Telmisartan

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Generic Name of Telmisartan - Learn More

Telmisartan

Telmisartan Precaution - What You Need to Know

Before starting Telmisartan therapy, patients should consult their healthcare provider, especially if they have any underlying health conditions. Key precautions include:
- Renal Impairment: Patients with renal impairment or kidney disease should use Telmisartan with caution. The drug can cause elevations in serum creatinine and blood urea nitrogen (BUN), especially in individuals with pre-existing kidney conditions.
- Electrolyte Imbalance: Telmisartan may cause hyperkalemia (elevated potassium levels), so it is essential to monitor serum potassium levels regularly. The drug should be used cautiously in patients with conditions that predispose them to hyperkalemia.
- Hypotension: Telmisartan can cause a drop in blood pressure, especially when starting therapy or in patients who are volume-depleted. Close monitoring of blood pressure is recommended.
- Pregnancy and Breastfeeding: Telmisartan is contraindicated during pregnancy, especially in the second and third trimesters, as it can cause fetal harm (including kidney dysfunction, low amniotic fluid, and developmental issues). It is also not recommended during breastfeeding as it may pass into breast milk.
- Liver Disease: Caution is required when using Telmisartan in patients with liver disease, as the drug is metabolized in the liver, and there may be an increased risk of toxicity or adverse reactions.

Telmisartan Indication - Uses and Benefits

Telmisartan is primarily prescribed for the management of hypertension (high blood pressure). It can also be used for other cardiovascular conditions:
- Hypertension: Telmisartan is used to treat high blood pressure, either as monotherapy or in combination with other antihypertensive drugs. Lowering blood pressure reduces the risk of strokes, heart attacks, and kidney problems.
- Cardiovascular Risk Reduction: Telmisartan is also indicated for the reduction of cardiovascular events in patients at high risk, particularly those with type 2 diabetes and previous cardiovascular disease.
- Heart Failure: In some cases, Telmisartan is used off-label to manage heart failure and reduce complications related to left ventricular dysfunction.

Telmisartan Contraindications - Important Warnings

Telmisartan should not be used in the following situations:
- Pregnancy: Telmisartan is contraindicated during pregnancy, particularly after the first trimester, due to the risk of fetal toxicity and other pregnancy complications. It is important to avoid using Telmisartan in pregnant women.
- Hypersensitivity: If a patient has a known hypersensitivity or allergic reaction to Telmisartan or any of its components, they should not use this medication.
- Severe Hepatic Impairment: Telmisartan is contraindicated in patients with severe liver impairment (e.g., cirrhosis) because the drug is metabolized by the liver, and improper metabolism may lead to toxicity.
- Concomitant Use with Aliskiren: The combination of Telmisartan with aliskiren (an antihypertensive drug) is contraindicated in patients with diabetes or renal impairment due to the increased risk of renal dysfunction, hyperkalemia, and hypotension.

Telmisartan Side Effects - What to Expect

Common and serious side effects associated with Telmisartan include:
- Common Side Effects:
- Dizziness or lightheadedness, especially when standing up quickly.
- Fatigue or tiredness.
- Back pain and muscle pain.
- Upper respiratory tract infections like a cold or cough.
- Serious Side Effects:
- Hyperkalemia (high potassium levels), which can lead to dangerous heart arrhythmias. Symptoms include muscle weakness, fatigue, or irregular heartbeat.
- Low blood pressure (hypotension), particularly after the first dose or in patients who are volume-depleted.
- Kidney Dysfunction: Elevated serum creatinine and blood urea nitrogen (BUN), which can indicate kidney problems.
- Angioedema: Swelling of the face, lips, tongue, or throat. This requires immediate medical attention, as it can cause breathing difficulties.
- Liver Dysfunction: Elevated liver enzymes or jaundice (yellowing of the skin or eyes) can occur in rare cases.

Telmisartan Pregnancy Category ID - Safety Information

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Telmisartan Mode of Action - How It Works

Telmisartan is an angiotensin II receptor blocker (ARB). It works by:
- Blocking Angiotensin II Receptors: Telmisartan selectively blocks the angiotensin II type 1 (AT1) receptors, preventing the effects of angiotensin II. Angiotensin II is a hormone that constricts blood vessels and raises blood pressure.
- Vasodilation: By blocking the AT1 receptor, Telmisartan causes the blood vessels to relax and expand (vasodilation), leading to a reduction in blood pressure.
- Reduction in Aldosterone Secretion: By blocking angiotensin II, Telmisartan also reduces the release of aldosterone, a hormone that promotes salt and water retention in the kidneys, further helping to lower blood pressure.
- Organ Protection: Telmisartan has additional benefits in protecting the kidneys and heart in patients with diabetes or heart disease, reducing the risk of cardiovascular events like strokes or heart attacks.

Telmisartan Drug Interactions - What to Avoid

Telmisartan may interact with other medications, food, or herbal products, potentially affecting its effectiveness or increasing the risk of side effects:
- Potassium-Sparing Diuretics: Co-administration with potassium-sparing diuretics (e.g., spironolactone, amiloride) may increase the risk of hyperkalemia. Monitoring of serum potassium levels is recommended.
- NSAIDs: The concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs) with Telmisartan may reduce the antihypertensive effect of Telmisartan and increase the risk of kidney dysfunction.
- Lithium: Telmisartan can increase the levels of lithium in the body, leading to lithium toxicity. Regular monitoring of lithium levels is necessary.
- ACE Inhibitors and ARBs: The combined use of Telmisartan with angiotensin-converting enzyme inhibitors (ACE inhibitors) or other angiotensin receptor blockers (ARBs) increases the risk of hyperkalemia and renal impairment. Such combinations should be avoided or used cautiously, with frequent monitoring of kidney function and potassium levels.
- Salt Substitutes: Salt substitutes containing potassium should be avoided, as they can increase the risk of hyperkalemia when used with Telmisartan.

Telmisartan Pregnancy Category Note - Key Information

Pregnancy category: 1st trimester, C; 2nd and 3rd trimesters, D

Telmisartan Adult Dose - Recommended Dosage

The usual recommended starting dose of Telmisartan for adults is:
- Hypertension: The standard starting dose is 40 mg once daily. If needed, the dose can be increased to 80 mg or 160 mg once daily, depending on the patient's response to the medication.
- Cardiovascular Risk Reduction: The usual dose is 80 mg once daily.
- Heart Failure: If used for heart failure, the starting dose is 40 mg once daily, and the dose may be titrated depending on clinical response and tolerability.

Telmisartan Child Dose - Dosage for Children

Telmisartan is not typically prescribed for pediatric patients under 18 years of age, as its safety and efficacy in children have not been well established. However, in certain cases, especially for children with hypertension, a healthcare provider may prescribe an off-label dose, usually based on the child’s weight and clinical condition.
- For children aged 6-16 years, the usual dose is 1 mg/kg body weight, starting with a maximum of 40 mg daily. The dose may be adjusted based on the patient's response and tolerance.

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Telmisartan is an effective angiotensin II receptor blocker (ARB) used for managing hypertension and reducing the risk of cardiovascular events. It should be used with caution in patients with renal impairment, pregnancy, or electrolyte imbalances. Regular monitoring of blood pressure, kidney function, and potassium levels is recommended for patients on Telmisartan therapy.

Telmisartan Renal Dose - Dosage for Kidney Conditions

Telmisartan is primarily eliminated through the liver, so dose adjustments are generally not necessary for patients with mild to moderate renal impairment. However, it should be used cautiously in patients with severe renal impairment or those with end-stage renal disease (ESRD). Monitoring of renal function is advised, especially when co-administering with other drugs that affect kidney function.
- Moderate Renal Impairment (CrCl 30-60 mL/min): Standard dose, but close monitoring is recommended.
- Severe Renal Impairment (CrCl <30 mL/min): Caution should be exercised, and careful monitoring is necessary. Telmisartan should generally be avoided in such cases.