Telmisartan

Telmisartan is a prescription medication used to treat Hypertension, and for Cardiovascular risk reduction.

• Telmisartan is available under the following different brand names: Micardis

Dosages of Telmisartan:

Adult and Pediatric dosage

Tablet

• 20mg
• 40mg
• 80mg

Hypertension

Adult dosage

• 40 mg/day orally initially; titrated to 20-80 mg/day orally, depending on response; patients with volume depletion should receive the lower dosage initially, under close supervision

Cardiovascular risk reduction

Adult dosage

• 80 mg orally once daily 

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Telmisartan include:

• stuffy nose, 
• sinus pain, 
• back pain, and
• diarrhea 

Serious side effects of Telmisartan include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• lightheadedness, 
• little or no urination, 
• swelling in the feet or ankles, 
• rapid weight gain, 
• unusual pain or tightness in the lower body, 
• skin ulcer, 
• nausea, 
• weakness, 
• tingly feeling, 
• chest pain, 
• irregular heartbeats, and
• loss of movement

Rare side effects of Telmisartan include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Telmisartan has severe interactions with at least 2 other drugs:
  • aliskiren
  • elagolix
• Telmisartan has serious interactions with at least 16 other drugs. 
• Telmisartan has moderate interactions with at least 131 other drugs.
• Telmisartan has minor interactions with the following drugs:
  • agrimony
  • cornsilk
  • entecavir
  • food
  • noni juice
  • octacosanol
  • reishi
  • shepherd’s purse
  • simvastatin 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to telmisartan or any other component of this product
• coadministration with aliskiren in patients with diabetes

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Telmisartan?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Telmisartan?”

Cautions

• Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death
• Hyperkalemia may occur in patients on ARBs, particularly in patients with advanced renal impairment, heart failure, on renal replacement therapy, or on potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes, or other drugs that increase potassium level
• As the majority of telmisartan is eliminated by biliary excretion, patients with biliary obstructive disorders or hepatic insufficiency can be expected to have reduced clearance
• Pregnancy (2nd and 3rd trimesters); significant risk of fetal or neonatal morbidity and mortality (see Black Box Warnings)
• Dual blockade of the renin-angiotensin system with angiotensin-receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, or aliskiren is associated with increased risk of hypotension, hyperkalemia, and altered renal function (including acute renal failure) in comparison with monotherapy
• Most patients receiving the combination of two RAS inhibitors do not obtain any additional benefit compared to monotherapy; avoid combined use of RAS inhibitors; closely monitor blood pressure, renal function, and electrolytes in patients on benazepril and other agents that affect the RAS

Drug interaction overview

• Not for coadministration with aliskiren in patients with diabetes; avoid the use of aliskiren with telmisartan in patients with renal impairment (GFR less than 60 ml/min/1.73 m2)
• When coadministered with digoxin, median increases in digoxin peak plasma concentration (49%) and trough concentration (20%) were observed; monitor digoxin levels when initiating, adjusting and discontinuing telmisartan

Pregnancy and Lactation

• May cause fetal harm when administered to a pregnant woman
• Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death
• Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents
• When pregnancy is detected, discontinue as soon as possible
• There is no information regarding the presence of telmisartan in human milk, the effects on the breastfed infant, or the effects on milk production
• Present in the milk of lactating rats
• Advise a nursing woman not to breastfeed during treatment