Telmisartan is a medication used to treat hypertension and cardiovascular diseases, belonging to the class of Angiotensin II Receptor Blockers (ARBs). Its primary action is to block the binding of angiotensin II to its receptors, causing vasodilation, lowering blood pressure, and reducing cardiac workload. This medication is commonly used to control chronic hypertension and to help improve cardiac function after myocardial infarction.
Clinical studies show that Telmisartan not only effectively lowers blood pressure but also reduces the risk of cardiovascular events, especially providing additional protection for patients with diabetes or kidney disease. When using this medication, it should be combined with a healthy diet and regular exercise to achieve optimal therapeutic effects.
The generic name of this medication is Telmisartan. Common brand names in Taiwan and Hong Kong include:
It belongs to the class of “Angiotensin II Receptor Blockers” (ARBs). These drugs selectively block the AT₁ receptors for angiotensin II, reducing vasoconstriction and aldosterone secretion, thereby lowering blood pressure and protecting renal function.
Mainly used for:
Mild side effects include:
Serious side effects require immediate medical attention:
Contraindications: Not recommended for pregnant women in the second and third trimesters, as it may harm the fetus. Patients with severe renal impairment or bilateral renal artery stenosis should use cautiously.
Regular monitoring of blood pressure, serum potassium, and liver and kidney function is necessary during treatment. Diabetic patients should monitor blood glucose levels, as ARBs may affect glucose metabolism. If planning pregnancy, inform your physician immediately to adjust medication accordingly.
Concurrent use with the following medications may increase side effects:
The starting dose is usually 40 mg once daily, adjustable up to a maximum of 80 mg based on blood pressure response. It can be used alone or in combination with other antihypertensives (such as diuretics). The tablet should be swallowed whole, taken with or without food, but at a fixed time each day.
In heart failure, the initial dose is lower (e.g., 20 mg per dose), and should be combined with other heart failure treatments. Elderly or renal impairment patients should have dosage adjustments; do not increase or decrease the dose without medical supervision.
If you remember within 2 hours of the missed dose, take it immediately. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for the missed one.
Overdose may cause severe hypotension or dizziness. Seek medical attention immediately. Treatment may include gastric lavage, intravenous fluids, or vasopressors. Do not attempt to treat overdose yourself; go to the emergency room for professional care.
Telmisartan itself does not directly affect blood potassium levels. However, if the patient is also using diuretics or other medications that may increase potassium levels (such as potassium-sparing diuretics or ACE inhibitors), regular monitoring of blood potassium is necessary. When used alone, generally there is no need to restrict dietary potassium intake, but patients with renal impairment should follow medical advice for adjustments.
What are common side effects of Telmisartan? How can they be alleviated?Common side effects include dizziness, headache, or fatigue, which usually lessen as the body adapts. If persistent dizziness or muscle soreness occurs, check if it is related to low blood pressure, and avoid sudden position changes. If severe discomfort occurs, stop the medication and consult a doctor. Do not adjust the dose on your own.
What are the risks of combining Telmisartan with NSAIDs?Combining with NSAIDs (such as ibuprofen) may reduce the antihypertensive effect of Telmisartan and increase the risk of kidney dysfunction. If short-term use of painkillers is necessary, inform your doctor about your medication and monitor blood pressure and urine output closely.
Can women who are pregnant or planning pregnancy use Telmisartan?Telmisartan may harm the fetus after the second trimester of pregnancy. Women who are pregnant or planning pregnancy should inform their doctor immediately and consider alternative treatments during early pregnancy. The medication can affect placental blood flow, so strict adherence to medical instructions is essential.
How to determine if dosage adjustment is needed during long-term use of Telmisartan?Blood pressure control is the main factor for dosage adjustment. If daily blood pressure readings remain above the target range (e.g., over 140/90 mmHg), or if unexplained dizziness or fainting occurs, consult your doctor promptly. The physician may adjust the treatment plan based on renal function, serum potassium, and severity of side effects.
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