Telmisartan

Telmisartan is a drug that is used to treat high blood pressure (hypertension). It may be used alone or with other drugs to treat high blood pressure.

Drug Information

• Name = Micardis®
• Active ingredient = telmisartan
• Strength = 20 mg,40 mg and 80 mg
• Dosage = Tablets
• Company = Boehringer Ingelheim|
• Availability = Prescription only
• Approval date = November 10,1998

Hypertension

Blood pressure is caused by blood pressing against arteries and the resistance to blood flow through the arteries. Because they are muscles, arteries normally expand when blood flows through them. In the rested state, the heart beats about 60 to 80 times a minute, and blood pressure should be less than 120/80 mm Hg (millimeters of mercury) for an adult. Blood pressure that stays between 120–139/80–89 is considered prehypertension, and above this level (140/90 mm Hg or higher) is considered high (hypertension).

High blood pressure can occur in children or adults, but it's more common among people over age 35. Hypertension is most common in the following populations:

• African Americans
• middle-aged and elderly
• obese
• heavy drinkers
• diabetics
• people with kidney disease

How It Works

Telmisartan belongs to a class of drugs called angiotensin II (A2) receptor antagonists. A2 causes high blood pressure by constricting arteries and causing the release of aldosterone, a hormone that causes the body to retain salt and water. Telmisartan blocks the binding of A2 to its receptor in many tissues, including vascular smooth muscle (for example, heart muscle), and the adrenal glands. This prevents A2 from increasing blood pressure.

Risks

Interactions

• When taken together with digoxin, telmisartan can raise the amount of digoxin in the blood. Digoxin levels in the blood are usually monitored with regular blood tests, and the dose adjusted if necessary.
• Concurrent treatment with potassium supplements, ACE inhibitors, and certain kinds of diuretics known as potassium-sparing diuretics increases the risk of high blood levels of potassium (hyperkalemia), which can be dangerous.

• Telmisartan in combination with diuretics ("water pills") may cause dizziness, fainting, or other symptoms of low blood pressure.

Overdose

Signs and symptoms of overdose include the following:

• decreased blood pressure
• dizziness
• increased heart rate

Precautions

• Telmisartan can cause fetal harm and death if taken during the second or third trimester of pregnancy. Therefore, telmisartan is not recommended during pregnancy.

• Breastfeeding while on telmisartan is not recommended, as the drug does enter breast milk.

Side Effects

Some of the common side effects of telmisartan are listed below:

• Flu-like symptoms
• Upper respiratory infection
• Back pain
• Sinusitis
• Diarrhea
• Sore throat/pharyngitis

Side effects are usually mild and do not last long.

Alternatives

Telmisartan is not the only approach to hypertension management. Other options include lifestyle modifications and drugs such as diuretics, beta-blockers, calcium channel blockers, and ACE inhibitors.

Clinical Trials

ACCORD: Action to Control Cardiovascular Risk in Diabetes

ALLHAT: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

The Framingham Heart Study

References

• Lexi-comp Drug Information Handbook, 12th edition.
• Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute.

External Links

• American Heart Association- Hypertension
• Official Micardis Website
• FDA Patient Information-Micardis