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an angiotensin II antagonist used as an antihypertensive, administered orally.



Pharmacologic class: Angiotensin II receptor antagonist

Therapeutic class: Antihypertensive

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

FDA Box Warning

Drugs that act directly on the renin-angiotensin system can cause injury to or death of a developing fetus. Discontinue drug as soon as possible when pregnancy is detected.


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


Tablets: 20 mg, 40 mg, 80 mg

Indications and dosages


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

Cardiovascular risk reduction

Adults: 80 mg P.O. daily in patients unable to take angiotensin-converting enzyme (ACE) inhibitors


• Hypersensitivity to drug or its components


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

• concomitant use of ACE inhibitors and angiotensin receptor blockers (avoid use)

• pregnant or breastfeeding patients

• children younger than age 18 (safety not established).


• Don't remove tablet from blister pack until just before giving.

• Know that drug may be used alone or with other antihypertensives.

Adverse reactions

CNS: dizziness, headache, fatigue

CV: chest pain, peripheral edema, hypertension, intermittent claudication

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

Skin: ulcer

Other: pain, flu or flulike symptoms, hypersensitivity


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

Ace inhibitors (ramipril): increased ramipril steady-state Cmax and area under the curve (AUC), decreased telmisartan Cmax and AUC

Digoxin: increased digoxin blood level

Lithium: increased serum lithium concentration and toxicity

Nonsteroidal anti-inflammatory drugs, including selective cyclooxygenase-2 inhibitors): deterioration of renal function, including possible acute renal failure in elderly patients, volume-depleted patients (including those on diuretic therapy), or with compromised renal function; attenuated telmisartan antihypertensive effect

Drug-diagnostic tests. Creatinine: slight elevation

Drug-food. Any food: slightly reduced drug bioavailability

Patient monitoring

• Monitor blood pressure frequently and watch for signs and symptoms of hypotension.

• Closely monitor patient with impaired hepatic or renal function. 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.


An angiotensin II receptor blocker drug, C33H30N4O2, used primarily to treat hypertension.


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