Generic Name
TelmisartanTherapeutic Class: Cardiovascular
Indications:
Hypertension- Treatment of essential hypertension in adults;
Hypertension- Treatment of essential hypertension in adults;
Cardiovascular prevention- Reduction of cardiovascular morbidity in adults with:
1) Atherothrombotic cardiovascular disease (history of coronary heart disease, stroke, or peripheral arterial disease) or
2) Type 2 diabetes mellitus with documented target organ damage.
Presentation:
Telmisartan 40: Each tablet contains Telmisartan BP 40 mg,
Telmisartan 80: Each tablet contains Telmisartan BP 80 mg.
Description:
Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis. Telmisartan has a much greater affinity (>3,000 fold) for the AT1 receptor than for the AT2 receptor. Because telmisartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Telmisartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.
Dosage & Administration:
Dosage must be individualized. The usual starting dose of Telmisartan tablets is 40 mg once a day. The blood pressure response is dose-related over the range of 20 to 80 mg. Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks. When additional blood pressure reduction beyond that achieved with 80 mg Telmisartan is required, may switch to the combination. No initial dosage adjustment is necessary for elderly patients or patients with renal impairment, including those on hemodialysis. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored. Telmisartan tablets may be administered with other antihypertensive agents. Telmisartan tablets may be administered with or without food. Initial therapy with Telmisartan is not recommended in patients ≥75 years old or with hepatic impairment.
Side Effects:
In hypertensive patients: The most common side effects of Telmisartan tablets include sinus pain and congestion (sinusitis), back pain, diarrhea, etc.
For patients of cardiovascular risk reduction: The most common side effects of Telmisartan tablets in CV risk reduction include intermittent claudication and skin ulcer.
Precautions:
1) Avoid fetal or neonatal exposure
2) Hypotension
3) Monitor carefully in patients with impaired hepatic or renal function
4) Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker
Use in Pregnancy & Lactation:
Pregnancy: Pregnancy Category D.
Lactation: It is not known whether Telmisartan is excreted in human milk.
Interaction:
1) NSAIDS: Increased risk of renal impairment and loss of antihypertensive effect
2) Co-administration with Aliskiren with Telmisartan in patients with diabetes should be avoided
Overdose:
The most likely manifestation of overdosage with Telmisartan tablets would be hypotension, dizziness, and tachycardia; bradycardia, an increase in serum creatinine, and acute renal failure could occur from parasympathetic (vagal) stimulation.
Storage:
Do not store above 300 C. Protect from light and high humidity. Keep out of the reach of children.
2) Type 2 diabetes mellitus with documented target organ damage.
Presentation:
Telmisartan 40: Each tablet contains Telmisartan BP 40 mg,
Telmisartan 80: Each tablet contains Telmisartan BP 80 mg.
Description:
Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis. Telmisartan has a much greater affinity (>3,000 fold) for the AT1 receptor than for the AT2 receptor. Because telmisartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Telmisartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.
Dosage & Administration:
Dosage must be individualized. The usual starting dose of Telmisartan tablets is 40 mg once a day. The blood pressure response is dose-related over the range of 20 to 80 mg. Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks. When additional blood pressure reduction beyond that achieved with 80 mg Telmisartan is required, may switch to the combination. No initial dosage adjustment is necessary for elderly patients or patients with renal impairment, including those on hemodialysis. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored. Telmisartan tablets may be administered with other antihypertensive agents. Telmisartan tablets may be administered with or without food. Initial therapy with Telmisartan is not recommended in patients ≥75 years old or with hepatic impairment.
Side Effects:
In hypertensive patients: The most common side effects of Telmisartan tablets include sinus pain and congestion (sinusitis), back pain, diarrhea, etc.
For patients of cardiovascular risk reduction: The most common side effects of Telmisartan tablets in CV risk reduction include intermittent claudication and skin ulcer.
Precautions:
1) Avoid fetal or neonatal exposure
2) Hypotension
3) Monitor carefully in patients with impaired hepatic or renal function
4) Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker
Use in Pregnancy & Lactation:
Pregnancy: Pregnancy Category D.
Lactation: It is not known whether Telmisartan is excreted in human milk.
Interaction:
1) NSAIDS: Increased risk of renal impairment and loss of antihypertensive effect
2) Co-administration with Aliskiren with Telmisartan in patients with diabetes should be avoided
Overdose:
The most likely manifestation of overdosage with Telmisartan tablets would be hypotension, dizziness, and tachycardia; bradycardia, an increase in serum creatinine, and acute renal failure could occur from parasympathetic (vagal) stimulation.
Storage:
Do not store above 300 C. Protect from light and high humidity. Keep out of the reach of children.