treatment should be instituted.
Neither Losartan (Temisartan Diur) nor the active metabolite can be removed by hemodialysis.
Hydrochlorothiazide (Temisartan Diur): The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias.
The degree to which Hydrochlorothiazide (Temisartan Diur) is removed by hemodialysis has not been established.
What should I avoid while taking Temisartan Diur?
This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Drinking alcohol can further lower your blood pressure and may increase certain side effects of Temisartan Diur.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
Do not use potassium supplements or salt substitutes while you are taking Temisartan Diur, unless your doctor has told you to.
Temisartan Diur warnings
Fetal Toxicity
Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue Temisartan Diur as soon as possible.
Thiazides cross the placental barrier and appear in cord blood. Adverse reactions include fetal or neonatal jaundice, thrombocytopenia.
Hypotension in Volume- or Salt-Depleted Patients
In patients with an activated renin-angiotensin system, such as volume- or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment with Temisartan Diur. Correct volume or salt depletion prior to administration of Temisartan Diur. Do not use Temisartan Diur as initial therapy in patients with intravascular volume depletion.
Impaired Renal Function
Changes in renal function including acute renal failure can be caused by drugs that inhibit the reninangiotensin system and by diuretics. Patients whose renal function may depend in part on the activity of the renin-angiotensin system (e.g., patients with renal artery stenosis, chronic kidney disease, severe congestive heart failure, or volume depletion) may be at particular risk of developing acute renal failure on Temisartan Diur. Monitor renal function periodically in these patients. Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function on Temisartan Diur.
Hypersensitivity
Hypersensitivity reactions to Hydrochlorothiazide (Temisartan Diur) may occur in patients with or without a history of allergy or bronchial asthma, but are more likely in patients with such a history.
Electrolyte and Metabolic Effects
In double-blind clinical trials of various doses of Temisartan Diur, the incidence of hypertensive patients who developed hypokalemia (serum potassium <3.5 mEq/L) was 6.7% versus 3.5% for placebo; the incidence of hyperkalemia (serum potassium >5.7 mEq/L) was 0.4% versus 0% for placebo.
Temisartan Diur contains Hydrochlorothiazide (Temisartan Diur) which can cause hypokalemia, hyponatremia and hypomagnesemia. Hypomagnesemia can result in hypokalemia which may be difficult to treat despite potassium repletion. Temisartan Diur also contains Losartan (Temisartan Diur) which can cause hyperkalemia. Monitor serum electrolytes periodically.
Hydrochlorothiazide (Temisartan Diur) may alter glucose tolerance and raise serum levels of cholesterol and triglycerides.
Hyperuricemia may occur or frank gout may be precipitated in patients receiving thiazide therapy. Because Losartan (Temisartan Diur) decreases uric acid, Losartan (Temisartan Diur) in combination with Hydrochlorothiazide (Temisartan Diur) attenuates the diuretic-induced hyperuricemia.
Hydrochlorothiazide (Temisartan Diur) decreases urinary calcium excretion and may cause elevations of serum calcium. Monitor calcium levels.
Acute Myopia and Secondary Angle-Closure Glaucoma
Hydrochlorothiazide (Temisartan Diur), a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation. Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue Hydrochlorothiazide (Temisartan Diur) as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy.
Systemic Lupus Erythematosus
Thiazide diuretics have been reported to cause exacerbation or activation of systemic lupus erythematosus.
Postsympathectomy Patients
The antihypertensive effects of the drug may be enhanced in the postsympathectomy patient.
What should I discuss with my healthcare provider before taking Temisartan Diur?
You should not use Temisartan Diur if you are allergic to Hydrochlorothiazide (Temisartan Diur) or Losartan (Temisartan Diur), if you are unable to urinate.
If you have diabetes, do not use Temisartan Diur together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna).
You may also need to avoid taking Temisartan Diur with aliskiren if you have kidney disease
To make sure Temisartan Diur is safe for you, tell your doctor if you have:
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kidney disease;
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liver disease;
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congestive heart failure;
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glaucoma;
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asthma;
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low or high levels of potassium in your blood;
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gout;
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lupus;
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diabetes; or
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an allergy to sulfa drugs or penicillin.
Do not use Temisartan Diur if you are pregnant. Stop using and tell your doctor right away if you become pregnant. Temisartan Diur can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.
It is not known whether Temisartan Diur passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Temisartan Diur precautions
Fetal Toxicity
Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue Temisartan Diur as soon as possible.
Thiazides cross the placental barrier and appear in cord blood. Adverse reactions include fetal or neonatal jaundice, thrombocytopenia.
Hypotension in Volume- or Salt-Depleted Patients
In patients with an activated renin-angiotensin system, such as volume- or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment with Temisartan Diur. Correct volume or salt depletion prior to administration of Temisartan Diur. Do not use Temisartan Diur as initial therapy in patients with intravascular volume depletion.
Impaired Renal Function
Changes in renal function including acute renal failure can be caused by drugs that inhibit the reninangiotensin system and by diuretics. Patients whose renal function may depend in part on the activity of the renin-angiotensin system (e.g., patients with renal artery stenosis, chronic kidney disease, severe congestive heart failure, or volume depletion) may be at particular risk of developing acute renal failure on Temisartan Diur. Monitor renal function periodically in these patients. Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function on Temisartan Diur.
Hypersensitivity
Hypersensitivity reactions to Hydrochlorothiazide (Temisartan Diur) may occur in patients with or without a history of allergy or bronchial asthma, but are more likely in patients with such a history.
Electrolyte and Metabolic Effects
In double-blind clinical trials of various doses of Temisartan Diur, the incidence of hypertensive patients who developed hypokalemia (serum potassium <3.5 mEq/L) was 6.7% versus 3.5% for placebo; the incidence of hyperkalemia (serum potassium >5.7 mEq/L) was 0.4% versus 0% for placebo.
Temisartan Diur contains Hydrochlorothiazide (Temisartan Diur) which can cause hypokalemia, hyponatremia and hypomagnesemia. Hypomagnesemia can result in hypokalemia which may be difficult to treat despite potassium repletion. Temisartan Diur also contains Losartan (Temisartan Diur) which can cause hyperkalemia. Monitor serum electrolytes periodically.
Hydrochlorothiazide (Temisartan Diur) may alter glucose tolerance and raise serum levels of cholesterol and triglycerides.
Hyperuricemia may occur or frank gout may be precipitated in patients receiving thiazide therapy. Because Losartan (Temisartan Diur) decreases uric acid, Losartan (Temisartan Diur) in combination with Hydrochlorothiazide (Temisartan Diur) attenuates the diuretic-induced hyperuricemia.
Hydrochlorothiazide (Temisartan Diur) decreases urinary calcium excretion and may cause elevations of serum calcium. Monitor calcium levels.
Acute Myopia and Secondary Angle-Closure Glaucoma
Hydrochlorothiazide (Temisartan Diur), a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation. Untreated acute angle-closure glaucoma can lead to permanent vision loss. The primary treatment is to discontinue Hydrochlorothiazide (Temisartan Diur) as rapidly as possible. Prompt medical or surgical treatments may need to be considered if the intraocular pressure remains uncontrolled. Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy.
Systemic Lupus Erythematosus
Thiazide diuretics have been reported to cause exacerbation or activation of systemic lupus erythematosus.
Postsympathectomy Patients
The antihypertensive effects of the drug may be enhanced in the postsympathectomy patient.
What happens if I miss a dose of Temisartan Diur?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DailyMed. "AMLODIPINE BESYLATE; HYDROCHLOROTHIAZIDE; OLMESARTAN MEDOXOMIL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DailyMed. "LOSARTAN POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "hydrochlorothiazide". http://www.drugbank.ca/drugs/DB00999 (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
