Kinzalkomb marketed in Belgium by Bayer is a fixed combination of
telmisartan 80 mg and
hydrochlorothiazide 125 mg for the treatment of
hypertension. New guidelines for the treatment of
hypertension were recently released both in Europe and the United States (see article by J.M. Krzesinski in this issue). They offer the choice of using a fixed
biotherapy even as first line treatment.
Hydrochlorothiazide at low dose is a frequent component of such
biotherapies: it is efficacious and secure.
Telmisartan is a highly selective blocker of
angiotensin II AT1 receptors ("
sartans"); it is at least as effective as the classical
antihypertensive agents; thanks to its half-life, the longest of all
sartans', it provides adequate
antihypertensive coverage throughout the whole 24-hour postdose interval and particularly over the last 6 hours of the dosage interval. Its tolerability profile is equivalent to placebo. The combination
telmisartan-hydrochlorothiazide is more effective than each agent alone at lowering blood pressure; furthermore
telmisartan possesses a
potassium-sparing effect that when the two drugs are coadministered attenuates the kaliuretic effect of
hydrochlorothiazide. Various large trials are currently under way (ONTARGET, TRANSCEND, PROFESS, PROTECTION, DETAIL). These studies which together involve some 50,000 patients will hopefully help to further specify the role of
telmisartan in condition which require an intervention on the renin-angiotensin system.