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Telmisartan is a non-peptide angiotensin II receptor antagonist. Angiotensin II is formed through a reaction catalyzed by angiotensin-converting enzyme (ACE) and is a key component of the renin-angiotensin system, causing vasoconstriction, aldosterone synthesis and release, cardiac stimulation, and sodium reabsorption by the kidneys. Telmisartan selectively blocks angiotensin II from binding to AT1 receptors in various tissues, such as vascular smooth muscle and the adrenal gland, thereby preventing its vasoconstrictive and aldosterone-secreting effects.
Telmisartan has a significantly higher affinity (>3,000 times) for the AT1 receptor than the AT2 receptor. Since Telmisartan does not inhibit ACE, it does not interfere with bradykinin response. Additionally, it does not bind to or block other hormone receptors or ion channels involved in cardiovascular regulation.
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✅ Description:
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✔️ Tems is prescribed for:
- Hypertension: Treatment of essential hypertension in adults.
- Cardiovascular Prevention: Reducing cardiovascular morbidity in adults with:
- Atherothrombotic cardiovascular disease (e.g., history of coronary heart disease, stroke, or peripheral arterial disease), or
- Type 2 diabetes mellitus with documented target organ damage.
This medication should be used under the guidance of a registered physician.
✔️ Side Effects
- For Hypertension: Common side effects include sinus pain and congestion (sinusitis), back pain, and diarrhea.
- For Cardiovascular Risk Reduction: Common side effects include intermittent claudication and skin ulcers.
✔️ The dosage of Tems should be individualized:
- Usual Starting Dose: 40 mg once daily. The antihypertensive effect is dose-dependent in the range of 20 to 80 mg.
- Maximum Effectiveness: Usually observed within 4 weeks. Combination therapy may be considered for additional blood pressure reduction beyond 80 mg.
- Special Populations:
- No initial dosage adjustment is required for elderly patients or those with renal impairment, including patients on hemodialysis. However, blood pressure should be monitored closely as orthostatic hypotension may occur.
- Patients with biliary obstructive disorders or hepatic insufficiency should be carefully monitored, and dose adjustments should be made gradually.
Pediatric Use: Safety and efficacy have not been established in pediatric patients.
Geriatric Use: No significant differences in safety or effectiveness compared to younger adults.
✔️ Administration:
- May be taken with or without food.
- Initial therapy with Tems is not recommended for patients aged ≥75 years or those with hepatic impairment.
✔️ Interactions
- NSAIDs: May increase the risk of renal impairment and reduce the antihypertensive effect.
- Aliskiren: Avoid co-administration with Tems in patients with diabetes.
✔️ Contraindications
- Hypersensitivity to Telmisartan or any of its components.
✔️ Pregnancy & Lactation
- Pregnancy: Category C (first trimester) and Category D (second and third trimesters). Avoid use due to the risk of fetal harm.
- Lactation: Consider discontinuing breastfeeding or the drug, based on its importance to the mother.
✔️ Precautions & Warnings
- Avoid exposure to the drug during pregnancy or breastfeeding.
- Use caution in patients with hepatic or renal impairment.
- Monitor patients for hypotension.
- Concomitant use of ACE inhibitors and angiotensin receptor blockers should be avoided.
✔️ Storage
- Store below 30°C.
- Protect from light and humidity.
- Keep out of reach of children.
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
