Telmisartan

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Molecule Description

Telmisartan belongs to Angiotensin Receptor Inhibitors, also called Angiotensin Receptor Antagonists (ARAs). It is a medication primarily used to manage high blood pressure (hypertension). By lowering blood pressure, it significantly helps to reduce the risk of serious cardiovascular events such as heart disease, stroke, or death in patients who are at high risk. Telmisartan works by blocking the action of Angiotensin II, a naturally occurring hormone. Angiotensin II causes blood vessels to narrow. By blocking its action, telmisartan relaxes and widens blood vessels. This vasodilation (widening of blood vessels) helps reduce pressure on the blood vessel walls and allows the heart to pump more efficiently. Telmisartan should be avoided by patients with certain pre-existing conditions, including kidney problems, diabetes, or severe liver issues. You should avoid potassium supplements while taking telmisartan, as this combination can lead to dangerously high potassium levels (hyperkalemia). Combining telmisartan with certain painkillers, such as aspirin and ibuprofen, is advised against, as it can increase the risk of kidney problems and reduce the effectiveness of the telmisartan treatment. Consumption of alcohol while on telmisartan treatment can significantly increase the risk of low blood pressure. This medication may cause side effects like dizziness or tiredness. If these effects occur, patients should not drive. Individuals who are breastfeeding should consult their doctor before using telmisartan.

Uses

Chronic heart failure
Heart attack (myocardial infarction) causing dysfunction of the left lower chamber of the heart
High blood pressure
Diabetic kidney disease

Contraindications

When should one not use Telmisartan

Pregnancy
Allergic reaction to Telmisartan
Liver or kidney disease
Renal Artery Stenosis (a condition where a blood vessel in the kidney is narrow)

Side effects

Common side effects of this drug are:

A drop in blood pressure
Headache
Dizziness
Rash, swelling of the face, lips and throat (serious)
Nausea, vomiting, diarrhea, upper respiratory tract infection
Can cause deranged kidney function
Increased in white blood cells
Fainting
Spinning of head
Depression
Swelling, dry mouth
Decreased hemoglobin
Muscle pain

Precautions and Warnings

Pregnancy

Telmisartan can harm the fetus seriously. Do not take Telmisartan if you are pregnant or planning a pregnancy.

Breast Feeding

Telmisartan is not recommended for breastfeeding mothers. There is no sufficient data available to say whether Telmisartan can be harmful to the nursing infant if breastfed by a mother who is on the medication of Telmisartan. But it is advisable to seek a physician’s help to find a safer alternative.

Driving

Telmisartan is not known to affect your driving ability. If you experience dizziness or drowsiness with Telmisartan, avoid driving.

Alcohol

Caution is advised as alcohol can decrease your blood pressure and can increase side effects like sedation or drowsiness.

Other General Warnings

Talk to your doctor if

Have a history of angioedema (swelling of the face, lips, throat, tongue)
Have excessive vomiting or diarrhea
You are known to have narrowing or blockage of the blood vessels leading to your kidneys or had a kidney transplant recently
Have liver disease
You suffer from heart failure with or without renal impairment or concomitant severe life-threatening cardiac arrhythmias
You have high blood pressure and diabetes-related kidney problems. Your doctor shall regularly ask you to do kidney tests and test for electrolytes (e.g. potassium)

Mode of Action

How Does It Work?

Angiotensin-II is a substance produced in the body which causes constriction of blood vessels. This leads to an increase in blood pressure. Telmisartan prevents the binding of Angiotensin-II to its receptors, thus causing the blood vessels to relax and lowers the blood pressure.

Interactions

Interactions with other medicines

Aspirin and NSAIDs reduce the action of Telmisartan on blood pressure
All ACE inhibitors, Azathioprine, Lithium, Aspirin and Aliskiren, should be avoided
Medicines which are known to increase potassium levels like Diuretics

Interactions with food items

Avoid high potassium-containing food
Low-salt diet preferred
High levels of potassium can cause irregular heartbeat, confusion, weakness, feelings of heaviness in the legs or tingling of the extremities

Dosage

Overdose

Overdose symptoms can include increased heart rate, extremely low blood pressure, dizziness, increased levels of potassium in the blood, kidney failure, loss of consciousness. Seek immediate emergency medical help if you suspect overdose.

Missed a Dose

If you missed any dose, take it as soon as you remember. If it is time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose of medicine to compensate for a missed one.

Frequently Asked Questions (FAQs)

You must give an account of your past and present diseases, especially diabetes, and all the ongoing medications, supplements and herbal medicines that you are taking. If you take anti-diabetic medication or insulin, track your blood sugar carefully while taking this medicine, particularly during the first month of its use. The combination of anti-diabetic medicines when on Telmisartan, may cause significant changes in your blood sugar levels owing to drug interactions. Aspirin and painkillers also diminish the positive effect on blood pressure of Telmisartan. Hence, sharing the complete history is of utmost importance.

Common side effects are usually mild and may include dizziness, lightheadedness, or tiredness. Some people may also experience flu-like symptoms, back pain, or an upset stomach.

No. Telmisartan is not safe during pregnancy and must be stopped immediately if you become pregnant, as it can harm the developing baby. Consult your doctor if you are breastfeeding or pregnant.

Yes. Avoid potassium supplements and salt substitutes containing potassium, as telmisartan may increase potassium levels, leading to hyperkalemia (dangerously high potassium).

You should tell your doctor if you take ibuprofen or large doses of aspirin, since combining them with telmisartan can increase the risk of kidney problems and reduce the medicine’s effectiveness.

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