telmisartan

telmisartan /tel·mi·sar·tan/ (tel″mĭ-sahr´tan) an angiotensin II antagonist used as an antihypertensive.

---

telmisartan,

an antihypertensive.

indications This drug is used to treat hypertension, either alone or in combination with other drugs.

contraindication Known hypersensitivity to this drug prohibits its use.

adverse effects Adverse effects of telmisartan include dizziness, insomnia, dyspepsia, and cough. Common side effects include anxiety, diarrhea, anorexia, vomiting, myalgia, pain, and upper respiratory infection.

---

telmisartan

Micardis

Pharmacologic class: Angiotensin II receptor antagonist

Therapeutic class: Antihypertensive

Pregnancy risk category C (first trimester), D (second and third trimesters)

FDA Boxed Warning

• When used during second or third trimester of pregnancy, drug may cause fetal harm or death. Discontinue as soon as pregnancy is detected.

Action

Inhibits vasoconstricting effects and blocks aldosterone-producing effects of angiotensin II at various receptor sites, including vascular smooth muscle and adrenal glands

Availability

Tablets: 20 mg, 40 mg, 80 mg

⊘Indications and dosages

➣ Hypertension

Adults: 40 mg P.O. daily, titrated up or down within range of 20 to 80 mg daily based on response and tolerance

Contraindications

• Hypersensitivity to drug or its components
• Pregnancy (second and third trimesters), breastfeeding

Precautions

Use cautiously in:
• heart failure, impaired renal function secondary to primary renal disease or renal stenosis, obstructive biliary disorders, hepatic impairment, volume or sodium depletion
• patients receiving high-dose diuretics
• pregnant patients in first trimester
• females of childbearing age
• children younger than age 18 (safety not established).

Administration

• Don't remove tablet from blister pack until just before giving.
• Know that drug may be used alone or with other antihypertensives.

Route	Onset	Peak	Duration
P.O.	Unknown	0.5-1 hr	24 hr

Adverse reactions

CNS: dizziness, headache, fatigue

CV: chest pain, peripheral edema, hypertension

EENT: sinusitis, pharyngitis

GI: nausea, vomiting, diarrhea, dyspepsia, abdominal pain

GU: urinary tract infection

Musculoskeletal: myalgia, back and leg pain

Respiratory: cough, upper respiratory infection

Other: pain, flu or flulike symptoms

Interactions

Drug-drug. Antihypertensives, diuretics: increased risk of hypotension

Digoxin: increased digoxin blood level

Warfarin: decreased warfarin blood level

Drug-diagnostic tests. Creatinine: slight elevation

Drug-food. Any food: slightly reduced drug bioavailability

Patient monitoring

• Watch for signs and symptoms of hypotension.
• Correct volume deficits as appropriate before therapy starts. Monitor fluid intake and output and creatinine level during therapy.

Patient teaching

• Tell patient to take 1 hour before or 2 hours after meals.
• Caution patient not to remove tablet from blister pack until just before taking.
• Advise patient to report swelling or chest pain.
• Teach patient to measure blood pressure regularly and report significant changes.
• Tell patient to report suspected pregnancy to prescriber. Caution her not to breastfeed.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

---

telmisartan

Micardis^® Cardiology An angiotensin II receptor antagonist for treating HTN. See Angiotensin II receptor antagonist.