The patient should not use this drug if having the allergy to telmisartan.
You should restrict alcohol drinking. Alcohol can lower the blood pressure and may come out some of the drug side effects.
When you are prescribed to take telmisartan you should not combine it with salt substitutes or potassium supplements.
You are recommended to check the blood pressure regularly and even often. The consulting with the personal doctor should be regular too.
If you are being cured for high blood pressure, continue taking this drug even if your health conditions seem to be well. It often occurs that the high blood pressure has no clear symptoms. Most patients need to take drugs for high blood pressure permanently.
Rarely telmisartan drug can give rise to a breakdown of musculoskeletal tissues resulting into renal failure. If you have noticed unexplained muscle pain or weakness especially if you also have fever, or feel uncommon tiredness, or have dark colored urine you are recommended to call your doctor immediately.
Women who plan to be pregnant or are pregnant should inform their doctor about it as soon as possible. When used in pregnancy during the second and third trimesters, this drug may act on the renin-angiotensin system in the way that can be harmful for an unborn baby and lead to fatality to the developing fetus.
Patients taking Micardis medication may have slight dizziness or lightheadedness in the first days of the treatment. It may be linked to hypotension and should be reported to a doctor. Such patients may need special dose adjustments or tests to be sure that Micardis is safe for them. Lightheadedness, fainting and other signs of hypotension should be immediately reported to a doctor.
A patient taking Micardis should not use potassium supplements.
MIcardis may affect mental alertness due to such side effects as dizzeness, fainting, somnolence and others. Patients with such side effects should not engage in potentially dangerous activities including driving, operating machinery or any other activity demanding mental attentiveness.
Telmisartan restricts the vasoconstrictor and effects of certain chemicals in the body (causing cardiac stimulation) by cordoning the binding of angiotensin II to the AT1 receptor in different tissues of the body. Both AT1 and AT2 receptors are related to cardiovascular homeostasis and found in the adrenal gland and vascular smooth muscle.
The treatment of hypertension (high blood pressure) involves the blockade process of rennin-angiotensin system with ACE inhibitors. Renin-angiotensin system (RAS) blockade is one of the principle things in the treatment of patients with cardiovascular disease. Telmisartan is an angiotensin II receptor blocker with a profound antihypertensive specific effect. However Telmisartan does not affect any other hormone receptors or ion channels responsible for normalization of cardiovascular work.
The diuretic effect of Hydrochlorothiazide is involved in the renal tubular mechanisms of electrolyte reabsorption. The effect of the drug is increased excretion of sodium salt and chloride. In addition the drug decreases plasma volume, enlarges aldosterone secretion and urinary potassium loss.
The antihypertensive effects of Telmisartan were estimated during 6 main placebo-controlled clinical trials. The medication effects were demonstrated in the dose range of 20 to 160 mg. Telmisartan was estimated as a single medication and in combination with hydrochlorothiazide.
More than 1770 patients took part in the studies. All of them had been diagnosed with mild to moderate hypertension (diastolic blood pressure of 95-114mmHg). The majority of the patients (1031) received Telmisartan daily as a treatment for their hypertension.
The measure of blood pressure from the starting level (when the placebo effect was subtracted) was about (systolic blood pressure/diastolic blood pressure) 6-8 mmHg for 20 mg of Telmisartan, 9-13/6-8 mmHg for 40 mg of Telmisartan and 12-13/7-8 mmHg for 80 mg of Telmisartan. It was assessed that the largest used dose – 160 mg of Telmisartan did not have any further reduction in blood pressure.
The treatment with Telmisartan has shown that the blood pressure was decreased after the 1st dose of the medication with the max antihypertensive effect in the end of the 4th week.
The clinical studies also demonstrated that blood pressure little by little (from several days to 1 week) returned to its measures before the treatment with cessation of the treatment.
Long term use of the medication provides the maintained effect of Telmisartan at least for one year.
It was observed that Telmisartan antihypertensive effect is not affected by age of a patient, his/her gender, and weight and body mass index.
The doses of 20, 40 and 80 mg produce the antihypertensive effect for 24 hours, so the medication is to be taken once daily. The blood pressure should be monitored regularly.
A new study conducted in Spain suggests that consuming a tablet for hypertension before going to bed may be best for the patients with high blood pressure control problems.
It was proven that taking medications for blood pressure at different times of the day negatively influence the patients’ blood pressure patterns. More than 660 patients took part in the study. All of them have been diagnosed with chronic kidney disease and hypertension. 50% of participants took their prescribed blood pressure-lowering meds before going to sleep and 50% took their medications in the morning.
The researchers noted that patients who took at least one blood pressure-lowering drug before sleep got better control of their blood pressure. Besides, only one-third of these patients tend to suffer a heart-related condition such as heart attack, heart failure or stroke.
The researchers also found that sleep-time blood pressure offered a significantly more exact measure of heart health than blood pressure when a person wakes up. The results of the study display that the risk of cardiovascular disease in patients with high blood pressure can be decreased up to 50 % if the drugs for lowering blood pressure are administered at bedtime rather than in the morning.
Some experts believe that chronotherapy or the delivery of a drug to a patient at certain time considering his/her biorhythms might have real benefits for his/her health condition.
Unfortunately doctors usually don’t fix the time of day their patients should take medications. Patients with high blood pressure typically take their drugs in the morning. Besides, taking medications early in the morning may provoke side effects, most often fatigue and drowsiness in hypertensive patients.
Experts are sure that chronotherapy may help reduce adverse reactions and increase the beneficial effects of antihypertensive medications.
Micardis dosage for hypertension treatment is usually 40 mg once a day, still the dosage may be chosen according to individual characteristics of patient’s state of health and his condition. Clinical studies proved that the response from the blood pressure is related to the dose of Micardis and stretches from 20 to 80 mg.
It is notified that antihypertensive effect of the drug appears usually within 2 weeks after the treatment is initiated and the maximal blood pressure normalization (reduction) is usually achieved after 4 weeks.
It the reduction of blood pressure achieved by Micardis dosage of 80 mg is not enough for a patient, a diuretic may be coadministered.
Elderly patients with other serious conditions should be examined regularly and their blood pressure is to be often monitored.
Micardis may be prescribed with other antihypertensive medications.
To reduce cardiovascular risk doctors usually recommend Micardis in the dosage of 80 mg once per day. In patients with cardiovascular disease the Micardis therapy should be accompanied with regular monitoring of blood pressure. Is some cases other antihypertensive medications may be administered.
- other blood pressure medications;
- steroids (prednisone);
- other diuretics, such as amiloride, bumetanide, chlorthalidone, ethacrynic acid, furosemide, hydrochlorothiazide, indapamide, metolazone, spironolactone, triamterene, torsemide;
- blood thinners (warfarin);
- cholestyramine or colestipol;
- oral insulin or other diabetes medications;
- aspirin or other non-steroidal anti-inflammatory drugs;
- narcotic pain relievers;
- muscle relaxers;
- medications to treat seizures.
There are other medications which can potentially affect telmisartan or be affected by it. If you take the medications not included in the list above, tell your doctor about them, even if they are vitamins, minerals or herbal products.
Micardis may have certain side effects of minor or mild character, they may include:
- back pain;
- stomach pain;
- skin rash;
- stuffy nose, sore throat;
- dry cough.
If these less serious side effects bother you or have persistent character, consult your doctor for dose changes.
Micardis may rarely cause other adverse reactions which are serious and demand emergency medical help. If you experience a severe allergic reaction such as hives, difficulty breathing, swelling, get medical assistance right away. In rare cases, Micardis can cause a condition may lead to the breakdown of skeletal muscle tissue and kidney failure. In case you have muscle pain, tenderness, or weakness, fever, nausea or vomiting, and dark colored urine stop using this medication and call your doctor or seek medical help. Other serious side effects may include:
- eye pain;
- vision problems, vision changes;
- feeling light-headed, fainting;
- quick weight gain;
- irregular heartbeats;
- urinating less than usual, or not at all;
- dry mouth;
- increased thirst;
- increased urination;
You may experience other side effects of Micardis, consult your doctor without delay if you feel worse or your symptoms do no improve.
Take Micardis as your doctor ordered you to do. Taking in larger doses or for longer than recommended is restricted. Follow the directions of your doctor or read the directions on your prescription label.
The dose adjusted for you may be altered by your medical professional to make the treatment more effective.
Take Micardis with full glass of water, you may take it with or without food.
It is necessary to check the blood pressure during treatment so you should visit your doctor often.
The drug may need from 2 to 4 weeks to get the blood pressure of a patient under control. Do not stop using the drug even if you feel better, keep using it as directed. Consult with your doctor if your symptoms do not improve after a month of treatment.
While being treated with this medication you should avoid drinking alcohol. Alcohol in combination with the medication can lower your blood pressure and contribute to the development of certain side effects of Micardis.
Potassium supplements or salt substitutes should not be used while taking Micardis.
You should also remember that getting up too fast from a sitting or lying position, can make you feel dizzy. Try to get up slowly to avoid a fall and dizziness.
- kidney disease;
- liver disease;
- congestive heart failure;
- low or high levels of magnesium or potassium in your blood;
- allergic reactions to sulfa drugs, penicillin.
These conditions require special dose adjustment and you may have to undergo special tests to use Micardis without harm for your health.
This medication may cause harm to an unborn baby. It should not be used by pregnant women.
It is not clinically proved if Micardis passes into breast milk. If you are breast-feeding a baby, do not take this medication.