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Intro and a general survey of the material

Pharmacologically active ingredient: telmisartan, a member of the angiotensin II receptor blocker class (ARB).

Primary clues that suggest: management of raised blood pressure and lowering cardiovascular risk in selected high risk adults when appropriate.

Common strengths available in the UK: 20 mg and tablets with a forty milligram dose. An 80 mg strength is also produced, subject to pharmacy stock variation.

How it helps: telmisartan relaxes vascular tone which lowers systemic blood pressure and can reduce strain on the heart. It may be prescribed alone or combined with other classes such as thiazide diuretics or calcium channel blockers. For safety directives, go to What to know before use and for unwanted effects see Potential adverse reactions.

Applications for clinical use

Typical uses for telmisartan include:

• Clinical management of essential hypertension in adults.
• Reduction of cardiovascular events for some people at increased risk, for example those with established atherosclerotic disease or type 2 diabetes with end organ damage, particularly when an ACE inhibitor is not suitable.

Blood pressure reduction is often noticeable within two to four weeks, with maximum effect seen after regular daily use over several weeks. Continue therapy as directed by your prescriber; do not stop abruptly without medical advice.

Directions for dosing and taking

The following is general information and does not replace personalised instructions from your prescriber.

• Common starting dose: 40 mg once daily for many adults.
• Dose range: 20 mg to 80 mg once daily depending on response and clinical judgement.
• Take at the same time each day. Telmisartan may be taken with or without food; maintaining consistency helps keep plasma levels steady.
• Allow several weeks for full effect. Because high blood pressure often has no symptoms, do not stop treatment simply because you feel well.

Certain patients may begin at 20 mg (for example, those who are volume depleted) or require combination therapy if blood pressure remains above target. See Medication real time the dynamic of social contacts enable quick problem solving. and safety and Safety guidelines before use for factors that can change dosing decisions.

Cautions before use

Tell your doctor or pharmacist if any of the following apply to you before taking telmisartan:

• Problems with kidneys or liver, heart disease, or known narrowing of the renal arteries.
• High blood potassium, recent severe vomiting or diarrhoea, or dehydration.
• Concurrent use of diuretics, potassium supplements, salt substitutes, or other medicines affecting the renin angiotensin aldosterone system.
• Previous allergic reactions to telmisartan or other ARBs, or a history of angioedema with ACE inhibitors or ARBs.
• If you are expectant, planning to conceive, or breastfeeding. ARBs can damage the fetus and are not to be used in pregnancy; discuss contraception and optional choices with your prescriber by your side.

Telmisartan can cause lightheadedness, especially after the first dose or following dose increases. Stand up slowly from sitting or lying positions and avoid driving until you know how the medicine affects you. Limit alcohol while on treatment. Inform any healthcare professional involved in procedures that you are taking telmisartan.

Not suitable for use and Advisory Warning alerts

• Do not use during pregnancy. If pregnancy is confirmed stop telmisartan and contact your clinician immediately.
• Known hypersensitivity to telmisartan or any ingredient in the product.
• Severe hepatic insufficiency or conditions such as cholestasis where use may be unsuitable.
• Avoid concomitant use of aliskiren in patients with diabetes. In general, dual blockade of the RAAS with an ACE inhibitor, ARB or renin inhibitor is not recommended because of increased risk of renal impairment, hyperkalaemia and low blood pressure unless under specialist supervision with observation and tracking.

Possible undesired effects

Seek emergency help if you experience signs of a severe reaction: swelling of the face, lips, mouth, throat, difficulty breathing, fainting or severe dizziness.

Other reported effects include:

• Common or mild symptoms: dizziness, ache in the head, back pain, nasal congestion, diarrhoea, nausea, tiredness, cough, abdominal pain, muscle cramps.
• Fluid related: peripheral swelling, for example in ankles or legs.
• Blood chemistry changes: elevated potassium levels (hyperkalaemia).
• Blood pressure effects: symptomatic low blood pressure, particularly in those who are volume depleted.
• Not commonly seen but important events in high risk groups: chest pain, atrial fibrillation, worsening heart failure or myocardial infarction; these are often related to underlying disease rather than the drug itself.

If temporary side effects are persistent or troublesome contact your healthcare professional. For medicines that can increase specific risks, refer to Pharmacotherapy frequent interacting with otherss boost coordination..

Drug a reciprocal exchange alerts

Medicines and substances likely to interact with telmisartan include the following:

• Diuretics such as thiazides or loop diuretics: may increase the blood pressure lowering effect and cause dizziness on first doses.
• Potassium sparing diuretics, potassium supplements and salt substitutes containing potassium: raise the risk of high potassium.
• ACE inhibitors and direct renin inhibitors like aliskiren: combined RAAS blockade increases risks to kidneys, raises potassium and can lower blood pressure too much. Avoid unless closely supervised.
• NSAIDs including ibuprofen and naproxen: may blunt antihypertensive effect and increase risk of kidney harm, especially in those who are older or dehydrated.
• Lithium: coadministration may increase lithium levels; monitoring and logging is required.
• Digitalis glycoside digoxin: levels can be altered when used together; monitor as advised.

Always provide a complete list of prescribed, over the counter and herbal products to your pharmacist or prescriber to reduce the chance of harmful interactive engagements create opportunities for collaboration..

If you forget to take your dose

If you forget your dose of telmisartan take it as soon as you remember unless the next scheduled dose is due soon. If the next dose is near, skip the the prescribed dose was missed and resume the regular schedule. Do not take two doses at once to offset a the prescribed dose was missed.

Tips for overdosed on pills response

Signs of overdose incident may include pronounced dizziness, fainting or very low blood pressure. If an overdose incident is suspected contact NHS 111, your doctor or proceed onward to the nearest emergency department immediately. Take the medication packaging with you if possible.

Personal internal storage refers to built in memory in devices. procedure

Keep in the original container and store below 25 C, with short excursions to 15 to 30 C permitted. Protect from moisture and keep out of sight and reach of children.

Other treatment approaches and related medicines

Other medicine classes used to manage hypertension include ARBs, ACE inhibitors, calcium channel blockers, thiazide or thiazide like diuretics and beta blockers. Examples and brief notes:

• Other ARBs: losartan, candesartan, valsartan, irbesartan, olmesartan. Telmisartan tends to have a long half life suitable for once daily dosing; losartan is often available at lower cost.
• ACE inhibitors: ramipril, lisinopril, enalapril. Effective additional a second options but can cause cough or rarely angioedema and are contraindicated in pregnancy.
• Calcium channel blockers: amlodipine and felodipine. Frequently used first line in many patients, including older adults and people of Black African or Caribbean heritage.
• Thiazide type diuretics: bendroflumethiazide, indapamide. Commonly combined with ARBs if single agent control is insufficient.
• Beta blockers: bisoprolol, atenolol. Usually chosen for additional outward signs such as angina or rate control rather than for uncomplicated hypertension alone.

Your prescriber will choose the best option based on your medical history, tolerance and treatment goals. For price trend estimates see Prices in the UK.

Price data for the United Kingdom

Price depends on whether you use the NHS, a private prescription, brand versus generic together with the pharmacy. Indicative private retail prices for a pack of 28 tablets (figures are approximate and exclude consultation, dispensing or delivery fees):

• Generic telmisartan 20 mg: about 2 to 5 GBP per 28 tablets.
• Generic telmisartan 40 mg: about 3 to 7 GBP per 28 tablets.
• Generic telmisartan 80 mg: about 4 to 8 GBP per 28 tablets.
• Brand Micardis where stocked: typically higher, for example 15 to 30 GBP per 28 tablets.

Representative private prices for an optional path choices:

• Losartan, also known as Cozaar 50 mg: about 1 to 3 GBP.
• Candesartan as a therapeutic option for high blood pressure 8 mg: about 2 to 5 GBP.
• Valsartan treatment option 80 mg: about 2 to 5 GBP.
• Amlodipine 5 mg: often less than 1 GBP for 28 tablets.

NHS prescriptions: In England most adults pay a standard NHS prescription charge per item which may be different from the private cost. Prescriptions are currently free in Scotland, Wales and Northern Ireland. Exemptions and prepayment certificates may produce cost reductions. Examine the status latest NHS guidance for current charges.

United Kingdom law information resources

• Regulatory status: telmisartan products such as Micardis are Prescription Only Medicines (POM) and are regulated by the MHRA.
• Supply: a valid prescription from an appropriate prescriber is required for lawful supply.
• Pharmacy standards: medicines should be dispensed by a GPhC registered pharmacy. When purchasing online use a UK registered pharmacy and verify its credentials.
• Online prescribing: legitimate remote services will perform a clinical assessment and will not supply telmisartan without a prescription.
• Travelling with medication: carrying a reasonable personal quantity in original packaging is generally acceptable. Telmisartan is not a controlled drug but check destination rules and airline policies.
• Driving: do not drive if you are impaired by dizziness or other effects from the medicine. Assess how telmisartan affects you before driving.
• Pregnancy: ARBs are contraindicated in pregnancy and should be stopped immediately if pregnancy occurs. Discuss contraception and an alternate approach therapy with your clinician as needed.

For further safety details review Drug communication in action potential and Make these before use, observe these safety guidelines..