telmisartan at a glance
Medicine class
Angiotensin II receptor blocker (ARB)
Licensed uses
Adult essential hypertension and cardiovascular risk reduction in specified high-risk adults
Food
May be taken with or without food
Storage
Keep in the original blister to protect the tablets from moisture
What is telmisartan used for?
The selected UK product is licensed for use in adults.
Treatment of essential hypertension.
Reduction of cardiovascular morbidity in adults with established atherothrombotic cardiovascular disease, such as previous coronary heart disease, stroke or peripheral arterial disease.
Reduction of cardiovascular morbidity in adults with type 2 diabetes and documented target-organ damage.
How does telmisartan work?
Telmisartan selectively blocks angiotensin II at AT1 receptors. This reduces angiotensin-driven blood-vessel narrowing and aldosterone release, allowing vessels to relax and blood pressure to fall. Unlike ACE inhibitors, it does not inhibit the enzyme that breaks down bradykinin.
telmisartan preparations and strengths
Tablet
Route: Oral
Strengths: 20 mg, 40 mg, 80 mg
How to take telmisartan
Follow the directions on the prescription label. Swallow the tablet whole with liquid, with or without food.
Remove the tablet from its sealed blister shortly before taking it because it absorbs moisture.
Do not stop treatment solely because high blood pressure causes no symptoms; discuss changes with the prescriber.
If swallowing tablets is difficult, seek pharmacist or prescriber advice. Crushing or dispersing telmisartan tablets is an off-label method and should be individually assessed.
telmisartan side effects
Common or expected effects
- Low blood pressure is reported as common when telmisartan is used for cardiovascular prevention.
Get urgent medical advice
- Severe allergic reaction or angioedema, including swelling affecting the airway.
- Acute kidney injury, which may present with markedly reduced urine output or significant swelling.
- Severe infection with whole-body illness, described as sepsis in the product information.
- Intestinal angioedema causing abdominal pain, nausea, vomiting or diarrhoea.
- Very high potassium, which can cause weakness, an abnormal heartbeat or collapse.
telmisartan in pregnancy
Telmisartan should not be started during pregnancy and is contraindicated in the second and third trimesters. Anyone planning pregnancy should discuss changing treatment beforehand; if pregnancy occurs, the prescriber should be contacted promptly so telmisartan can be stopped and replaced where appropriate. Later-pregnancy exposure can impair fetal kidney function and amniotic-fluid production and may require specialist ultrasound monitoring.
telmisartan while breastfeeding
There are no direct data on telmisartan levels in breast milk. The selected product is not recommended during breastfeeding, and an alternative with better-established evidence is generally preferred, particularly for a newborn or premature infant. Specialist advice notes that telmisartan may sometimes be used cautiously for a specific clinical reason, with specialist assessment and monitoring of infant feeding, weight, alertness and urine output.
telmisartan interactions
Check prescribed, over-the-counter and complementary products because telmisartan can affect blood pressure, kidney function and potassium.
ACE inhibitors or other ARBs
Combining renin–angiotensin system blockers increases the risks of low blood pressure, high potassium and impaired kidney function and is generally not recommended.
Aliskiren
The combination is contraindicated in people with diabetes or impaired renal function and otherwise requires careful clinical justification.
Potassium supplements, potassium-containing salt substitutes or potassium-sparing diuretics
These can cause a clinically important rise in blood potassium and require avoidance or close monitoring.
Common questions about telmisartan
Answers are fully visible for fast scanning and source review.
Is telmisartan an ACE inhibitor?
No. Telmisartan is an angiotensin II receptor blocker. It blocks the AT1 receptor rather than inhibiting angiotensin-converting enzyme.
Can telmisartan be taken with food?
Yes. The tablet may be taken with or without food and swallowed with liquid.
Why must telmisartan stay in its blister?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.