Description
Indications |
Listed in Dosage. |
Dosage |
Adult : PO HTN Initial: 40 mg once daily, may be adjusted to 20-80 mg once daily. CV risk reduction 80 mg once daily. |
Dosage Details |
Oral Hypertension Adult: Initially, 40 mg once daily, may be adjusted to 20-80 mg once daily if needed.
Oral Adult: 80 mg once daily. |
Renal Impairment |
Severe impairment or on haemodialysis: Initially, 20 mg once daily. |
Hepatic Impairment |
Mild to moderate: Max: 40 mg once daily. Severe: Contraindicated. |
Administration |
May be taken with or without food. |
Contraindications |
Concomitant use w/ aliskiren in patients w/ diabetes and renal impairment (GFR <60 mL/min). Severe hepatic impairment. Pregnancy. |
Special Precautions |
Volume- or salt-depleted patients including patients on prolonged diuretic therapy. Patients w/ renal artery stenosis, aortic or mitral stenosis, obstructive biliary disease. Renal and mild to moderate hepatic impairment. Lactation. |
Adverse Drug Reactions |
Dizziness, fatigue, headache, sinusitis, upper resp tract infection, pharyngitis, UTI, back pain, myalgia, diarrhoea, abdominal pain, dyspepsia, nausea. Potentially Fatal: Intermittent claudication and skin ulcer. |
Pregnancy Category (US FDA) |
PO: D |
Monitoring Parameters |
Monitor BP, electrolytes and serum creatinine levels. |
Overdosage |
Symptoms: Hypotension, bradycardia, tachycardia, dizziness, acute renal failure and elevated serum creatinine. Management: Supportive and symptomatic treatment. Induction of emesis and/or gastric lavage. Activated charcoal may be useful. Salt and volume replacement should be given immediately if hypotension occurs and place patient in supine position. |
Drug Interactions |
May increase plasma levels of digoxin. May increase serum lithium levels and toxicity. May reduce plasma levels of warfarin. Increased risk of hyperkalaemia w/ K-sparing diuretics, K supplements or K-containing salt substitutes. May antagonise hypotensive effect and increase risk of renal impairment w/ NSAIDs. Potentially Fatal: May increase nephrotoxic, hyperkalaemic and hypotensive effect w/ aliskiren in patients w/ diabetes and renal impairment (GFR <60 mL/min). |
Food Interaction |
Food may slightly decrease the bioavailability. |
Mechanism of Action |
Description: Telmisartan is a nonpeptide AT1 angiotensin II receptor antagonist. It exerts antihypertensive activity by preventing angiotensin II from binding to AT1 receptors thus inhibiting the vasoconstricting and aldosterone-secreting effects of angiotensin II. Onset: 1-2 hr. Duration: Up to 24 hr. Pharmacokinetics: Absorption: Rapidly absorbed from the GI tract. Food may slightly decrease the bioavailability. Absolute bioavailability: Dose-dependent (approx 42% after 40-mg dose; 58% after 160-mg dose). Time to peak plasma concentration: Approx 0.5-1 hr. Distribution: Volume of distribution: 500 L. Plasma protein binding: >99%. Metabolism: Undergoes conjugation w/ glucuronic acid to form inactive metabolites. Excretion: Via faeces (97%, as unchanged drug). Terminal elimination half-life: Approx 24 hr. |
Storage |
Store at 25°C. |
MIMS Class |
Angiotensin II Antagonists |
