Overview
Telmisartan is an angiotensin II receptor blocker (ARB) used primarily for the treatment of hypertension. It works by selectively blocking the binding of angiotensin II to the AT1 receptor, leading to vasodilation and reduced blood pressure. It may also be used to reduce cardiovascular risk in certain high-risk patients.
Mechanism of Action
Telmisartan is a selective angiotensin II receptor blocker (ARB) that antagonizes the AT1 receptor. By blocking the binding of angiotensin II, it inhibits vasoconstriction, aldosterone secretion, and other effects of the renin-angiotensin-aldosterone system (RAAS), resulting in vasodilation and reduced blood pressure.
Indications
- Treatment of hypertension
- Cardiovascular risk reduction in patients unable to take ACE inhibitors
Common Doses
- 20 mg
- 40 mg
- 80 mg
Dosage
The usual starting dose for hypertension is 40 mg once daily, which can be increased to 80 mg once daily based on blood pressure response. Dose adjustment may be needed in patients with hepatic impairment.
Contraindications
- Known hypersensitivity to telmisartan or any component of the product
- Co-administration with aliskiren in patients with diabetes
Side Effects
- Dizziness
- Hypotension
- Hyperkalemia
- Renal dysfunction
- Angioedema (rare)
- Upper respiratory infection
- Back pain
- Diarrhea
Interactions
- Do not co-administer with aliskiren in patients with diabetes
- Avoid use of aliskiren with telmisartan in patients with renal impairment
- Increased risk of hyperkalemia with potassium-sparing diuretics, potassium supplements, or salt substitutes
- Increased risk of renal impairment with NSAIDs
- Potential additive hypotensive effects with other antihypertensives
Counseling Points
- Take once daily with or without food
- Report any signs of angioedema (swelling of face, lips, throat) immediately
- Avoid pregnancy while taking this medication
- Monitor blood pressure regularly
- Report dizziness, lightheadedness, or signs of hyperkalemia (muscle weakness, irregular heartbeat)
- Do not use potassium supplements or salt substitutes without medical advice