telmisartan (Micardis)
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Introduction
Tradename: Micardis.
Indications
- treatment of hypertension*
- chronic heart failure
- diabetic nephropathy
- nondiabetic proteinuric nephropathy
- myocardial infarction[3]
- ischemic stroke[3]
* Telmisartan superior in controlling 24-hour blood pressure compared with other ARBs[4]
* Telmisartan with similar cardiovascular outcomes to those of other ARBs[4]
Dosage
Tabs: 20, 40, 80 mg
Pharmacokinetics
- bioavailablity 42-58%, orally active (not prodrug)
- peak effect 0.5-1 hour
- metabolized via conjugation to inactive metabolites
- terminal 1/2life of 24 hours
- 97% excreted in feces
- clearance: 800 mL/min
Adverse effects
- see ARB
- drug adverse effects of angiotensin II receptor antagonists
- drug adverse effects of renin-angiotensin-aldosterone system inhibitors (RAAS inhibitors)
- drug adverse effects of antihypertensive agents
Drug interactions
- weak inhibitor of cyt P450 2C19
- telmisartain may increase levels of:
- K+ & K+-sparing diuretics may increase risk of hyperkalemia
- warfarin ?
- drug interaction(s) of calcineurin inhibitors with ARBs
- drug interaction(s) of calcium channel blockers with ARBs
- drug interaction(s) of renin-angiotensin-aldosterone inhibitors with trimethoprim-sulfamethoxazole
- drug interaction(s) of ARB with trimethoprim
- drug interaction(s) of angiotensin II receptor antagonists with aliskiren
- drug interaction(s) of ACE inhibitors with angiotensin II receptor antagonists
- drug interaction(s) of diuretics with angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs with ARBs
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs & antihypertensives
Mechanism of action
see ACE inhibitors vs angiotensin receptor blockers (ARB)
More general terms
Component of
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, Update 9/99
- ↑ Journal Watch 24(23):174, 2004 Barnett AH, Bain SC, Bouter P, Karlberg B, Madsbad S, Jervell J, Mustonen J; Diabetics Exposed to Telmisartan and Enalapril Study Group. Angiotensin-receptor blockade versus converting-enzyme inhibition in type 2 diabetes and nephropathy. N Engl J Med. 2004 Nov 4;351(19):1952-61. Epub 2004 Oct 31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15516696
- ↑ 3.0 3.1 3.2 Deprecated Reference
- ↑ 4.0 4.1 4.2 Yum Y, Kim JH, Joo HJ, Kim YH, Kim EJ Three-Year Cardiovascular Outcomes of Telmisartan in Patients with Hypertension: An Electronic Health Record - Based Cohort Study. Am J Hypertens. 2024 Jan 29:hpae012. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38285627 https://academic.oup.com/ajh/advance-article-abstract/doi/10.1093/ajh/hpae012/7591421