Telmisartan

A newer angiotensin-II receptor antagonist, a useful alternative for the patient who has to discontinue ACE inhibitor because of persistent cough. It is used in the treatment of hypertension.


Adult Dose
Dose: 40 mg
Single Dose: 40 (40)
Frequency: 24 hourly
Route: PO
Instructions: But 20 mg may be sufficient , increased if necessary after at least 4 weeks, to max. 80 mg once daily.
Neonatal
Paedriatic
Characteristics
. It is of Synthetic origin. It belongs to Angiotensin-II receptor antagonist pharmacological group on the basis of mechanism of action and also classified in Antihypertensive Agents pharmacological group.
Contraindications
Telmisartan is contraindicated in conditions like Pregnancy,Breast feeding,Adjunct in treatment of opioid dependance,Dry or painful cough.
Effects
The severe or irreversible adverse effects of Telmisartan, which give rise to further complications include Dyspnea, Blood disorders.The symptomatic adverse reactions produced by Telmisartan are more or less tolerable and if they become severe, they can be treated symptomatically, these include Flatulence, Myalgia, Anxiety, Rashes, Pruritus, Pharyngitis, Hypotension, Arthralgia, Leg cramps, Sinusitis, Eczema, Back pain, Gastrointestinal disturbances, Increased sweating.
Indications
Telmisartan is primarily indicated in conditions like Hypertension, and can also be given in adjunctive therapy as an alternative drug of choice in Diabetic nephropathy, Heart failure.
Interactions
Telmisartan is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementDigoxinTelmisartan may increase the serum concentration of Digoxin.ModerateMonitor for increased serum concentrations and/or toxic effects of Digoxin if telmisartan is initiated/dose increased, or decreased serum concentrations/effects if telmisartan is discontinued/dose decreased. LithiumReversible increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with Telmisartan.RamiprilWhen co-administering telmisartan and ramipril, the response may be greater because of the possibly additive pharmacodynamic effects of the combined drugs, and also because of the increased exposure to ramipril and ramiprilat in the presence of telmisartan.Moderate These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Increased level of Blood urea nitrogen (BUN) concentrationsIncreased in serum creatininElevated liver enzymes
Risks
Drug should not be given to patients suffering from Kidney dysfunction, and patients suffering from Liver Malfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Warnings
Hepatic impairment-avoid if severe; active gastric or duodenal ulceration or other GI disease (Increased risk of gastro-intestinal bleeding); use with caution in renal artery stenosis, aortic or mitral valve stenosis and in obstructive hypertrophic cardiomyopathy.Monitor plasma-potassium concentration, particularly in elderly and in patients with renal impairment; lower initial doses may be appropriate in these patients.
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