telmisartan, MicardisPharmacy Author:
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmDDr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99. Medical and Pharmacy Editor:
Jay W. Marks, MD
Jay W. Marks, MDJay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
GENERIC NAME: telmisartanBRAND NAME: MicardisDRUG CLASS AND MECHANISM: Telmisartan is a member of a family of drugs called angiotensin receptor blockers (ARBs), which includes losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), and candesartan (Atacand). Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE), is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on muscle cells of blood vessels. Angiotensin's attachment to the receptors causes muscle cells to shorten and narrow the blood vessels (vasoconstrict), which leads to an increase in blood pressure (hypertension). Telmisartan blocks the angiotensin receptor. By blocking the action of angiotensin, telmisartan widens blood vessels (vasodilate) and reduces blood pressure. Telmisartan was approved by the FDA in November 2000. PRESCRIPTION: Yes GENERIC AVAILABLE: No PREPARATIONS: Tablets: 20, 40, and 80 mg. STORAGE: Telmisartan should be stored at room temperature, 15-30 C (59-86 F). The tablets should be kept in their blister-pack packaging until they are used. PRESCRIBED FOR: Telmisartan is used for the treatment of hypertension (high blood pressure). It also is used for reducing the risk of heart attack, stroke, or death from cardiovascular causes in patients 55 years of age or older at high risk of developing major cardiovascular events but who are unable to take ACE inhibitors. DOSING: The recommended dose for treating hypertension is 20-80 mg daily. The recommended dose for cardiovascular risk reduction is 80 mg daily. DRUG INTERACTIONS: Telmisartan can increase blood concentrations of digoxin (Lanoxin) and lithium (Eskalith, Lithobid). Therefore blood levels of digoxin and lithium should be monitored and doses adjusted if necessary. Combining telmisartan with potassium-sparing diuretics (for example., spironolactone (Aldactone), triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to hyperkalemia (elevated potassium in the blood). Combining telmisartan or other ARBs with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible. There have been reports that aspirin and other NSAIDs such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ARBs. PREGNANCY: Medications that interfere with the angiotensin converting enzyme system, such as telmisartan, have been found to cause fetal and neonatal toxicity and death when taken by pregnant women. Pregnant mothers should discontinue use of telmisartan as soon as they know they are pregnant.
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