Telmisartan (oral route)


    Brand Name

    US Brand Name

    Micardis


    Description

    Telmisartan is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks.

    Telmisartan is also used to lower the risk of heart attacks or stroke in patients 55 years of age and older who have diabetes or heart problems.

    Telmisartan is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. As a result, telmisartan relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Tablet

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of telmisartan in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of telmisartan in the elderly.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Aliskiren
    • Sparsentan

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Benazepril
    • Captopril
    • Cyclosporine
    • Dabigatran Etexilate
    • Digoxin
    • Enalapril
    • Enalaprilat
    • Fosinopril
    • Furosemide
    • Lisinopril
    • Lithium
    • Mavorixafor
    • Moexipril
    • Morphine
    • Morphine Sulfate Liposome
    • Mycophenolate Mofetil
    • Perindopril
    • Potassium Citrate
    • Potassium Phosphate
    • Quinapril
    • Ramipril
    • Repotrectinib
    • Seladelpar
    • Tacrolimus
    • Tenofovir Alafenamide
    • Trandolapril
    • Trimethoprim
    • Venetoclax

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Aceclofenac
    • Acemetacin
    • Amtolmetin Guacil
    • Bromfenac
    • Bufexamac
    • Celecoxib
    • Choline Salicylate
    • Clonixin
    • Dexibuprofen
    • Dexketoprofen
    • Diclofenac
    • Diflunisal
    • Dipyrone
    • Droxicam
    • Etodolac
    • Etofenamate
    • Etoricoxib
    • Felbinac
    • Fenoprofen
    • Fepradinol
    • Feprazone
    • Floctafenine
    • Flufenamic Acid
    • Flurbiprofen
    • Ibuprofen
    • Indomethacin
    • Ketoprofen
    • Ketorolac
    • Lornoxicam
    • Loxoprofen
    • Lumiracoxib
    • Meclofenamate
    • Mefenamic Acid
    • Meloxicam
    • Morniflumate
    • Nabumetone
    • Naproxen
    • Nepafenac
    • Niflumic Acid
    • Nimesulide

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Congestive heart failure, severe—Use may lead to kidney problems.
    • Diabetic patients who are also taking aliskiren (Tekturna®)—Should not be used in these patients.
    • Electrolyte imbalances (e.g., high potassium or low sodium in the blood) or
    • Fluid imbalances (caused by dehydration, vomiting, or diarrhea) or
    • Kidney disease—Use with caution. May make these conditions worse.
    • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    In addition to taking this medicine, treatment for your high blood pressure may include weight control and a change in the foods you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

    Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

    Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You might have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

    This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

    You may take this medicine with or without food.

    This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the dose at the same time each day.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For oral dosage form (tablets):
      • For high blood pressure:
        • Adults—At first, 40 milligrams (mg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 80 mg per day.
        • Children—Use and dose must be determined by your doctor.
      • To lower the risk of heart attacks or stroke:
        • Adults—80 milligrams (mg) once a day.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Storage

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Protect the tablets from moisture. Do not remove them from the blister pack until you are ready to take a dose.


    Precautions

    It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

    Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

    Dizziness, lightheadedness, or fainting may occur with this medicine, especially when you get up suddenly from a lying or sitting position. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

    Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

    Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.

    Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    Rare

    • Changes in vision
    • dizziness, lightheadedness, or fainting
    • fast heartbeat
    • large hives
    • painful urination or changes in urinary frequency
    • swelling in the hands, lower legs, and feet

    Incidence not known

    • Blurred vision
    • chest pain or discomfort
    • confusion
    • dark-colored urine
    • decreased urine output
    • dilated neck veins
    • extreme fatigue
    • flushing
    • hives or welts
    • hoarseness
    • irregular breathing
    • irritation
    • itching
    • joint pain, stiffness, or swelling
    • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    • muscle cramps or stiffness
    • numbness or tingling in the hands, feet, or lips
    • pain or discomfort in the arms, jaw, back, or neck
    • pounding in the ears
    • rash
    • redness of the skin
    • slow, fast, or irregular heartbeat
    • sweating
    • swelling of the eyelids, face, or lips
    • tightness in the chest
    • trouble breathing or swallowing
    • trouble with speaking or walking
    • trouble with thinking
    • unusual tiredness or weakness
    • unusually warm skin
    • weakness or heaviness of the legs
    • weakness, numbness, or tingling in the arms or legs
    • weight gain

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Abdominal or stomach pain
    • back pain
    • bloating or gas
    • changes in appetite
    • coughing
    • diarrhea
    • dry mouth
    • ear pain or hearing problems
    • fever
    • general tiredness or weakness
    • headache
    • heartburn
    • increased sweating
    • muscle pain or spasm
    • nausea
    • nervousness
    • runny or stuffy nose
    • sneezing
    • sore throat

    Incidence not known

    • Acid or sour stomach
    • belching
    • decreased interest in sexual intercourse
    • difficulty with moving
    • inability to have or keep an erection
    • indigestion
    • joint pain
    • lack or loss of strength
    • leg cramps
    • loss in sexual ability, desire, drive, or performance
    • muscle aching
    • stomach discomfort or upset
    • swelling
    • weakness

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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