A new generation drug telmisartan in the treatment of hypertension. All about the drug Telmisartan - composition, side effects, cost and analogues Telmisartan contraindications

Telsartan 80 is a drug that belongs to angiotensin antagonists. Used to treat arterial hypertension and other pathologies.

Telmisartan.

ATX

ATX code - C09C A07.

Release forms and composition

Available in tablet form. The active component of the product is telmisartan. One tablet contains 80 mg of active substance, has white and capsule-shaped. The tablets are uncoated, each of them is engraved on one side with the number 80.

The excipients are sodium hydroxide, water, povidone, meglumine, magnesium stearate and mannitol.

Pharmacological action

The antihypertensive effect of the active substance is ensured by antagonistic blocking of vascular receptors sensitive to angiotensin 2. The telmisartan molecule has a similar chemical structure, therefore attaches to receptors instead of the hormone, blocking its effect. Vascular tone does not increase, which stops the rise blood pressure.

The active component of the drug binds receptors on long time. It is characteristic that receptors of the AT1 subtype are blocked. Other angiotensin receptor subtypes remain free. Their exact role in the body is not fully understood, so they do not need to be inactivated to control blood pressure levels.

Under the influence of the drug, the production of free aldosterone is also inhibited. At the same time, the amount of renin remains the same. Cell membrane channels responsible for ion transport are also not affected.

Telsartan is not an angiotensin-converting enzyme inhibitor. This makes it impossible for some undesirable symptoms to occur, because this enzyme is also responsible for the breakdown of bradykinin.

Pharmacokinetics

When taking the drug orally, the active component quickly passes through the mucous membrane of the small intestine. It binds almost completely to transport peptides. Most of it is transported in conjunction with albumin.

The total bioavailability of the product is about 50%. May decrease when taking the medication with food.

The main mechanism of metabolic transformation of the drug in the body is conjugation to a glucuronide. The resulting substance has no pharmacological activity.

Most of the active substance is excreted in its original form. The half-life is 5-10 hours. Fully active ingredient leaves the body within 24 hours.

Indications for use

The product is used for:

• therapy of arterial hypertension;
• prevention of deaths from CVS pathologies in people over 55 years of age who have a high risk of developing them due to functional disorders cardiovascular system;
• prevention of complications in patients with insulin-independent diabetes mellitus who have been diagnosed with a lesion internal organs associated with the underlying disease.

Contraindications

Contraindications to the use of this drug are:

• hypersensitivity to the main active ingredient or other substances included in the composition;
• obstruction of the biliary tract;
• insufficiency of liver function during the period of decompensation;
• hereditary fermentopathy with fructose intolerance;
• age under 18 years;
• pregnancy and lactation period.

With caution

The drug should be prescribed with caution to patients with mild hepatic impairment.

How to take Telsartan 80

The tablets are taken every day. You can take it regardless of meal time, washing it down with the required amount of water.

The initial dosage of the drug is 40 mg. If this amount of the drug does not allow full control of blood pressure levels, the dose is increased.

The maximum daily dosage is 80 mg. Further increase is impractical, since it does not lead to an increase in the effectiveness of the product.

It should be taken into account that the effect of the drug does not appear immediately. The optimal effect is achieved after 1-2 months of continuous use.

Sometimes Telsartan is combined with thiazide diuretics. This combination allows you to further reduce blood pressure.

In particularly severe cases with hypertension it is possible to prescribe 160 mg of telmisartan in combination with 12.5-25 mg of hydrochlorothiazide.

For diabetes

In type 2 diabetes mellitus, Telsartan can be taken to prevent vascular complications in the kidneys, heart, and retina. The drug is prescribed in a dosage of 40 or 80 mg, depending on the severity of hypertension.

The drug is taken over a long period of time. Clinical studies show that systolic and diastolic pressure when taken from 8 to 12 weeks decreases by 15 and 11 mm Hg. Art. respectively.

Patients with diabetes and hypertension can combine the drug with amlodipine. This combination allows you to keep your blood pressure levels within normal limits.

Before taking the product, you must consult your doctor. The dosage and duration of therapy should be selected on an individual basis.

Side effects of Telsartan 80

Studies have shown that the frequency of side effects occurring when taking Telsartan is approximately equal to the frequency of pathological reactions in patients receiving placebo. It also did not depend on the age and gender of people.

Gastrointestinal tract

From the outside digestive system may be observed:

• stomach ache;
• dry mouth;
• diarrhea;
• nausea;
• vomit;
• dyspeptic disorder;
• flatulence.

Blood-forming organs

From the hematopoietic organs the following may appear:

• anemia;
• thrombocytopenia;
• eosinophilia;
• decrease in hemoglobin level.

Central nervous system

The central nervous system may react to the drug with the appearance of:

• depressive disorders;
• insomnia;
• anxiety states;
• drowsiness;
• visual impairment;
• dizziness.

From the urinary system

The drug may cause:

• impaired renal function;
• acute renal failure.

From the respiratory system

Telsartan may cause:

• shortness of breath;
• cough;
• diseases of the lower respiratory tract.

From the skin

May occur:

• increased sweating;
• rash;
• erythema;
• swelling;
• dermatitis;
• hives;
• eczema.

From the genitourinary system

Sexual function does not suffer when taking Telsartan.

From the cardiovascular system

• arterial hypotension;
• orthostatic hypotension;
• tachycardia, bradycardia.

From the musculoskeletal system and connective tissue

The musculoskeletal system may respond to treatment with the appearance of:

• pain in muscles and joints;
• tendon pain;
• seizures;
• lumbodynia.

From the liver and biliary tract

Under the influence of telmisartan, the level of activity of liver enzymes may change.

Allergies

Anaphylactic reactions to the drug may occur.

Impact on the ability to operate machinery

Studies of the effect of the drug on the ability to control mechanisms have not been conducted. It is recommended to limit the time spent behind the wheel if side symptoms from the central nervous system appear.

Special instructions

Hypotension may accompany the first dose of the drug in patients with insufficient circulating blood volume or low level plasma sodium.

Acute hypotension may occur if the patient has renal vascular stenosis or congestive heart failure.

Telmisartan is not effective in the treatment of patients with primary hyperaldosteronism.

The drug is prescribed with caution to people with stenosis of the aortic or mitral valve.

The use of the drug may cause an increase in potassium levels in the bloodstream. In some patient groups, periodic monitoring of plasma electrolyte levels may be required.

There is a risk of hypoglycemia in people receiving insulin or other antidiabetic agents. It is worth taking this into account when selecting the dose of these drugs. It is necessary to constantly monitor the concentration of glucose in the bloodstream.

Use during pregnancy and lactation

Treatment with telmisartan cannot be carried out during pregnancy. If there is an urgent need to continue antihypertensive therapy, you should consult your doctor. He will select suitable replacement drugs.

If it is necessary to use the drug to treat women during lactation, it is recommended to transfer the child to artificial feeding. This precaution is due to the lack of information about the effects of telmisartan, which may be contained in milk, on the body of infants.

Prescription of Telsartan for 80 children

The drug is not used to treat patients under 18 years of age.

Use in old age

Use for renal impairment

A decrease in renal function leads to the fact that the active component of the drug binds to plasma peptides by 100%. The elimination of telmisartan in mild and moderate forms of renal failure does not change.

Use for liver dysfunction

For mild to moderate liver failure, the daily dosage of the drug should be no more than 40 mg.

Overdose of Telsartan 80

Data on overdose are limited. Hypotension and increased or decreased heart rate may occur.

If you suspect an overdose of telmisartan, you should consult a doctor. In this case, it is recommended to symptomatic therapy. Hemodialysis is not effective.

Interaction with other drugs

The drug potentiates the effect of other antihypertensive medications.

The combination of Telsartan with statins and paracetamol does not lead to any side effects.

The drug may increase the maximum effective concentration of digoxin in the bloodstream. This requires content monitoring.

Combination with drugs containing lithium salts increases their toxicity. It is necessary to use such a combination only under the condition of careful monitoring of the lithium content in the bloodstream.

Acetylsalicylic acid and other non-steroidal anti-inflammatory drugs may reduce the effectiveness of the drug. NSAIDs that inhibit cyclooxygenase activity in combination with telmisartan may lead to impaired renal function in some groups of patients.

Conditions for dispensing from a pharmacy

Dispensed with a doctor's prescription.

Can I buy it without a prescription?

Price for Telsartan 80

The cost of the product depends on the place of purchase.

Storage conditions of the drug

Must be stored in a dry place at a temperature not exceeding + 25°C.

Best before date

The product is suitable for use within 2 years from the date of release.

Telmisartan 40 mg price

1 package 80 euros
2 packages 75 euros each
3 packs 70 euros each

Telmisartan 40 mg buy in Moscow

Medicine Telmisartan 40 mg direct deliveries from Germany to Moscow tel +7 926 3666610, payment to the courier upon receipt, delivery to all cities of Russia and CIS countries, all offered drugs have European Union (EU) certificates of conformity

If you want to buy the German drug Telmisartan or check the price, contact our representatives, we provide guarantees of authenticity and attach an original receipt from a German pharmacy

Telmisartan instructions

Drug name
Telmisartan
International name
Telmisartan
Indications
Arterial hypertension.
Pharmacological action
Antihypertensive agent, angiotensin II receptor antagonist (AT1 type). It has a very high affinity for this receptor subtype. By selectively and long-term binding to receptors, telmisartan displaces angiotensin II from its connection with AT1 receptors. Does not show affinity for other AT receptor subtypes. The functional significance of other receptor subtypes and the effect of increased (as a result of the administration of telmisartan) levels of angiotensin II on them is not known. Telmisartan reduces the level of aldosterone in the blood plasma, does not inhibit plasma renin, does not block ion channels, and does not inhibit ACE (kinase II), which also destroys bradykinin. Therefore, there are no side effects associated with bradykinin.
Telmisartan has a pronounced antihypertensive effect and is widely used to control and maintain blood pressure within acceptable values.
The product is effective throughout the day, the duration of the effect after its use is observed within 48 hours. The drug begins to act within 3 hours after the initial dose, and just a month after the start of treatment with Telmisartan, blood pressure decreases to the maximum level in both the lower and upper values, without affecting the pulse rate.
When the drug is discontinued, the pressure will return to those parameters that were at the beginning of the treatment period, but no withdrawal syndrome is observed.
Telmisartan has a positive effect on the cardiovascular system and reduces the risk of strokes and heart attacks, as well as death in patients with a significant cardiovascular risk who cannot take angiotensin-converting enzyme inhibitors.
Taking Telmisartan in patients with high blood pressure and cardiomyopathy is associated with a decrease in left ventricular mass.
Method of use of the drug
The drug is used regardless of the time of meal, 20-40 mg per day; in some cases, the daily dosage can reach 80 mg.
However, patients with liver problems should not take more than 40 mg per day.
Elderly people or people with renal failure do not need dose adjustment.
The active substance is telmisartan. Other substances included in the drug are the following: povidone, sodium hydroxide, sorbitol, meglumine, hydroxypropyl methylcellulose, magnesium stearate, mannitol.
Interaction with other drugs
The effect of lowering blood pressure is enhanced by simultaneous administration of Telmisartan and thiazide diuretics (for example, hydrochlorothiazide).
The product can also enhance the effects of other medicines with the effect of hypotension.
If Telmisartan is taken with medications that increase the concentration of potassium in the blood plasma, the risk of developing hyperkalemia, that is, a pathological condition that appears due to a significant increase in the amount of potassium in the blood, increases significantly.
If you take Telmisartan and Digoxin at the same time, the level of the latter in the blood increases, so in this case it is very important to regularly check and monitor the concentration of the second drug in the blood.
When taking medications containing lithium, there is an increase in the amount of this element in the blood, which can have a toxic effect on the body.
Side effects of the drug
Telmisartan, like any other drug, has its own side effects and contraindications. Side effects:
dizziness;
cough;
headaches;
nausea;
myalgia;
diarrhea;
flu-like symptoms;
decreased hemoglobin levels;
pain in the abdomen, chest, lower back;
increased uric acid levels.
Drivers of motor vehicles and people working at complex technical facilities should carefully evaluate the possible side effects before driving or operating precision machinery, since after taking Telmisartan, dizziness or drowsiness may occur, and attention and concentration may become dull.
People suffering from hyponatremia or having a reduced circulating blood volume may experience symptomatic arterial hypotension after taking the first tablet of the drug.
The use of Telmisartan by patients suffering from renal artery stenosis significantly increases the risk of developing severe hypotension and renal failure. This category of patients should take Telmisartan carefully.
Contraindications of the drug
The drug should not be taken during pregnancy. Even those who are planning to become a mother should refuse to take it. Breastfeeding women should stop breastfeeding during drug therapy.
The safety of taking the drug for children and adolescents has not yet been determined, therefore, to avoid health problems for children, Telmisartan is contraindicated.
You should also not take the medicine in the following cases:
sensitivity to the components of the drug;
serious diseases and dysfunction of the liver and kidneys;
obstruction of the biliary tract.
How to store
store at a temperature no higher than 25 degrees

Formula: C33H30N4O2, chemical name: 4"-[methyl]-2-biphenyl-carboxylic acid.
Pharmacological group: intermediates/antagonists of angiotensin II receptors (AT1 subtype).
Pharmacological action: antihypertensive.

Pharmacological properties

Telmisartan has a high affinity for angiotensin 2 receptors (AT1 subtype). Telmisartan has a blocking effect on angiotensin 2 receptors (AT1 subtype). Telmisartan displaces angiotensin 2 from its connection with the receptor, but is not an agonist for this receptor. Telmisartan binds only to the AT1 subtype of angiotensin 2 receptors. Telmisartan binds to the receptors for a long period. Telmisartan acts on other receptors, including AT2 receptors and other, less studied angiotensin receptors. Telmisartan inhibits (dose-dependently) the pressor effect of angiotensin 2, reduces the level of aldosterone in the blood serum, increases diuresis, and the excretion of chlorides and sodium. Telmisartan does not inhibit serum renin or block ion channels. Telmisartan does not inhibit angiotensin-converting enzyme. Telmisartan reduces the level of albuminuria and has a nephroprotective effect. Telmisartan reduces blood flow in the kidneys by 10%, without impairing glomerular filtration. Reduces the severity of myocardial hypertrophy when used in high doses. In patients with arterial hypertension, it reduces both systolic and diastolic blood pressure without changing heart rate. Telmisartan at a dose of 80 mg completely blocks the hypertensive effect of angiotensin 2 in patients.
Telmisartan is well absorbed from the gastrointestinal tract. Telmisartan undergoes a “first pass” effect through the liver, so its absolute bioavailability is 40–60%. When taken with food, the area under the concentration-time curve decreases by 6% (at a dose of 40 mg) - 19% (at a dose of 160 mg). 3 hours after administration, the level of the drug in the blood plasma levels out, regardless of the time of meal. When taking a single dose of 80 mg of the drug, the maximum concentration is achieved within 1 hour. The maximum concentration and area under the concentration-time curve were approximately 3 and 2 times, respectively, higher in women than in men; however, there is no significant effect on efficiency. Telmisartan intensively binds to plasma proteins (99.5%), mainly to acidic alpha1-glycoprotein and albumin. Telmisartan is highly lipophilic and easily penetrates into tissues. It is evenly distributed in the body, the volume of distribution is 500 liters. In the liver, telmisartan is metabolized by conjugation with glucuronic acid to form a stable inactive acyl glucuronide, rapidly excreted in the bile: approximately 11% of the glucuronide and 85% of unchanged telmisartan are determined in the feces; renal excretion is no more than 2%. Telmisartan is eliminated slowly, with a half-life of approximately 31 hours in women and 21 hours in men. 3 hours after ingestion it develops hypotensive effect, which persists for more than a day and stabilizes within 1 – 2 months. When treatment is discontinued, blood pressure gradually (over several days) returns to its original level, while rebound hypertension does not develop. In patients with renal failure (including patients on hemodialysis), no dose change is required. Telmisartan is not removed by hemodialysis. The pharmacokinetic parameters of telmisartan in elderly patients do not differ from those in young patients, so no dose adjustment is required. In patients with mild to moderate liver dysfunction (class A and B on the Child-Pugh scale), the daily dose of telmisartan should not exceed 40 mg.

Indications

Arterial hypertension; reducing cardiovascular morbidity and mortality in patients aged 55 years and older who have a high risk of developing cardiovascular pathology.

Method of administration of telmisartan and dose

Telmisartan is taken orally, regardless of food intake, 20–40 mg per day at a time, if necessary - up to 80 mg. In patients with moderate impairment of the functional state of the liver, the daily dose should not exceed 40 mg.
In patients with moderate impairment of renal function, it is necessary to regularly monitor the content of electrolytes (potassium) and creatinine in the blood serum.
Liver dysfunction when prescribed telmisartan was observed in most cases in Japanese residents.
Telmisartan is less effective in black patients.
Drivers need to be careful vehicles and people whose professions are associated with the speed of psychomotor reactions and increased concentration.

Contraindications for use

Hypersensitivity, severe impairment of liver and kidney function, biliary tract obstruction, pregnancy, breastfeeding, age under 18 years (safety and effectiveness of use have not been established).

Restrictions on use

Bilateral renal artery stenosis or stenosis of the artery of a single kidney, obstructive hypertrophic cardiomyopathy, liver and/or kidney dysfunction, hyponatremia, hyperkalemia, chronic heart failure, peptic ulcer, conditions after kidney transplantation (no experience with use), mitral and aortic valve stenosis, aortic stenosis, primary aldosteronism (safety and effectiveness have not been established), diseases gastrointestinal tract, ischemic disease SNRD, idiopathic hypertrophic subaortic stenosis, decreased circulating blood volume due to previous diuretic treatment, restriction of salt intake, vomiting or diarrhea.

Use during pregnancy and breastfeeding

The use of telmisartan is contraindicated during pregnancy. If pregnancy is diagnosed, the use of telmisartan should be stopped immediately. If necessary, alternative treatment should be prescribed ( antihypertensive drugs which are approved for use during pregnancy). In preclinical studies of telmisartan, no teratogenic effects were identified, but fetotoxicity (oligohydroamnion, decreased renal function, delayed ossification of the skull) and neonatal toxicity (hypotension, renal failure, hyperkalemia) were established. Patients who are planning pregnancy should be prescribed alternative treatment. If therapy with angiotensin II receptor antagonists occurred during the second trimester of pregnancy, then ultrasound testing of the condition of the skull and renal function of the fetus is recommended. Neonates whose mothers took angiotensin II receptor antagonists should be closely monitored for hypotension. Studies of the effect of telmisartan on human fertility have not been conducted. Treatment with telmisartan is contraindicated during breastfeeding; you need to stop breastfeeding.

Side effects of telmisartan

Cardiovascular system and blood: chest pain, bradycardia, marked decrease in blood pressure, tachycardia, orthostatic hypotension, eosinophilia, anemia, thrombocytopenia, decreased hemoglobin.
Nervous system and sensory organs: dizziness, headache, anxiety, depression, insomnia, vertigo, fainting, visual disturbances.
Digestive system: nausea, abdominal pain, dyspepsia, diarrhea, dry mouth, flatulence, stomach discomfort, vomiting, liver dysfunction, liver disease.
Respiratory system: cough, flu-like symptoms, pharyngitis, decreased tolerance to upper respiratory tract infections, upper respiratory tract infections, shortness of breath.
Genitourinary system: urinary tract infections (including cystitis), renal dysfunction (including acute renal failure).
Allergic reactions: hypersensitivity (urticaria, erythema, angioedema), anaphylactic reactions, itching, eczema, rash (including drug rash), hyperhidrosis, angioedema (fatal), toxic rash.
Musculoskeletal system: arthralgia, pain in lower limbs, back pain, myalgia, muscle spasms (calf muscle cramps), tendon pain (symptoms similar to tendinitis).
Others: pain in chest, influenza-like syndrome, hyperkalemia, general weakness, hypoglycemia (in patients with diabetes), sepsis (including fatal sepsis).
Laboratory indicators: increased concentration of uric acid, creatinine in the blood, decreased hemoglobin concentration, increased activity of liver enzymes, increased concentration of creatine phosphokinase.

Interaction of telmisartan with other substances

Hydrochlorothiazide mutually enhances the hypotensive effect. Telmisartan may increase the hypotensive effect of other antihypertensive drugs. Telmisartan increases the content of digoxin and lithium in the blood, so monitoring the content of the latter in the blood plasma is recommended. When used together with angiotensin-converting enzyme inhibitors, potassium-sparing diuretics and other drugs that can increase the content of potassium in the blood serum, as well as potassium-containing food additives, especially in patients with renal failure, the risk of developing hyperkalemia increases. In patients receiving non-steroidal anti-inflammatory drugs and telmisartan, at the beginning of therapy it is necessary to compensate for the volume of circulating blood and monitor renal function. A decrease in the effect of antihypertensive drugs, such as telmisartan, due to inhibition of the vasodilatory effect of prostaglandins, was observed when combined with non-steroidal anti-inflammatory drugs.

Overdose

In case of an overdose of telmisartan, hypotension, bradycardia or tachycardia develop. Required: symptomatic and supportive treatment; Dialysis is ineffective.

Trade names of drugs with the active ingredient telmisartan

Combined drugs:
Amlodipine + Telmisartan: Twynsta®;
Hydrochlorothiazide + Telmisartan: MicardisPlus®.

Among the abundance of drugs that lower blood and intracranial pressure without harming the heart rhythm, it is difficult to find a drug with a minimum of side effects. It's difficult, but possible. Telmisartan is an effective drug in the fight against high blood pressure, to which all of the above directly applies.

The instructions for use of Telmisartan indicate that this drug acts within three hours after administration.

Compound

One tablet of Telmisartan can contain 40 or 80 mg of the active substance - telmisartan. Excipients are sodium hydroxide, meglumine, povidone, magnesium stearate, hydroxypropyl methylcellulose, mannitol.

Telmisartan was placed on the radar (Register medicines), this is a medication approved in the Russian Federation, effective against high blood pressure, without harming the functioning of the heart. Indications for the use of this drug are chronic hypertension (increased blood and intracranial pressure) and the prevention of cardiovascular diseases.

Side effect

According to the instructions, Telmisartan is characterized by the following side effects:

• Diarrhea;
• Cough;
• Dizziness;
• Myalgia;
• Headache;
• ARVI symptoms;
• Decrease in the amount of hemoglobin in the blood;
• Pain syndrome in the lumbar region, chest, abdomen;
• Increased amount of uric acid;
• Drowsiness;
• Reduced concentration (use with caution for drivers and those whose work involves high concentration of attention).

Take under medical supervision, with caution

The blurb for Telmisartan states that those with renal artery stenosis should take this medication with caution due to the risk of developing renal failure.

Patients with hyponatremia should be prepared for the fact that after taking the first Telmisartan tablet they may experience symptoms of high blood pressure.

1. While waiting for the baby to be born;
2. During breastfeeding;
3. Children under 18 years of age;
4. If you are allergic to one of the substances included in this drug;
5. In case of severe impairment of the kidneys and liver;
6. With obstruction of the biliary tract.

Price

For Telmisartan, the price depends on the country of origin. If this is Germany, then the cost of a package of Telmisartan 98 pieces will be approximately 80 Euros. For Ukrainian Telmisartan 40 mg, the price will be approximately 80 hryvnia per package, which includes 28 tablets.

Analogues of this drug produced in Turkey and produced in Slovenia will cost from 300 to 900 rubles, depending on the number of tablets in the package and dosage. (40 mg or 80 mg). For analogues of Telmisartan 80 mg, the price will definitely be higher.

Telmisartan analogs

1. Mikardis (Germany);
2. Telmista (Poland/Slovenia);
3. Teseo (Poland);
4. Praytor (Germany);
5. Twinsta (Slovenia);
6. Telmisartan-Teva (Hungary);
7. Telpres (Spain);
8. Telsartan (India);
9. Tsart (India);
10. Hipotel (Ukraine).

The first two are the most popular in the Russian Federation, since the price for these analogues of Telmisartan is 600 and 1200 rubles, respectively. To the question whether there are Russian analogues of Telmisartan, there is a clear answer - not yet.

Russian patients have to be content with imported pharmaceutical products. Telmisartan Teva, an Israeli product sold all over the world, has proven itself well among domestic patients.

Dosage

For high blood pressure, you should take 1 tablet of Telmisartan 40 mg per day. For the prevention of heart disease vascular diseases(as well as heart attack and stroke) should take 80 mg of Telmisartan per day.

The patient’s blood pressure is completely normalized after a month of taking this drug. And it begins to act (lower blood pressure) within three hours after administration. Those with minor liver problems should not drink more than 40 mg of this drug in a 24-hour period.

Interaction with other drugs

If you take Telmisartan 80 mg or 40 mg together with Digoxin, the concentration of the latter in the blood will increase. It is not recommended to take the drug described above and potassium-sparing diuretics at the same time. The simultaneous use of Telmisartan and NSAIDs (the same aspirin) reduces the effect, within which it decreases high blood pressure at the patient.

Taking Telmisartan with other drugs that lower blood pressure can cause an excessive reduction in blood pressure to fatal levels. Therefore, it is better not to take several types of medications at once, the purpose of which is to normalize blood pressure.

If you take Telmisartan 40 or 80 at the same time as corticosteroids, this will reduce the antihypertensive (lowering blood pressure) effect of Telmisartan.

Taking a dose of 80 mg of Telmisartan can completely stop the increase in blood pressure. The blood pressure will be normal within two days.

In the treatment of cardiovascular diseases, doctors use several pharmacological groups, one of them is called sartans. Another name more often found in medical publications is angiotensin II receptor blockers (ARBs).

These medications are usually used in a situation where the patient is diagnosed not only with arterial hypertension, but also with concomitant pathologies. Among them metabolic syndrome, left ventricular hypertrophy, CHF, proteinuria, etc.

The ARB group, in turn, includes four subgroups, one of them is called non-biphenyl tetrazole derivatives. A prominent representative of this subgroup is Telmisartan tablets.

Description

Telmisartan is produced strictly in tablet form, active substance That’s what it’s called – telmisartan. One tablet contains 40 mg or 80 mg (there are two dosage options). A number of formative ingredients are represented by sodium hydroxide, povidone, meglumine, mannitol, magnesium stearate, talc.

The tablets themselves are white or whitish with barely noticeable impurities, round, flat-cylindrical in shape. Variations in the packaging of tablets in portions are different - from 10 pieces in a contour package to 98 in a jar.

Pharmacodynamic profile

Telmisartan is classified as a specific angiotensin II receptor antagonist. It shows its effectiveness when taken internally. The active component is distinguished by its high similarity to the AT1 subtype of angiotensin II receptors (through them the function of angiotensin II is displayed). This connection is long-term. Proximity to other receptors is not inherent in the ingredient; certain pharmaceutical connections possible in this situation have not been studied.

But it was found that telmisartan lowers aldosterone levels in biological fluid, it does not inhibit renin in the plasma part of the blood, nor does it close ion channels.

Telmisartan does not inhibit ACE, the same enzyme that destroys bradykinin. Therefore, those negative reactions associated with the destruction of bradykinin are not expected. It has been proven that individuals taking this sartan at a dosage of 80 mg can hope to completely block the hypertensive effect of angiotensin II. And the onset of this action is noted within 3 hours after the first tablet taken. General action remains valid for 24 hours, and 2 days remain significant.

In people with hypertension, telmisartan reduces SBP and DBP; it does not affect heart rate. If you abruptly take the medicine, the pressure will smoothly return to its usual values, withdrawal syndrome is not predicted.

Pharmacokinetic profile

The medicinal composition from the gastrointestinal tract is quickly absorbed. Its biological availability is 50%. The concentration of the substance in the plasma will be even 3 hours after administration, and this does not correlate with meals. Statistics show that plasma concentrations differ between men and women, with the latter being higher. But there is still no significant clinical difference.

The main component is 99.5% bound to plasma proteins. Metabolism is characterized by conjugation with glucuronic acid. Metabolites do not demonstrate clinically important activity. The elimination period is 20 hours. The component is released through the intestinal route, in its original form. Less than 2% of the dose taken is evacuated by the kidneys.

For elderly hypertensive patients (65+), dose adjustment is not necessary - the pharmacokinetic index of the ingredient is indistinguishable in patients of different ages. Persons with renal failure (RF) also do not need to change the dose. In patients with hepatopathologies, the dosage cannot exceed 40 mg.

Who is it shown to?

The instructions for use of Telmisartan indicate only two acceptable reasons for prescribing the drug. The first and main one is arterial hypertension. Sartans are among the popular remedies used in the treatment of this chronic disease.

Another reason for prescribing is a reduction in the incidence of cardiovascular diseases, as well as a reduction in mortality in patients over 55 years of age with high risk CVD.

Who shouldn't drink

The instructions for Telmisartan note that the medicine is not prescribed to pregnant and lactating women. If a woman is planning a child and drinks this remedy, she needs to replace it with something softer (but only on the advice of a doctor).

Other contraindications include:

These are strict contraindications noted in the annotation for Telmisartan. But there are also relative ones, these are those diagnoses that require careful prescription of sartans.

Such diseases and conditions include bilateral stenosis of the renal arteries, failure of the hepatic and renal function, decreased volume of blood volume, hyponatremia, hypokalemia, post-transplantation condition after renal transplantation (due to lack of clinical experience), CHF, aortic/mitral valve stenosis, hypertrophic obstructive cardiomyopathy, primary aldosteronism, and also hemodialysis.

More information about gestation and breastfeeding: why Telmisartan should not be taken

As already written above, this medication is prohibited during gestation, like analogues of Telmisartan. This remedy is especially dangerous in the first third of pregnancy. If pregnancy is discovered while taking the medication, the pills should be stopped immediately. If necessary, alternative therapy is prescribed - medications from other pharmaceutical groups that are conditionally permitted during pregnancy are selected.

The second and third trimester are also a reason to choose a different treatment. Preclinical studies revealed the fetotoxicity of the component. It, in turn, is manifested by a decrease in renal function, oligohydroamnion, and slower cranial ossification. Neonatal toxicity is also noted - the same PN, hypotension, hyperkalemia.

As already mentioned, patients planning pregnancy should abandon Telmisartan in favor of medications more suitable for this period. If the pregnant woman still took sartans, she needs an additional ultrasound to assess the functions of the fetus’s kidneys, as well as the condition of its skull.

The lactation period is another taboo for Telisartan. But research works regarding fertility and the impact on it medicinal composition, have not yet been carried out.

How to use

The product is taken orally, like other tablets, without crushing or chewing, and washed down with water. Taking Telmisartan is not tied to a meal schedule.

For hypertension, standard prescriptions are as follows:

In order to reduce CVD, the medicine is also taken 1/24, but immediately at a dosage of 80 mg. For the initial period of treatment, auxiliary blood pressure correction is recommended.

Negative reactions

Those cases that occurred in observational practice do not correlate in any way with the gender, age, or race of the patients.

What negative actions can you expect:

1. Infections. Infrequently, genitourinary tract infections (and cystitis are included in their list), infections of the upper respiratory tract. With an unknown frequency - sepsis.
2. Hematopoietic system and lymphatic system. Anemia is infrequently recorded, thrombocytopenia is rarely recorded, and eosinophilia is recorded with an uncertain frequency.
3. CNS. Sleep disturbances are uncommon, depressive states, vertigo. Unreasonable anxiety syndrome and fainting rarely occur.
4. Vision. Visual defects are uncommon.
5. SSS. Bradycardia, a significant decrease in pressure, and orthostatic hypotension are not very often recorded. Tachycardia is less common.
6. Breath. Infrequently, cough and shortness of breath are detected as a negative reaction.
7. Digestion. Pain in the epigastrium of varying severity, dyspepsia, indigestion, vomiting, and bloating are rarely diagnosed. Dry mouth, gastric discomfort, and hepato-dysfunction rarely appear.
8. Allergic reactions. Infrequently, they manifest themselves as skin itching, rashes of varying severity, and increased sweating. Rarely they are expressed by hypersensitivity, eczema, angioedema, drug and toxic rash.
9. ODE. Infrequently, muscle pain, spinal pain, muscle spasms. Arthralgia and pain in the legs rarely occur. Tendon pain occurs with uncertain frequency.
10. Kidneys and urinary tract. Infrequently, renal dysfunction is observed (including acute renal failure).
11. Other. Chest pain, general fatigue, lethargy and weakness occur less often. Fixation of influenza-like syndrome is rarely observed.
12. Laboratory profile. Hyperkalemia is not very often found, increased rate creatinine in urine. Rarely noted increased content uric acid in biofluid, increased activation of liver fermentation, increased CPK activity, decreased hemoglobin, hypoglycemia in diabetics.

The post-marketing period of taking Telmisartan found that interstitial pulmonary disease rarely occurs in patients - there are no reasons why this happens.

No cases of overdose of the described drug have been found in practice. But the predicted symptoms will be a pronounced decrease in blood pressure and MS disorders. Treatment will consist of symptomatic therapy; hemodialysis will not be effective.

Telmisartan tends to increase the hypotensive effect of other drugs of the same profile.

Other types of interactions with clinical significance of telmisartan plus:

Persons receiving NSAIDs and telmisartan first undergo monitoring of blood volume (volume must be restored), then monitoring of renal function is carried out.

The risk of developing hyperkalemia increases if you take telmisartan together with ACE inhibitors, immunosuppressants, potassium-sparing diuretics, trimethoprim, and potassium-sparing food supplements. Constant monitoring of K in the serum part of the blood is necessary.

Important Notes

Certain combinations of formulations may impair renal function in certain patients. Therefore, a therapeutic regimen with double blockade of the RAAS should only be individual, and monitoring of renal functions is mandatory.

In diabetic patients with additional cardiovascular risk, the very use of medications that affect arterial hypertension, increases the risk of acute myocardial infarction or cardiac-related mortality.

In some patients with diabetes, cardiac ischemia may be asymptomatic, which is why it is not always diagnosed. Therefore, if a doctor wants to prescribe telmisartan to a diabetic, a preliminary diagnosis is required (including an exercise test).

A combination of telmisartan with diuretics (thiazide) is possible, which together will have the desired hypotensive effect. If the patient at the start of taking sartans has a reduced blood volume, if diuretic therapy was carried out the day before, if the amount of salt in food is limited, if vomiting and diarrhea are present, hypertension (symptomatic) may occur. This happens especially often as an effect of the first dose.

What to replace

The drug is well tolerated, but in some cases the medicinal product must be replaced. And you can replace it with Myocardis, Teseo, Telmista, Twinsta, Praytor.

Many analogues of the drug Telmisartan are cheaper. But this does not mean that the replacement should be done independently: ask the doctor why he prescribed this particular drug for you, whether it makes sense to find a cheaper option, why Telmisartan specifically should not be changed, etc.

The price of Telmisartan is very high, the largest package will cost several thousand (5-6 according to various sources). And such a high price must be paid for Russian medicine. And, for example, the Indian analogue Telsartan, a medicine with the same basic component, costs about 500 rubles for 28 pieces of 80 mg each.