Telmisartan

Basic telmisartan information

• INN (international nonproprietary name): Telmisartan
• Brand names available in the United Kingdom: Micardis; generic telmisartan tablets
• ATC code: C09CA07
• Forms and dosages: Tablets 20 mg, 40 mg and 80 mg
• Manufacturers in the United Kingdom: Boehringer Ingelheim and generic manufacturers
• Registration status in the United Kingdom: Prescription-only medicine (POM)
• OTC / Rx classification: Prescription-only medicine (POM)

Everyday use and best practices

Telmisartan is taken once daily. A regular routine helps it to work well in managing hypertension and reducing cardiovascular risk.

Morning vs evening dosing

Telmisartan is often taken in the morning, as it controls blood pressure throughout the day. Some prescribers may suggest the evening instead, so follow the advice you are given.

Here are a few tips for proper timing:

• Try to take your telmisartan at the same time each day to maintain consistent blood levels.
• If switching times, make gradual adjustments and consult with your healthcare provider.

Try not to miss doses, as this is important to maintain blood pressure control.

Taking with or without meals

Food does not significantly affect the absorption of telmisartan, so it can be taken with or without meals.

• Taking telmisartan with a regular meal, such as breakfast, can help you remember your dose.
• A balanced diet rich in fruit, vegetables and whole grains supports blood pressure control.
• Be mindful of alcohol intake, which can exacerbate side effects such as dizziness or low blood pressure.

Safety priorities

Telmisartan is prescribed for hypertension and to reduce cardiovascular risk, but it is not suitable for everyone.

Who should avoid it (MHRA warnings)

Telmisartan should be avoided, or is contraindicated, in the following groups:

• Individuals with severe hepatic impairment or biliary obstructive disorders.
• Patients experiencing hypersensitivity to the medication's ingredients.
• Women who are pregnant, especially during the second and third trimesters; it should not be used in early pregnancy unless clearly necessary, and not when planning pregnancy.
• Patients with diabetes or renal impairment who take aliskiren.
• Caution is also needed in bilateral renal artery stenosis and volume depletion.

Tell the prescriber your complete health history and all the medicines you take.

Activities to limit (driving, work safety)

Some side effects of telmisartan can impact safety. Dizziness and hypotension are common, particularly when first starting the medication. These effects may hinder the ability to perform tasks that require full concentration or coordination.

Therefore, it’s advisable to:

• Avoid driving until you know how telmisartan affects you.
• Refrain from operating heavy machinery in the early stages of treatment.
• Limit engaging in strenuous physical activities or jobs with safety regulations.

Dosage and adjustments

General regimen (NHS guidance)

For hypertension in adults, the initial dose is typically 40 mg once daily. Some people need only 20 mg, and the dose can be increased to 80 mg once daily according to response and tolerability. Regular follow-ups help to fine-tune the treatment. Telmisartan is used both for blood pressure management and for lowering cardiovascular risk.

Special cases (elderly, comorbidities)

When considering telmisartan for the elderly or individuals with comorbidities, particular caution is warranted. While a dose adjustment isn’t generally necessary for the elderly, regular monitoring of renal function is crucial, especially for those with existing liver or kidney conditions.

In patients with mild to moderate hepatic impairment the dose should not exceed 40 mg daily, and in renal impairment monitoring of kidney function and potassium is advised. Close monitoring and regular reviews with healthcare providers are important.