Telmisartan

Telmisartan

June 8, 2020

Telmisartan is an angiotensin II receptor blocker or ARB prescribed by doctors for the treatment and prevention of:

  • High blood pressure with no known cause
  • Reducing the risk of stroke, heart attack among people with coronary heart disease, type 2 diabetes or previous stroke

Telmisartan is a good blood pressure-lowering medication that protects the kidney with fewer side effects. It is especially helpful for people with mild to moderate kidney disease and diabetes.  It works similarly with ACE inhibitors but it does not cause the same side effects like coughing. Telmisartan is FDA-approved for medical use since 1999.

As an angiotensin receptor blocker or ARB, Telmisartan relaxes the blood vessels by blocking the chemical angiotensin II that makes the blood vessels tighter. Angiotensin II acts on the receptor cells in the body. It causes the peripheral blood vessels to become narrow and by stimulating the production of aldosterone hormone.

Blocking the action of this natural chemical widens the blood vessels. There will be more space and less resistance in the blood vessels. More blood can pass easily without the heart having to pump blood that hard. Blocking the action of this natural chemical reduces the production of aldosterone hormone on the kidneys. As a result, there is an increasing amount of fluid being removed from the blood by the kidney. There is also a decrease in the amount of fluid in the blood vessels which lessens the resistance. The combined effects lower the blood pressure.

How to Use Telmisartan

Telmisartan comes as a tablet form to take orally. The amount and duration of treatment depend on your condition and the strength of the medicine. It’s typically given to adults who are 55 years of age and older, who are at high risk of major heart diseases and who can’t tolerate ACE inhibitors.

  • The typical recommended dose for the treatment of high blood pressure in an adult is 20mg to 80mg once a day.
  • The typical recommended dose for the treatment of cardiovascular risk reduction is 80mg once a day.
  • The peak of the action is observable 1 to 2 hours after intake. The duration of the effects lasts for 24 hours.
  • Your doctor may lower your dose if you are taking a diuretic medicine.
  • For a missed dose take it as soon as you remember. Do not take two doses to make up for the missed one.

Possible Side Effects of Telmisartan

Like another angiotensin II receptor blocker, this medication is generally well-tolerated.  Tell your doctor if the following side effects do not go away:

  • Dizziness
  • Headache
  • Diarrhea
  • Stomach upset
  • Back pain
  • Fatigue
  • Upper respiratory tract infections
  • Hyperkalaemia
  • Flu-like symptoms
  • Anxiety
  • Depression
  • Abnormal vision

Some side effects can be serious. If you will experience any of the following side effects, call your doctor right away:

  • Allergic reactions with signs like itching, swelling of the face, throat, tongue, feet, ankle and lower legs
  • Difficulty swallowing and breathing
  • Blistering of the skin
  • Very low blood pressure that causes dizziness when moving from lying down or sitting position
  • Liver problems with signs like abdominal pain, jaundice, black stool
  • Some patients may also experience erectile dysfunction and reduced renal function.

What should I know before taking Telmisartan?

  • Use this with care among patients with:
    • Decreased liver and kidney functions
    • Elderly people
    • Mitral valve stenosis or heart valve disease
    • Severe heart failure
    • Diabetes
    • Heart disease characterized by thickening of the internal heart muscle and a blockage inside the heart
    • Low volume of fluid or salt in the body due to vomiting, kidney dialysis, dehydration, low salt diet and diuretics therapy
    • Renal artery stenosis or narrowing in one or both of the arteries that supply blood to the aorta
    • Ischaemic heart disease, a type of heart disease due to inadequate supply of blood to the heart
    • People with high levels of potassium in their blood or hyperkalemia
  • Do not use Telmisartan among people with:
    • Biliary obstruction or blockage of the bile duct
    • Severely decreased liver function
    • High blood pressure due to high levels of aldosterone
    • Inherited tolerance to fructose diet
    • Pregnant or breastfeeding women
  • Telmisartan can interact with other drugs. It is important that you tell your doctor what medicines you are taking including those bought without prescriptions, vitamins, and herbal supplements.
  • This medicine has additive effects with other medicines that decrease blood pressure. As a result, you may experience dizziness when standing.
  • Telmisartan may cause blood pressure to become too low. Your risk is higher if you are taking a high dose of diuretics or dehydrated.

Getting the Best Result from Telmisartan

  • Telmisartan can cause dizziness and drowsiness just like any other blood pressure-lowering medication. Avoid performing potentially hazardous activities such as driving while taking this medication.
  • Avoid alcohol as this can enhance the blood pressure-lowering effects.
  • Pregnant must not use this, particularly during the second and third trimester as it may be harmful to the developing baby. Breastfeeding women must not use this unless absolutely necessary. You should discuss the risk and benefits with your doctor before taking this medicine.
  • Avoid taking NSAIDs and any type of painkiller as this reduces the blood lowering effects of Telmisartan. Elderly patients and patients with poor kidney function must not use this drug with NSAIDs as this may result in reduced kidney function including kidney failure.
  • Some medications can raise the potassium levels in the blood when taken with Telmisartan.

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