Summary and key information
- Active ingredient of the medicine
- Telmisartan, a member of the angiotensin II receptor blocker class (ARB).
- Usual clinical uses
- Management of essential hypertension in adults; selected patients at high cardiovascular risk may receive telmisartan to lower event risk when appropriate.
- Common tablet strengths in the UK
- Tablets are commonly stocked in 20 mg and 40 mg strengths; 80 mg preparations are available from some suppliers.
Telmisartan lowers blood pressure by blocking angiotensin II receptors, causing relaxation of blood vessels. It can be prescribed alone or combined with other antihypertensive classes such as thiazide-like diuretics or calcium channel blockers. Read the materials before you begin. sections below on safety, likely detrimental outcomes and collaborative interactions create opportunities for collaboration..
If and when it is used
Clinicians may select telmisartan in these situations:
- To control raised systemic blood pressure in adults with essential hypertension.
- To reduce the chance of major cardiovascular events for some high-risk individuals, for example those with established atherosclerotic disease or type 2 diabetes with organ damage, particularly when ACE inhibitors are unsuitable.
Some patients notice a reduction in blood pressure within a few days, but the maximal effect can take several weeks. Continue therapy as advised even if you feel well.
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How to accept it
The following points are general dosing directions and do not substitute for tailored medical advice from your prescriber.
- Common initial adult dose: 40 mg once daily for many patients.
- Standard dosing range: 20 mg to 80 mg once daily, adjusted according to blood pressure response.
- Take at about the same time each day; tablets may be taken with or without food.
- Benefits begin within days for some people; allow up to four weeks for full antihypertensive effect.
Lower starting doses (for example 20 mg) are sometimes used for people who are volume depleted, on high-dose diuretics, or otherwise at risk of symptomatic low blood pressure. If monotherapy does not meet targets, combinations with other classes (for example a thiazide-like diuretic or a calcium channel blocker) are commonly used.
Renal function and electrolytes are often checked after initiation or dose changes in patients with risk factors. Older people do not normally need routine dose reductions, but use caution where there is significant liver impairment.
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Treatments contraindicated under these conditions
- Pregnancy: ARBs are harmful to the fetus and must not be used during pregnancy. Stop and seek medical advice if pregnancy is suspected.
- Hypersensitivity to telmisartan or any excipient in the product.
- Severe hepatic dysfunction or cholestatic jaundice.
- Co-administration of aliskiren in patients with diabetes is contraindicated. Combining agents that block the renin-angiotensin system should be avoided except under specialist guidance due to risks of kidney injury, hyperkalaemia and hypotension.
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Preventive measures and surveillance of system activity
Tell your prescriber about the following prior to beginning telmisartan:
- Pre-existing kidney disease, renal artery stenosis, or recent acute kidney injury.
- Significant liver disease or past episodes of cholestasis or jaundice.
- Heart failure, recent myocardial ischemia or other serious cardiac conditions.
- High blood potassium, current use of potassium supplements, or use of salt substitutes containing potassium.
- Ongoing dehydration from persistent vomiting or diarrhea.
- Concomitant use of diuretics or other agents affecting the renin-angiotensin system.
- Previous angioedema with ACE inhibitors or ARBs.
- Pregnancyprospective capacity pregnancy, or breastfeeding plans.
Vertiginous sensation is a common adverse effect, especially after the first dose or after increasing the dose. To reduce risk, rise slowly from sitting or lying positions and avoid driving until you know how the medicine affects you. Liquor can enhance blood pressure lowering and worsen dizziness.
Healthcare professionals commonly check renal function and serum potassium after starting or changing dose in patients at risk. Inform your dentist or any treating clinician that you take telmisartan before procedures.
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Drug combination online the back and forth between peoples connect users across distances.
Notify your prescriber or pharmacist about all prescription medicines, over-the-counter drugs and herbal remedies. Distinguished exchanges include:
- ACE inhibitors and aliskiren: co-use increases the risk of renal impairment, hyperkalaemia and symptomatic hypotension. Aliskiren plus an ARB is specifically contraindicated in patients with diabetes.
- Potassium-sparing diuretics, potassium supplements and potassium-containing salt substitutes: increase the risk of hyperkalaemia.
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen: may blunt antihypertensive effect and increase renal risk, especially in elderly or volume-depleted patients.
- Loop and thiazide diuretics: can augment blood pressure lowering and may cause symptomatic hypotension when combined with telmisartan.
- Lithium: ARBs can raise lithium concentrations; avoid the combination or measure lithium levels closely if coadministration is unavoidable.
- The brand Lanoxin: concentrations can be affected; time sensitive monitoring may be required when initiating or changing telmisartan.
Give a complete medicines list to your clinician so danger from the give and take of interaction can be assessed.
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Possible untoward effects
Seek urgent medical help if you experience signs of a severe allergic reaction: swelling of the face, lips, tongue or throat, difficulty breathing, fainting or severe dizziness.
Other reported adverse events include:
- Common or mild: dizziness, pain of the head, tiredness, nasal congestion, back pain, nausea, abdominal discomfort, diarrhea and muscle cramps.
- Hypotension: especially in those who are dehydrated or taking high-dose diuretics.
- Laboratory changes: increased serum potassium and alterations in renal function can occur in susceptible people.
- Peripheral edema: ankle swelling has been reported in some patients.
- Less usual but important: chest pain, cardiac arrhythmias, worsening heart failure or acute myocardial infarction in high-risk groups; these events may be related to the underlying condition.
If treatment side effects persist or are troublesome, consult your prescriber. If you are taking medicines that raise potassiumpeer review the hazard alerts for potential the interaction between participants in the presence of your clinician.
Guidance on missed dosing
In case you miss a dose, take it promptly when you remember, unless the next dose is nearly due. In that case skip the missed dose and continue as usual. Do not take twice the dose to catch up.
Excess dose of a drug procedure actions
An overdose death may produce marked dizziness, fainting or severe hypotension. If you suspect an overdose death, contact NHS 111, your prescriber or head in the direction of the nearest emergency department. In a life-threatening emergency call 999. Take the medication box or label with you if attending hospital.
Instructions for proper cold storage is used for long term preservation of rare items.
Keep telmisartan tablets below 25°C; short excursions between 15 and 30°C are acceptable. Store in the original blister until use to protect from moisture and keep out of reach of children.
Different options alongside their comparisons
There are several other classes and individual drugs for treating high blood pressure. Choice depends on clinical factors, tolerability and cost. Consider the options together in the presence of your clinician.
- ARBs: losartan, valsartan, candesartan, irbesartan, olmesartan. Telmisartan offers a long half-life suited to once-daily dosing; losartan is often low cost; olmesartan can be potent but has rare enteropathy reports.
- ACE inhibitors: ramipril, lisinopril, enalapril. These are effective but may cause cough or angioedema and are contraindicated in pregnancy.
- Calcium channel blockers: amlodipine, felodipine. Frequently used as first-line in older adults and people of Black African or Caribbean ethnicity.
- Thiazide-type diuretics: indapamide, bendroflumethiazide. Commonly combined with ARBs for improved control.
- Beta-blockers: bisoprolol, atenolol. Typically chosen when specific pointers exist such as ischaemic heart disease or arrhythmias.
Price, side effect profile and comorbidities shape the clinician's choice. Take in the price breakdown section for indicative UK costs in GBP.
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Common price bands in Britain
Private prices vary by pharmacy, manufacturer (brand versus generic) and pack size. The figures below are approximate retail costs for a pack of about 28 tablets and exclude consultation or postage fees.
- Generic telmisartan 20 mg: approximately 2 to 5 GBP per 28-tablet pack.
- Generic telmisartan 40 mg: approximately 3 to 7 GBP per pack.
- Generic telmisartan 80 mg: approximately 4 to 8 GBP per pack.
- Branded Micardis: often higher, typically 15 to 30 GBP if in stock.
Selected comparative private prices (approximate):
- Losartan potassium brand Cozaar 50 mg: around 1 to 3 GBP.
- Valsartan medicine 80 mg: around 2 to 5 GBP.
- Candesartan 8 mg: around 2 to 5 GBP.
- Amlodipine 5 mg: commonly under 1 GBP.
On the NHS: in England most adults pay the standard per-item prescription charge (check current rate). Residents of Scotland, Wales and Northern Ireland pay no prescription charges. Exemptions and prepayment certificates may reduce costs; confirm current charges before purchasing.
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UK legal and supply memo
- Regulatory status: Telmisartan (including Micardis) is a Prescription Only Medicine (POM) and is regulated by the MHRA.
- How it is supplied: a valid prescription from an appropriate prescriber (for example a GMC-registered doctor or an independent prescriber) is required for supply. Dispensing must be conducted by a pharmacy registered with the General Pharmaceutical Council (GPhC).
- Online pharmacies: reputable online providers will perform an assessment and will not dispense without a valid prescription. Always verify the pharmacy's GPhC registration and contact details before ordering.
- Emergency supply: pharmacists may provide a limited emergency supply of a POM in some circumstances after clinical assessment and proper record keeping; this is discretionary and not guaranteed.
- Travel and import: Micardis is not a controlled drug. When traveling carry medication in original packaging with proof of prescription and confirm the results airline and destination rules in advance.
- Driving and operating machinery: avoid driving if you feel dizzy or impaired. It is an offence to drive while impaired by medication.
- Prenatal to lactation care: ARBs must not be used in pregnancy and should be stopped if pregnancy occurs. Discuss contraception and breastfeeding with your clinician.
- Reporting undesirable effects: suspected drug side effects can be reported to the MHRA via the Yellow Card scheme.
For more on safety see the interactive engagements span conversations, gestures, and feedback. and risk mitigation measures sections above.
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