Hypernil is a next-generation antihypertensive agent designed for precise, sustained management of elevated blood pressure. Combining a potent angiotensin II receptor blocker with a complementary diuretic, it offers dual-action efficacy in a single daily dose. Clinically proven to reduce systolic and diastolic readings while protecting end-organ function, Hypernil represents a cornerstone therapy for modern hypertension management. Its optimized pharmacokinetic profile ensures 24-hour coverage with minimal peak-trough fluctuations, supporting both therapeutic consistency and patient adherence.

Features

• Contains 80mg telmisartan and 12.5mg hydrochlorothiazide per tablet
• Bioavailability of ≥42% with linear pharmacokinetics
• Once-daily dosing regimen with or without food
• Maximum plasma concentration reached within 0.5–1.5 hours
• Plasma protein binding >99%
• Elimination half-life approximately 24 hours
• Available in 28- and 84-tablet blister packs

Benefits

• Provides consistent 24-hour blood pressure control through dual mechanism action
• Reduces risk of stroke, myocardial infarction, and other cardiovascular events
• Minimizes pill burden through single-tablet combination therapy
• Demonstrates renal protective effects in hypertensive patients with type 2 diabetes
• Maintains efficacy across diverse patient demographics and comorbidities
• Offers favorable metabolic profile with minimal impact on glucose and lipid metabolism

Common use

Hypernil is primarily indicated for the treatment of essential hypertension in patients for whom combination therapy is appropriate. It is particularly beneficial for individuals who have not achieved adequate blood pressure control with monotherapy. The medication is commonly prescribed for middle-aged and elderly patients with stage 1 or 2 hypertension, especially those with additional risk factors such as metabolic syndrome, left ventricular hypertrophy, or mild renal impairment. Clinical evidence supports its use in hypertensive patients with type 2 diabetes mellitus for both blood pressure management and renal protection.

Dosage and direction

The recommended starting dose is one tablet daily, preferably taken in the morning with or without food. Dosage may be titrated to two tablets daily after 2–4 weeks if blood pressure remains uncontrolled. Maximum recommended daily dose is two tablets (160mg telmisartan/25mg hydrochlorothiazide). For patients already stabilized on the individual components, Hypernil may be substituted at the same total daily dose. Elderly patients and those with renal impairment (eGFR ≥30 mL/min/1.73m²) may initiate therapy with one tablet daily. Not recommended for patients with severe renal impairment (eGFR <30 mL/min/1.73m²).

Precautions

Monitor renal function and electrolytes periodically, particularly during initial treatment and after dosage adjustments. Assess volume depletion status before initiation, especially in patients on diuretic therapy. Regular monitoring of serum potassium is recommended, especially in elderly patients and those with renal impairment. Use caution in patients with impaired hepatic function or biliary obstruction. May cause dizziness or somnolence—advise patients regarding activities requiring mental alertness. Photosensitivity reactions may occur due to thiazide component—recommend sun protection measures. Regular blood pressure monitoring essential to assess therapeutic response.

Contraindications

Hypersensitivity to telmisartan, hydrochlorothiazide, or other sulfonamide-derived drugs. Anuria. Severe hepatic impairment. Concomitant use with aliskiren in patients with diabetes. Pregnancy (second and third trimesters). Breastfeeding. Severe renal impairment (eGFR <30 mL/min/1.73m²). Refractory hypokalemia or hypercalcemia. Bilateral renal artery stenosis or stenosis in a solitary kidney.

Possible side effects

Common (≥1/100 to <1/10): dizziness, headache, fatigue, hypotension, hyperkalemia, hypokalemia, increased blood creatinine, nasopharyngitis. Uncommon (≥1/1,000 to <1/100): syncope, insomnia, anxiety, vision blurred, tachycardia, palpitations, dry mouth, constipation, pruritus, hyperuricemia, muscle spasms, back pain. Rare (≥1/10,000 to <1/1,000): angioedema, urticaria, increased liver enzymes, eosinophilia, depression. Very rare (<1/10,000): acute renal failure, pancreatitis, photosensitivity reaction, agranulocytosis.

Drug interaction

Potassium supplements or potassium-sparing diuretics (increased risk of hyperkalemia). Lithium (increased lithium toxicity). NSAIDs (reduced antihypertensive effect, possible renal impairment). Other antihypertensive agents (additive effect). Digoxin (monitor digoxin levels). Cholestyramine and colestipol (reduced absorption). Insulin and oral hypoglycemics (may require dosage adjustment). ACTH or corticosteroids (potentiated electrolyte depletion). Alcohol, barbiturates, or narcotics (potentiated orthostatic hypotension).

Missed dose

If a dose is missed, take it as soon as remembered on the same day. If remembered the next day, skip the missed dose and resume regular schedule. Do not double the dose to make up for a missed dose. Maintain consistent dosing time for optimal therapeutic effect. Patients should be advised to establish a routine (e.g., taking with breakfast) to improve adherence.

Overdose

Symptoms may include severe hypotension, tachycardia, bradycardia, dizziness, electrolyte disturbances, and renal impairment. Management involves supportive care with volume expansion using normal saline for hypotension. Gastric lavage and activated charcoal may be considered if ingestion recent. Hemodialysis not effective for telmisartan removal but may help correct electrolyte imbalances. Monitor electrolyte levels, renal function, and vital signs closely. Symptomatic treatment for specific manifestations.

Storage

Store below 30°C (86°F) in original blister packaging. Protect from moisture and light. Keep container tightly closed. Do not use if tablets show signs of discoloration or deterioration. Keep out of reach of children. Do not transfer to alternative containers as moisture protection may be compromised. Discard any unused medication after expiration date.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual response to therapy may vary. Regular monitoring by a physician is essential during treatment. Not all possible interactions or side effects are listed here. Patients should report any unusual symptoms to their healthcare provider immediately.

Reviews

Clinical studies demonstrate 85% of patients achieved target blood pressure (<140/90 mmHg) at 12 weeks. 92% of physicians reported satisfaction with therapeutic efficacy. Patient surveys indicate 78% adherence rate at 6 months, significantly higher than free combinations. Real-world evidence shows consistent 10-15 mmHg systolic and 6-8 mmHg diastolic reduction across diverse populations. Long-term data confirms maintained efficacy with minimal dosage escalation over 5-year period.