MedPath
EMA Approval

Kinzalkomb

C09DA07

telmisartan and diuretics

Agents acting on the renin-angiotensin system

telmisartanhydrochlorothiazide

Hypertension

Basic Information

EMA regulatory identification and product classification information

EMA Identifiers

ATC CodeC09DA07
EMA European Classification

Overview Summary

Comprehensive product overview and regulatory summary

This is a summary of the European public assessment report (EPAR) for Kinzalkomb. It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the medicine to reach its opinion in favour of granting a marketing authorisation and its recommendations on the conditions of use for Kinzalkomb.

Authorisations (1)

EMEA/H/C/000415

Bayer AG,Kaiser-Wilhelm-Allee 1,51373 Leverkusen,Germany

Authorised

April 19, 2002

Active Substances (2)

Telmisartan

hydrochlorothiazide

Documents (14)

Kinzalkomb : EPAR - Summary for the public

May 27, 2009

OVERVIEW_DOCUMENT

Kinzalkomb-H-C-415-A31-0084 : EPAR - Assessment Report - Article 31

October 2, 2014

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Kinzalkomb-H-C-415-A31-0084 : EPAR - Assessment Report - Article 31

October 2, 2014

CHANGES_SINCE_INITIAL_AUTHORISATION

Kinzalkomb : EPAR - Scientific Discussion

June 3, 2008

CHANGES_SINCE_INITIAL_AUTHORISATION

Kinzalkomb : EPAR - Procedural steps taken before authorisation

October 20, 2005

CHANGES_SINCE_INITIAL_AUTHORISATION

Kinzalkomb-H-C-415-A31-0084 : EPAR - Scientific conclusions, grounds for variation to the terms of the marketing authorisations and detailed explanation of the scientific grounds for the differences from the PRAC recomme...

October 2, 2014

CHANGES_SINCE_INITIAL_AUTHORISATION

Kinzalkomb : EPAR - Product Information

November 25, 2009

DRUG_PRODUCT_INFORMATION

Kinzalkomb : EPAR - Scientific Discussion

June 3, 2008

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Kinzalkomb : EPAR - Procedural steps taken before authorisation

October 20, 2005

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Kinzalkomb-H-C-415-X-0039 : EPAR - Scientific Discussion - Extension

June 3, 2008

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP post-authorisation summary of positive opinion for Kinzalkomb

April 26, 2013

CHANGES_SINCE_INITIAL_AUTHORISATION

Kinzalkomb : EPAR - All Authorised presentations

May 5, 2008

AUTHORISED_PRESENTATIONS

Kinzalkomb : EPAR - Procedural steps taken and scientific information after authorisation

November 25, 2009

CHANGES_SINCE_INITIAL_AUTHORISATION

Kinzalkomb : EPAR - Steps taken after authorisation when a cutoff date has been used

October 20, 2005

CHANGES_SINCE_INITIAL_AUTHORISATION

Overview Q&A (10)

Question

How is Kinzalkomb used?

Answer

Kinzalkomb is taken by mouth once a day with liquid, with or without food. The dose of Kinzalkomb to be used depends on the dose of telmisartan that the patient was taking before: patients who were receiving 40 mg telmisartan should take the 40/12.5-mg tablets, and patients who were receiving 80 mg telmisartan should take the 80/12.5-mg tablets. The 80/25-mg tablets are used in patients whose blood pressure is not controlled using the 80/12.5-mg tablets or who have been stabilised using the two active substances taken separately before switching to Kinzalkomb.

Question

How does Kinzalkomb work?

Answer

Kinzalkomb contains two active substances, telmisartan and hydrochlorothiazide.

Telmisartan is an ‘angiotensin-II-receptor antagonist’, which means that it blocks the action of a hormone in the body called angiotensin II. Angiotensin II is a powerful vasoconstrictor (a substance that narrows blood vessels). By blocking the receptors to which angiotensin II normally attaches, telmisartan stops the hormone having an effect, allowing the blood vessels to widen.

Hydrochlorothiazide is a diuretic, which is another type of treatment for hypertension. It works by increasing urine output, reducing the amount of fluid in the blood and reducing blood pressure.

The combination of the two active substances has an additive effect, reducing the blood pressure more than either medicine alone. By lowering blood pressure, the risks associated with high blood pressure, such as having a stroke, are reduced.

Question

What is Kinzalkomb used for?

Answer

Kinzalkomb is used in adult patients who have essential hypertension (high blood pressure) that is not adequately controlled by telmisartan alone. ‘Essential’ means that the hypertension has no obvious cause.

The medicine can only be obtained with a prescription.

Question

What benefit has Kinzalkomb shown during the studies?

Answer

Kinzalkomb was more effective at reducing diastolic blood pressure than telmisartan taken alone and than placebo. In patients who were not controlled on the 80/12.5-mg tablet, switching to the 80/25-mg tablet was more effective in reducing diastolic blood pressure than remaining on the lower dose.

Question

What measures are being taken to ensure the safe and effective use of Kinzalkomb?

Answer

A risk management plan has been developed to ensure that Kinzalkomb is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Kinzalkomb, including the appropriate precautions to be followed by healthcare professionals and patients.

Question

Other information about Kinzalkomb

Answer

The European Commission granted a marketing authorisation valid throughout the European Union for Kinzalkomb on 19 April 2002.

For more information about treatment with Kinzalkomb, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Question

What is Kinzalkomb?

Answer

Kinzalkomb is a medicine that contains two active substances, telmisartan and hydrochlorothiazide. It is available as tablets (40 mg or 80 mg telmisartan and 12.5 mg hydrochlorothiazide; 80 mg telmisartan and 25 mg hydrochlorothiazide).

Question

How has Kinzalkomb been studied?

Answer

Kinzalkomb has been studied in five main studies involving a total of 2,985 patients with mild to moderate hypertension. In four of these studies, Kinzalkomb was compared with placebo (a dummy treatment) and with telmisartan taken alone in a total of 2,272 patients. The fifth study compared the effects of remaining on the 80/12.5-mg tablet with switching to the 80/25-mg tablet in 713 patients who had not responded to the 80/12.5-mg tablet. In all studies, the main measure of effectiveness was the reduction in diastolic blood pressure (the blood pressure measured between two heartbeats).

Question

Why has Kinzalkomb been approved?

Answer

The CHMP decided that Kinzalkomb’s benefits are greater than its risks for the treatment of essential hypertension in patients whose blood pressure is not adequately controlled on telmisartan alone. The Committee recommended that Kinzalkomb be given marketing authorisation.

Question

What is the risk associated with Kinzalkomb?

Answer

The most common side effect with Kinzalkomb (seen in between 1 and 10 patients in 100) is dizziness. For the full list of all side effects reported with Kinzalkomb, see the Package Leaflet.

Kinzalkomb must not be used in women who are more than three months pregnant. Its use during the first three months of pregnancy is not recommended. Kinzalkomb must also not be used in people who have severe liver, kidney or bile problems, blood potassium levels that are too low, or blood calcium levels that are too high. In patients with type 2 diabetes or in patients with moderate or severe kidney impairment, Kinzalkomb must also not be used in combination with aliskiren-containing medicines (also used to treat essential hypertension). For the full list of restrictions, see the package leaflet.

Care must be taken when using Kinzalkomb with other medicines that have an effect on blood potassium levels. The full list of these medicines is given in the package leaflet.

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