Micardis Plus

When a single antihypertensive medicine is not enough to bring blood pressure under control, a combination product can simplify treatment and improve adherence. Micardis Plus tablets are a prescription-only combination medicine containing telmisartan (an ARB) and hydrochlorothiazide (a diuretic). Together they provide blood pressure control through two complementary mechanisms in a single daily tablet. A prescription can only be issued following a clinical consultation.

Micardis Plus is a branded prescription medicine manufactured by Boehringer Ingelheim. Each tablet contains two active ingredients: telmisartan and hydrochlorothiazide (HCT). Telmisartan is an angiotensin receptor blocker (ARB) that acts on the renin-angiotensin system to lower blood pressure. Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure through a complementary mechanism involving increased urine production and reduced fluid volume.

Micardis Plus is licensed in the UK for the treatment of essential hypertension (high blood pressure) in adults whose blood pressure is not adequately controlled on telmisartan alone. It is also indicated as a substitute in adults already being treated with the individual components of telmisartan and hydrochlorothiazide taken as separate medicines.

Three tablet strengths are available through this service. Each strength is identified by the doses of telmisartan and hydrochlorothiazide it contains. Micardis Plus is a fixed dose combination and cannot be used to adjust the two components independently. Your prescriber will determine which strength is appropriate for your blood pressure control needs.

Micardis Plus lowers blood pressure through the combined actions of its two active ingredients, each working through a different mechanism.

Telmisartan: Angiotensin Receptor Blockade

Telmisartan blocks the AT1 receptor, the receptor through which angiotensin II raises blood pressure by causing blood vessels to narrow and the body to retain sodium and water. By occupying this receptor without activating it, telmisartan prevents angiotensin II from exerting its effects. Blood vessels relax and widen, sodium and water retention decreases, and blood pressure falls as a result. Telmisartan has a long duration of action and is taken once daily.

Hydrochlorothiazide: Thiazide Diuretic

Hydrochlorothiazide acts on the distal convoluted tubule of the kidney, where it reduces the reabsorption of sodium and chloride. This leads to increased urine production, reducing the overall volume of fluid in the circulation. Lower circulating volume reduces the pressure the heart must work against, contributing a further blood pressure lowering effect that is complementary to that of telmisartan.

The combination of these two mechanisms provides additive blood pressure reduction compared to either component used alone. This is why Micardis Plus is prescribed when one medicine has not achieved adequate blood pressure control. Because both components are delivered in a single tablet, patients have only one tablet to take each day, which can support better adherence to treatment over time.

Always take Micardis Plus exactly as your prescriber instructs. The information below summarises key points from the current UK SmPC. Read the Patient Information Leaflet supplied with your medicine before starting treatment.

• Take one tablet once daily, at approximately the same time each day.
• Micardis Plus can be taken with or without food.
• Swallow the tablet whole with a glass of water. Do not crush or chew the tablet.
• If you miss a dose, take it as soon as you remember on the same day. If you only remember the following day, skip the missed dose and continue with your normal schedule. Do not take two doses on the same day.
• Do not stop taking Micardis Plus without speaking to your prescriber first. Blood pressure requires ongoing management, and stopping suddenly can cause it to rise again.
• Micardis Plus contains hydrochlorothiazide, a diuretic component that increases urine production. This effect is most noticeable in the first few hours after taking each dose. Taking the tablet in the morning helps ensure this effect occurs during the day rather than disrupting sleep. Your prescriber may arrange blood tests to check your kidney function, potassium levels, and sodium levels periodically during treatment. This is standard practice when taking a diuretic-containing combination medicine.

Micardis Plus is available in three strengths. The appropriate strength is determined by your prescriber based on your blood pressure, your previous response to telmisartan alone, and your individual clinical needs.

Micardis Plus 40 mg/12.5 mg Tablets

Each tablet contains telmisartan 40 mg and hydrochlorothiazide 12.5 mg. This is the lowest available strength and is typically used in patients stepping up from telmisartan 40 mg alone when further blood pressure reduction is needed. It provides the lower telmisartan dose combined with the lower diuretic dose, allowing dose escalation to begin cautiously.

Micardis Plus 80 mg/12.5 mg Tablets

Each tablet contains telmisartan 80 mg and hydrochlorothiazide 12.5 mg. This strength is commonly used in patients who were taking telmisartan 80 mg alone but require additional blood pressure lowering. The higher ARB dose is combined with the lower diuretic dose, giving a significant ARB effect with a moderate diuretic contribution.

Micardis Plus 80 mg/25 mg Tablets

Each tablet contains telmisartan 80 mg and hydrochlorothiazide 25 mg. This is the highest available strength and provides the maximum telmisartan dose combined with the higher diuretic dose. It is typically used in patients whose blood pressure has not been adequately controlled on the 80 mg/12.5 mg strength. All dose adjustments are made by your prescriber. Do not change your strength without medical advice.

The maximum recommended daily dose of telmisartan is 80 mg and the maximum of hydrochlorothiazide in this combination is 25 mg. Do not take more than one tablet of Micardis Plus per day. If you are also taking other antihypertensive medicines alongside Micardis Plus, follow your prescriber's instructions carefully.

Micardis Plus can cause side effects from either of its active components. The information below is based on the current UK SmPC. Refer to the Patient Information Leaflet for the full list.

Common Side Effects (may affect up to 1 in 10 people)

• Dizziness, particularly on standing up quickly (postural hypotension). The diuretic component can reduce circulating fluid volume, making this more likely.
• Low potassium levels (hypokalaemia) from the hydrochlorothiazide component. This can cause muscle cramps, weakness, or palpitations. Regular blood tests help monitor this.
• Raised blood uric acid levels, which may trigger gout in susceptible patients
• Raised blood glucose levels, which may be relevant in patients with or at risk of diabetes

Uncommon Side Effects (may affect up to 1 in 100 people)

• Low sodium levels (hyponatraemia), which can cause fatigue, confusion, and headache
• Nausea or abdominal discomfort
• Increased frequency of passing urine, particularly in the first hours after each dose
• Skin reactions including rash or increased sensitivity to sunlight

Serious Side Effects: Seek Urgent Medical Attention

Go to your nearest accident and emergency department or call 999 immediately if you experience:

• Angioedema: sudden swelling of the face, lips, tongue, or throat. This is rare but requires immediate emergency medical attention. If you have had angioedema from any ARB or ACE inhibitor before, you must not take Micardis Plus.
• Signs of severe electrolyte disturbance such as confusion, muscle weakness, or irregular heartbeat
• Severe dehydration symptoms such as extreme thirst, very dark urine, confusion, or fainting

Report any suspected side effect to your prescriber, pharmacist, or via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Micardis Plus May Be Suitable If You:

• Are an adult aged 18 or over with a confirmed diagnosis of essential hypertension
• Are already taking telmisartan alone and your blood pressure is not adequately controlled
• Are already taking telmisartan and hydrochlorothiazide as separate medicines and wish to simplify to a single combination tablet
• Are already prescribed Micardis Plus and require a repeat prescription through an online prescribing service

Micardis Plus Is Not Suitable If You:

• Are pregnant or planning to become pregnant. Telmisartan is contraindicated in pregnancy. ARBs cause serious harm to the developing baby, including kidney damage and foetal death, particularly in the second and third trimesters. Contact your prescriber immediately if you become pregnant while taking Micardis Plus.
• Are breastfeeding
• Have severe kidney impairment or are on dialysis
• Have severe liver disease or biliary obstruction
• Have low potassium or low sodium levels that have not been corrected
• Have diabetes or moderate to severe kidney impairment and are also taking aliskiren
• Have a known allergy or hypersensitivity to telmisartan, hydrochlorothiazide, sulfonamide-derived medicines, or any excipient listed in the SmPC
• Are under 18 years of age

Tell your prescriber about all medicines you take, including over the counter products and herbal supplements. Important interactions for Micardis Plus include interactions from both the telmisartan and hydrochlorothiazide components:

• Lithium: telmisartan can increase lithium blood levels. Hydrochlorothiazide may further increase this risk. The combination with lithium is generally not recommended.
• Potassium supplements, potassium-sparing diuretics (such as spironolactone or amiloride), and potassium-containing salt substitutes: these can raise blood potassium to dangerous levels when combined with the ARB component.
• NSAIDs such as ibuprofen: regular use can reduce the blood pressure lowering effect of Micardis Plus and increase the risk of kidney problems and electrolyte disturbances.
• Aliskiren: contraindicated in combination with the telmisartan component in patients with diabetes or significant kidney impairment.
• Antidiabetic medicines including insulin: hydrochlorothiazide may raise blood glucose, potentially reducing the effectiveness of antidiabetic treatment. Dose adjustments may be needed.
• Digoxin: hydrochlorothiazide induced low potassium can increase the risk of digoxin toxicity. Electrolyte monitoring is particularly important in patients taking both.

Your prescriber will review all current medicines during the clinical assessment before any prescription is considered.

Micardis Plus is a Prescription Only Medicine. The clinical consultation is the essential first step. A prescription will only be issued if a registered prescriber concludes, based on their individual assessment of your circumstances, that Micardis Plus is clinically appropriate for you.

When you complete a consultation through Pharmacy Planet, a registered prescriber will review your clinical information. This includes your blood pressure history, your current antihypertensive medication, your kidney function and electrolyte results where available, and any other relevant medical history. The prescriber will assess whether Micardis Plus is the right combination for your needs, which strength is appropriate, or whether a different approach would better suit your circumstances.

If you are being managed for hypertension by your GP or a specialist, please keep them informed of all medicines prescribed through online services. This supports safe and coordinated BP regulation and cardiovascular therapy.

• Store below 30°C.
• Store in the original packaging. Micardis Plus tablets are moisture sensitive and must be kept in the original blister packaging to protect from moisture.
• Keep out of the sight and reach of children.
• Do not use after the expiry date printed on the packaging.
• Do not dispose of medicines via household waste or wastewater. Return unused or out of date tablets to your pharmacist for safe disposal.
• Full storage instructions, including specific moisture-protection requirements, are provided in the Patient Information Leaflet supplied with your medicine.

The table below compares combination tablets that contain two active ingredients in a single dose. These are prescribed when a single medicine does not provide adequate blood pressure control.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation.

Pharmacy Planet is a GPhC-registered online pharmacy providing access to prescription medicines through a clinically led consultation process. Our registered prescribers and pharmacists are committed to patient safety, clinical accuracy, and responsible prescribing.

We follow GPhC standards, MHRA guidance, and ASA advertising regulations in all aspects of our service. Every prescription is reviewed and dispensed by qualified healthcare professionals. We provide clear, factual information to help patients understand their antihypertensive medication and make informed decisions about their cardiovascular therapy and heart health.

If you have questions about Micardis Plus or any other blood pressure medicine, our pharmacy team is available to help. We are committed to transparent, patient centred care.

References

1. Electronic Medicines Compendium (eMC). Micardis Plus 40 mg/12.5 mg, 80 mg/12.5 mg and 80 mg/25 mg film-coated tablets — Summary of Product Characteristics. https://www.medicines.org.uk/emc. Accessed May 2026.
2. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. NICE guideline NG136. https://www.nice.org.uk/guidance/ng136. Accessed May 2026.
3. NHS. High blood pressure (hypertension). https://www.nhs.uk/conditions/high-blood-pressure-hypertension. Accessed May 2026.
4. Joint Formulary Committee. British National Formulary (BNF). Telmisartan with hydrochlorothiazide. BMJ Group and Pharmaceutical Press. https://bnf.nice.org.uk. Accessed May 2026.
5. Medicines and Healthcare products Regulatory Agency (MHRA). Yellow Card — report a side effect. https://yellowcard.mhra.gov.uk. Accessed May 2026.