What is telmisartan, and how does it work (mechanism of action)?
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.
Brand name: Micardis
Generic name: telmisartan
Drug Class: angiotensin receptor blockers (ARBs)
Do I need a prescription for telmisartan? Yes
What are the uses for telmisartan?
Telmisartan is used for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.
Telmisartan is used for reducing the risk of heart attack, stroke, or death from cardiovascular causes in patients 55 years of age or older who are at high risk for developing major cardiovascular events and are unable to take ACE inhibitors. A high risk for cardiovascular events can be evidenced by a history of coronary artery disease, peripheral arterial disease, stroke, transient ischemic attack, or high-risk diabetes (insulin-dependent or non-insulin-dependent) with evidence of end-organ damage.
What are the side effects of telmisartan?
Like other angiotensin receptor blockers, telmisartan generally is well-tolerated. The most common side effects are:
- headache,
- dizziness,
- back pain,
- fatigue,
- stomach upset,
- upper respiratory tract infections,
- hyperkalemia, and
- diarrhea.
Other side effects include
The rare but serious side effects of telmisartan include
- Rhabdomyolysis (inflammation and destruction of muscle) and
- angioedema (swelling of soft tissues including those of the throat and larynx).

QUESTION
Salt and sodium are the same. See AnswerWhat is the dosage for telmisartan?
- The recommended dose for treating hypertension is 20-80 mg daily.
- The recommended dose for cardiovascular risk reduction is 80 mg daily.
Which drugs or supplements interact with telmisartan?
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.
Is telmisartan safe to take if I'm pregnant or breastfeeding?
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 the use of telmisartan as soon as they know they are pregnant.
It is not known if telmisartan is secreted into breast milk. Since most medicines are secreted into breast milk, potential risks and benefits need to be assessed in women who are nursing to determine if breastfeeding or telmisartan should be discontinued.
What else should I know about telmisartan?
What preparations of telmisartan are available?
Tablets: 20, 40, and 80 mg.
How should I keep telmisartan stored?
Telmisartan should be stored at room temperature, 15 C - 30 C (59 F - 86 F). The tablets should be kept in their blister-pack packaging until they are used.
Summary
Telmisartan (Micardis) is in the drug class of angiotensin receptor blockers (ARBs) and is prescribed for the treatment of high blood pressure, reducing the risk of heart attack, stroke, or death from cardiovascular causes (in patients aged 55 years and older). Side effects, dosing information, drug interactions, and warnings and precautions should be reviewed prior to taking any medication.
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High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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