8 Micardis HCT Side Effects and How to Manage Them
Key takeaways:
Micardis HCT (telmisartan / hydrochlorothiazide) is a combination blood pressure medication. It contains an angiotensin II receptor blocker (ARB) and a diuretic (“water pill”).
Common Micardis HCT side effects include dizziness, upper respiratory tract infections, and diarrhea. Fatigue, nausea, and back pain are also possible. In most cases, you can manage these effects on your own at home.
Rare but serious Micardis HCT side effects include severely low blood pressure, electrolyte changes, and kidney problems. Talk to your healthcare team about any questions or concerns regarding side effects.
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Table of contents
Micardis HCT (telmisartan / hydrochlorothiazide) is a combination blood pressure medication. It contains two active ingredients: telmisartan, an angiotensin II receptor blocker (ARB), and hydrochlorothiazide (HCT), a diuretic (“water pill”). Micardis HCT treats hypertension (high blood pressure) and lowers the risk of heart-related complications, such as a stroke or heart attack.
Overall, Micardis HCT is well tolerated and effective. But it can cause side effects. Knowing what to look out for and how to manage side effects can help you stay safe while taking Micardis HCT.
Micardis HCT side effects at a glance
Below is a list of common and rare Micardis HCT side effects. Keep in mind that this isn’t a complete list. Reach out to your healthcare team if you experience concerning symptoms, even if they aren’t listed here.
Common Micardis HCT side effects include:
Upper respiratory tract infection
Dizziness
Diarrhea
Fatigue
Nausea
Flu-like symptoms
Back pain
Rare but serious Micardis HCT side effects include:
Kidney problems
Severe electrolyte changes
Dangerously low blood pressure
Vision changes or eye pain
New or worsening lupus
Micardis HCT also has a boxed warning for causing harm to an unborn baby. This is the FDA’s strictest warning for medications. Let your prescriber know if you’re pregnant or trying to become pregnant while taking Micardis HCT. A different blood pressure medication is a safer choice during pregnancy.
Below, we’ll go into more detail about eight Micardis HCT side effects and how to manage them.
1. Dizziness
Dizziness is a common Micardis HCT side effect. It’s more likely when you first start taking the medication or after a dose increase. Dizziness typically happens as your blood pressure drops. It usually goes away after a few weeks as your body adjusts to a lower blood pressure.
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Dizziness can also happen if you sit up or stand too quickly. This is known as orthostatic hypotension. Move slowly when changing positions and give yourself time to adjust before you start walking to avoid falls. Staying hydrated and eating regularly can also help reduce dizziness.
If your dizziness persists, it may be a sign your blood pressure is too low. Your prescriber may have you check your blood pressure at home to make sure it stays within a safe range. Let them know if your readings are lower than recommended or dizziness worsens or doesn’t improve.
2. Upper respiratory infections
Upper respiratory tract infections (URTIs), such as the common cold, are another possible side effect of Micardis HCT. Symptoms may include a stuffy nose or painful sinuses, sore throat, and cough. It isn’t clear why this side effect happens, but there are steps you can take if you get sick.
Over-the-counter (OTC) cough and cold medications can help manage your symptoms. Just be sure to check with your healthcare team so you choose a product that won’t increase your blood pressure. Home remedies, such as a saline nasal rinse (neti pot) or hot tea with honey, can also help relieve your symptoms without medication.
In most cases, your symptoms should resolve on their own within a week or two. But if your symptoms are getting worse or you have a fever that doesn’t go away after a few days, it’s best to seek medical care.
3. Diarrhea
Occasionally, Micardis HCT may cause diarrhea. In most cases, diarrhea is mild and will go away on its own. In the meantime, be sure to stay hydrated, since diarrhea can lead to dehydration. Water, sports drinks, and broth are all helpful options.
It may also help to choose foods that are easy to digest, such as bananas, applesauce, and toast. Avoid spicy foods, foods high in fat, and caffeinated beverages, as they can worsen diarrhea.
If needed, you can try an OTC diarrhea treatment, such as loperamide (Imodium A-D). But if your diarrhea worsens or doesn’t improve after a few weeks, it’s best to seek medical care. There could be something else causing it that requires further treatment.
4. Fatigue
Some people report fatigue while taking Micardis HCT. Most blood pressure medications can make you feel tired. But it’s more likely with beta blockers than with Micardis HCT.
Exercising regularly, eating healthy foods, and getting enough sleep can help you manage fatigue at home. Keep in mind that Micardis HCT can make you pee more often. Taking it in the morning can help you avoid nighttime bathroom trips that interrupt your sleep.
Fatigue may improve as your body adjusts to the medication. If it worsens or doesn’t go away, let your prescriber know. They may want to adjust your medication or see if there’s another cause for your fatigue.
5. Nausea
Many medications can upset the stomach, including Micardis HCT. You can take Micardis HCT with or without food. But taking it with food can help prevent nausea.
If taking your Micardis HCT with food doesn’t help, check with your prescriber to see if a nausea medication could be a good option for you. There are both OTC and prescription medications that may help. Your prescriber may also check for other possible causes of your nausea.
6. Back pain
Some people taking Micardis HCT report back pain. This side effect is possible with other ARBs as well. It isn’t clear why back pain happens, but you can manage it at home.
Choosing the right sleeping positions, doing light exercise, and getting physical therapy can help soothe back pain. You can also try applying ice or heat to the painful area.
If needed, an OTC pain reliever, patch, or topical cream can also help relieve back pain. Talk to your healthcare team about the best option for you based on your other medications and health conditions.
7. Electrolyte changes
Both of the medications in Micardis HCT can affect the electrolyte levels in your body. Electrolytes include chemicals such as sodium, potassium, and magnesium.
Telmisartan can increase potassium levels, while HCT can lower potassium levels. HCT can also cause low sodium and magnesium levels as well as high calcium levels.
In most cases, these changes happen within the first few weeks of treatment. Your prescriber will likely keep an eye on your electrolyte levels to check for any problems. But let them know if you’re feeling dizzy, tired, or weaker than usual. They can help determine if your electrolyte levels could be the cause or if it’s a side effect of the medication itself.
8. Kidney problems
Micardis HCT helps protect kidney function for most people taking it. But in rare cases, it may cause sudden kidney problems. The risk of kidney problems is higher if you have existing kidney problems, certain heart problems, or take nonsteroidal anti-inflammatory drugs (NSAIDs).
Your prescriber will review your risk for this side effect before you start taking Micardis HCT. Be sure to provide them with your full medical history as well as an updated medication list. It’s also best to check with your healthcare team before taking an NSAID while you’re taking Micardis HCT.
Symptoms of a sudden kidney problem include peeing less than usual or not at all, chest pain, and trouble breathing. If these symptoms appear, seek medical care right away.
Frequently asked questions
It’s possible, but not common. The HCT component of Micardis HCT may contribute to erectile dysfunction (ED). But the telmisartan component may actually improve erections in some cases. So the overall risk of ED with the combination is relatively low overall.
ED is more common with other blood pressure medications, such as beta blockers. But if it happens, don’t hesitate to speak with your prescriber about it — they can offer treatment options to improve your symptoms.
Not usually. Angiotensin-converting enzyme (ACE) inhibitors are the class of blood pressure medications known to cause a dry cough. Micardis HCT isn’t an ACE inhibitor. It contains two other types of blood pressure medications, so it isn’t likely to have this side effect. Still, if you develop a persistent cough while taking it, let your prescriber know. They can help determine the cause and may suggest a different blood pressure medication if needed.
The bottom line
Micardis HCT (telmisartan / hydrochlorothiazide) is a combination blood pressure medication. Common Micardis HCT side effects include dizziness, upper respiratory infections, and diarrhea. Nausea, fatigue, and back pain are also possible. In most cases, these side effects are mild and can be managed on your own at home.
Rare but serious side effects include severely low blood pressure, electrolyte changes, and kidney problems. Let your prescriber know if any Micardis HCT side effects don’t go away or worsen. If symptoms feel life-threatening, seek emergency medical care.
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References
Aurobindo Pharma Limited. (2023). Telmisartan and hydrochlorothiazide - telmisartan and hydrochlorothiazide tablet [package insert].
Harężlak, T., et al. (2022). Drug interactions affecting kidney function: Beware of health threats from triple whammy. Advances in Therapy.
MacArthur, C. (2021). Why do I feel dizzy on heart medication and what can I do to stop it? British Heart Foundation.
National Kidney Foundation. (2024). Acute kidney injury (AKI).
Palaniappan, M., et al. (2015). Pattern of adverse drug reactions reported with cardiovascular drugs in a tertiary care teaching hospital. Journal of Clinical and Diagnostic Research.
Shrimanker, I., et al. (2023). Electrolytes. StatPearls.
Tomson, C. R. V., et al. (2021). Management of blood pressure in patients with chronic kidney disease not receiving dialysis: Synopsis of the 2021 KDIGO Clinical Practice Guideline. Annals of Internal Medicine.
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