Two medicines, side by side
Hydrochlorothiazide vs telmisartan
Hydrochlorothiazide and telmisartan are both labeled for high blood pressure. Drugs@FDA records approvals of hydrochlorothiazide since 1959 and of telmisartan since 1998. Pharmacies paid $0.0115 per hydrochlorothiazide 25 mg tablet and $0.106 per telmisartan 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Hydrochlorothiazide's other strengths are brand-only: $4.46 per mL (Inzirqo 10 mg/mL oral suspension). In FDA's classes, hydrochlorothiazide is a thiazide diuretic and telmisartan an angiotensin 2 receptor blocker.
Check it at the source: the hydrochlorothiazide FDA label on DailyMed (effective June 12, 2026); the telmisartan FDA label on DailyMed (effective May 29, 2026).
Highlights of the hydrochlorothiazide record
Hydrochlorothiazide (Inzirqo) · label of June 12, 2026
Used for
From the label: indicationsHydrochlorothiazide tablets USP are indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Hydrochlorothiazide tablets USP have also been found useful in edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. […]
On the market
- Earliest approval on file
- February 12, 1959
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0115 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 7
Highlights of the telmisartan record
Telmisartan (Micardis) · label of May 29, 2026
FETAL TOXICITY When pregnancy is detected, discontinue telmisartan as soon as possible [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)]. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1)]. WARNING: FETAL TOXICITY See full prescribing information for complete boxed warnings.
Used for
From the label: indicationsTelmisartanis an angiotensin II receptor blocker (ARB) indicated for: Treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions(1.1) 1.1 Hypertension Telmisartan is indicated for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- November 10, 1998
- Generic labelers
- 28 labelers
- Pharmacy cost
- $0.106 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Source: FDA drug labels via openFDA (Hydrochlorothiazide label of June 12, 2026, Telmisartan label of May 29, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydrochlorothiazide and telmisartan differ on the record?
In FDA's classes, hydrochlorothiazide is a thiazide diuretic and telmisartan an angiotensin 2 receptor blocker.
Half-life, in each label's words: Hydrochlorothiazide, “When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 …”; Telmisartan, “Telmisartan shows bi-exponential decay kinetics with a terminal elimination half-life of approximately 24 hours.”
Only the telmisartan label carries a boxed warning.
Generics: hydrochlorothiazide since 1973; telmisartan since 2014 (Drugs@FDA).
| Hydrochlorothiazide | Telmisartan | |
|---|---|---|
| Labeled for | Heart failure, High blood pressure, Edema (fluid retention) | High blood pressure, Heart attack and coronary artery disease |
| Pharmacologic class | Thiazide Diuretic | Angiotensin 2 Receptor Blocker |
| How it works (label) | n/a | Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). |
| Half-life (label) | When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 and 14.8 hours. | Telmisartan shows bi-exponential decay kinetics with a terminal elimination half-life of approximately 24 hours. |
| Earliest approval on file (Drugs@FDA) | February 12, 1959 | November 10, 1998 |
| First generic approved | January 12, 1973 | January 8, 2014 |
| Generic labelers (NDC) | 43 labelers | 28 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0115 per tablet (Hydrochlorothiazide 25 mg tablet) | $0.106 per tablet (Telmisartan 20 mg tablet) |
| 12-month price change | -7% | -4% |
| Boxed warning | No | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 7 | 3 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 144,413 | 17,745 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to hydrochlorothiazide
- every medicine labeled for the same conditions