Yes, all the drugs from angiotensin II receptor blockers (ARB) are effective, well-tolerated, widely used BP-lowering drugs. The PRISMA I study from 2005 demonstrated the superiority of telmisartan over ramipril (Angiotensin-converting enzyme (ACE) inhibitors – another group of drugs reducing hypertension) during the normalization of hypertension. Telmisartan was more effective than ramipril in reducing blood pressure throughout the 24-hour dosing interval and especially during the last 6 hour, when patients are at greatest risk of cerebrovascular events. Both drugs were well-tolerated, but ramipril caused more coughing.

Does telmisartan lower heart rate?

No, there is no evidence of telmisartan reducing heart rate. It does not affect heart rate like other hypertensive drugs such as amlodipine or nifedipine which can improve the cardiac drive. Nevertheless, there is clear clinical evidence of telmisartan enhancing renoprotection (kidney protection) as well as cardio protection. Telmisartan enhances cardiac protection by reducing: left ventricular hypertrophy (thickening of the wall of left ventricular in the heart resulting in the poor pumping of the blood), arterial arteriosclerosis (stiffness and thickening of arteries) and the recurrence of atrial fibrillation (irregular and rapid heart rhythm)

Is telmisartan a beta blocker?

No, telmisartan tablet is not a beta blocker. It belongs to the class of Angiotensin Receptor-Blockers (ARB). Telmisartan can at times be prescribed with a beta blocker which also helps in the reduction of hypertension. Beta blockers can help reduce hypertension by making the heart to beat more slowly and with less force, which lowers blood pressure.

Does telmisartan cause weight gain?

No. Telmisartan tablets cannot cause weight gain, they can cause the opposite effect. A study in 2010 concluded that telmisartan prevents weight gain and adipogenesis by energy uncoupling in several tissues. Abdominal obesity, which increases cardiometabolic risks, is often associated with hypertension.

Which is best telmisartan or amlodipine?

While telmisartan and amlodipine are prescribed to reduce hypertension, the mechanisms of action of both the drugs vary greatly which is why they are indicated in different groups of patients. Various factors such as associated comorbidities age of the patient and grade of hypertension etc can influence the prescribing pattern of the physician . An Indian study nevertheless demonstrated that a combination of telmisartan and amlodipine at low doses provided a better therapeutic approach when compared with individually separated high-dose mono-therapy.

Can telmisartan and amlodipine be taken together?

Yes, physicians / nephrologists can prescribe a combination of telmisartan and amlodipine if necessary. The synergy of both the drugs can rapidly help in controlling hyperthyroidism. An Indian study demonstrated that a combination of both telmisartan and amlodipine at low doses provided a better therapeutic approach when compared with individually separated high-dose mono-therapy.

When to take telmisartan?

The dosing frequency of telmisartan varies between patients. Doctors can instruct to take the drug on morning or night based on various factors such as: The presence of associated comorbidities with hypertension Avoidance of interactions in case of polypharmacy (taking many drugs at a time) A Spanish study in 2007 compared the bed time dosings of telmisartan with morning dosings. It was found that although both the dosings resulted in the significant reduction in blood pressure, the bedtime administration of telmisartan however was more effective than morning administration at lowering the mean nocturnal blood pressure thus enhancing the night-time blood pressure regulation.

Can I replace telmisartan with losartan?

No, telmisartan cannot be with losartan without the physician’s intervention despite being superior in the same category. A meta-analysis from Netherlands in 2003 compared the ability of telmisartan 40/80mg per day and losartan 50/100mg per day to reduce mean diastolic blood pressure (DBP) during the last 6 hours of the 24-hours dosing interval. It was concluded that telmisartan is superior to losartan in controlling DBP as well as systolic blood pressure (SBP) during the last 6 hours of the 24-hours dosing interval.

Can telmisartan cause anxiety?

No. So far there haven’t been any studies which described telmisartan induced anxiety. On the other hand, a German study in 2021 involving mice demonstrated that the administration of telmisartan prevented a diet-induced anxiety-like behaviour in the animals. I also could prevent obesity related cognitive deficits in Alzheimer’s disease.

Does telmisartan cause constipation?

No. So far, there haven’t been any studies which described the adverse effect of constipation when telmisartan was administered. On the contrary, about 3% of the patients taking telmisartan could experience diarrhoea. The other gastrointestinal adverse effects include: Dyspepsia (indigestion) (1%) Nausea (1%) Abdominal pain (1%)

How much telmisartan is safe?

20-80 mg of telmisartan tablet per day can be considered safe. Anything above the aforementioned given per day could be considered an overdose. The most noticeable effects of overdose include: Hypotension Tachycardia Bradycardia Dizziness Increased serum creatinine, and Acute renal failure

How long should I take telmisartan?

Maximum blood pressure reduction occurs 4 to 8 weeks after treatment begins and is maintained over time. Antihypertensive activity from telmisartan begins within 3 hours of the first dose. Blood pressure measurements show the antihypertensive effect lasts 24 hours after dosing and 4 hours before the next dose.

Who should not take telmisartan?

Telmisartan should not be given to any hypertensive patient hypersensitive to the drug. The other contraindications include the following: Renal artery stenosis (the narrowing of one or more renal arteries) Renal impairment Hepatic impairment Volume depletion (also called extracellular fluid volume contraction, which occurs as a result of loss of total body sodium resulting in increased heart rate and orthostatic hypotension) Hyponatremia (low concentration of sodium in the blood) Severe congestive heart failure (heart muscle can’t pump blood as well as it should) Pregnancy

Does telmisartan affect sleep?

Yes. Telmisartan could positively affect the sleep of the hypertensive patient to whom it is prescribed. A Spanish study in 2007 compared the bedtime dosings of telmisartan with morning dosings. It was found that telmisartan dosing on awakening and at bedtime similarly reduced blood pressure during the 24 hours. However, telmisartan at bedtime was especially efficient in reducing nocturnal blood pressure and increasing the sleep time–relative decline of blood pressure.

Is telmisartan a good blood pressure medication?

Yes, all the drugs from angiotensin II receptor blockers (in which telmisartan is also categorised) are effective, well-tolerated, and widely used for the treatment of hypertension. It must be understood that prescriptions for each hypertensive patient is tailormade taking into account of various factor – primarily the age and associated comorbidities. It would be futile attempt to expect telmisartan to be provided to each patient irrespective of the comorbidities.

Is telmisartan and olmesartan the same?

No. telmisartan and olmesartan are not the same. They are drugs belonging to the same category as angiotensin II receptor blockers. A 2017 Indian study compared the efficacy and tolerability of telmisartan, and olmesartan. After 12 weeks of observation, it was understood that although Olmesartan is the most efficacious drug in reducing hypertension, it is telmisartan which demonstrated shows the most favourable effects on fasting blood glucose as well as a lipid profile.

Is telmisartan bad for kidneys?

No. Telmisartan is not bad for kidneys. On the contrary telmisartan demonstrated the most potent renoprotection among all the ARBs (losartan, candesartan or olmesartan) in patients with early-stage diabetic nephropathy (kidney complications due to diabetes). The Indian study from 2016 concluded the effectiveness and tolerability of telmisartan in reducing proteinuria (protein in urine) in chronic kidney disease patients.

Can telmisartan be taken on empty stomach?

Yes, telmisartan is taken on with or without food. Nevertheless, it must be understood that the dosing frequency prescribed by the physician must be taken paramount. The main point of maintaining a dosing schedule is to ensure a constant supply of drugs in the blood, which is why it is important not to miss out on any doses.

Telmisartan Tablet – Uses, Side Effects, Composition and Price

Pace Hospitals

Overview

Telmisartan is a drug used mainly to treat hypertension (persistent increase in blood pressure) which belongs to the category of drug class - Angiotensin Receptor-Blockers (ARB). These ARB are usually prescribed to patients suffering with heart failure and chronic kidney disease, as hypertension is a prominent symptom in these patients.

Telmisartan tablet can also be given to any individuals at least 55 years old who have risk factors for cardiovascular disease, serious heart disorders such as stroke, heart attack etc.

Mechanism of action

As the name of the group suggests - Telmisartan tablet works on the basis of blocking angiotensin receptor in the body, due to which the protein hormone called angiotensin is not bonded. This results in the relaxation of the veins and arteries so that blood pressure is lowered apart from making it easier for the heart to pump blood. Thus, hypertension is controlled.

Telmisartan Tablet uses

Telmisartan tablet is a commonly prescribed medicine in patients with high blood pressure (hypertension) to prevent the complications of high blood pressure such as metabolic syndrome, heart attack or stroke, kidney damage, brain aneurysm, left ventricular hypertrophy, multi-infarct dementia, and also it is often prescribed alone or with one or two medicine.

Telmisartan Side effects

Various studies have been performed which demonstrated the adverse effects of ARB and telmisartan.

Organs and Systems

Respiratory System: The incidence of cough with telmisartan 80 mg/day has been reported in about 16% of the patients.

Electrolyte balance: It was noted that when patients with chronic non-diabetic proteinuric kidney disease (kidney disease in which protein is sent out through urine.) were prescribed with telmisartan and cilazapril plus hydrochlorothiazide, the extent of proteinuria was reduced, but the risk of hyperkalaemia (increased potassium level in blood) increased.

Urinary tract: Telmisartan increased the risks of renal impairment, as measured by the primary renal end-points of first occurrence of dialysis, renal transplantation, doubling of serum creatinine, or death.

Skin: Vulvar fixed drug eruptions (well-defined red to purple lesions appearing at the same sites on the skin each time a particular drug is used) have been attributed to telmisartan.

Combination of telmisartan and hydrochlorothiazide demonstrated pigmented purpuric dermatosis on the legs of the patient.

Nails: Fingernail clubbing and chromonychia (discoloration) have been reported with ARB and telmisartan.

Immunologic: Severe angioedema (an allergic trigger reaction to any medicine or chemical resulting in swelling underneath the skin.) pemphigus foliaceous (a non-contagious autoimmune condition causing painful and itchy blisters and sores on the skin, most often on your face, scalp and trunk).

Second-Generation Effects

Teratogenicity (foetal abnormalities/deformities due to a drug): Neonatal abnormalities can be observed in the newborn if the mother had taken ARB drugs during her pregnancy.

Neonate exposed to telmisartan during the first trimester of pregnancy could develop acute renal insufficiency, presenting with oligohydramnios (decreased amniotic fluid), renal tubular dysgenesis (severe kidney disorder characterized by abnormal development of the kidneys structures called proximal tubules are absent or underdeveloped).

Susceptibility Factors

Telmisartan tablet side effect in children

When telmisartan is given to hypertensive children, about 42% experienced adverse events such as headache, dizziness, and cough.

Drug Administration

Drug overdose: High doses of telmisartan and oxazepam was reported to have biochemical changes indicative of acute pancreatitis. The researchers suggested that the occurrence of mild pancreatitis following an overdose of telmisartan is a rare class effect.

Telmisartan dosage and indications

Hypertension: 20-80 mg of telmisartan van be given per day through the oral route. It could be started with 40 mg orally per day. The physician can adjust dose once every fortnight. A maximum dosage of 160 mg/day can be given.

Cardiovascular event risk reduction: 80 mg orally per day. While renal impairment doesn’t warrant any changes in dose, hepatic impairment on the other hand necessities the physician to start with low doses but titrate them gradually.

Telmisartan tablet is rapidly absorbed, although the amount absorbed varies. Telmisartan, when compared with the other commercially available ARBs, has the longest half-life of about 24 hours suggesting a long duration of action, which ensures the control of blood pressure with the once-daily dosing interval.

Contraindications of Telmisartan tablet

Telmisartan tablet is contraindicated in the patient who is hypersensitive to the drug. It is also contraindicated in pregnancy.

Caution must be maintained if the patient is diagnosed with:

Renal artery stenosis (the narrowing of one or more renal arteries)
Renal impairment
Hepatic impairment
Volume depletion (also called extracellular fluid volume contraction which occurs as a result of loss of total body sodium resulting in increased heart rate, and orthostatic hypotension)
Hyponatremia (low concentration of sodium in blood)
Severe congestive heart failure (heart muscle can’t not pump blood as well as it should)

Difference between losartan and telmisartan

Depending upon the terms of mechanism of action, there is no difference between losartan and telmisartan as both of them belong to the same therapeutic classification of drugs (angiotensin II receptor blockers).

Both work in reducing hypertension while demonstrating advantageous structural effects in the blood vessels, the kidneys and heart. There are little differences between them, such as:

Character	Losartan tablet	Telmisartan tablet
Accession	Losartan was the first angiotensin II receptor blocker to become available to the public.	Telmisartan is a more recently developed drug of the same therapeutic class.
Active metabolite conversion	Losartan is a pro-drug and requires cytochrome P450-mediated biotransformation to yield the active metabolite EXP-3174	Telmisartan is pharmacologically active and does not require conversion to an active metabolite.
Excretion	Losartan is predominantly excreted in urine	Telmisartan is excreted almost exclusively in the faces.
Half-life	EXP-3174 (metabolite of losartan) is in the range 6-9 hours	Telmisartan is half-life about 24 hours
Duration of action	Shorter	Longer
Dosage	50–100 mg once daily	40–80 mg once daily

Telmisartan Price list

The 35 most common brands of telmisartan tablet are given below:

Product	Company	Price (Rs.)
Telect 40mg Tablet 10s	Lupin	8.00
Temsan 40mg Tab	Emcure Pharma	27.46
Telmikind 40mg Tab 10s	Mankind Pharma	28.30
Zitelmi-40 Tab	FDC	59.00
Telvas-40 Tab	Aristo Pharma	59.00
Telong 40mg Tablet 10s	Bal Pharma	60.00
Hitarget-40 Tab	Panacea Biotec	62.30
Ibtel 40mg Tablet 10s	Indiabulls Pharmaceutical	65.60
Telast 40mg Tablet 10s	Intas	65.60
Telwin 40mg Tablet 10s	Psychotropics India	66.96
Telminorm 40 Mg Tablet 10s	Ipca Labs	66.98
Teli-40mg Tab	Cadila Pharma	66.98
Arbitel 40mg Tablet 10s	Micro Labs	67.00
Macsart-40mg Tablet 10s	Macleods	69.00
Aztel 40mg Tablet 10s	Azkka Pharmaceuticals Pvt Ltd.	69.04
Telcard 40 Mg Tablet 10s	Micro Labs	69.26
Telpres 40 Mg Tablet 10s	Abbott India	69.27
Tigatel 40mg Tablet 10s	Sun Pharma	69.33
Tazloc 40mg Tablet 10s	USV	78.00
Targit-40mg Tab 15s	Pfizer	82.00
Micardis 40 Mg Tablet 10s	Boehringer Ingelheim	93.77
Telsartan 40 Tab 15s	Dr. Reddy	95.50
Teleact 40mg Tab	Sun Pharma	100.13
Telista 40 Mg Tablet 15s	Lupin	100.46
Telsar 40mg Tablet 15s	Unichem	100.46
Tetan 40mg Tablet 15s	Torrent Pharma	100.46
Cresar 40 Mg Tablet 10s	Alembic Pharma	103.90
Tellzy 40mg Tablet 15s	Cipla	103.91
Telma-40mg Tab	Alembic Pharma	103.91

Frequently Asked Questions

Is telmisartan safe?

Yes, all the drugs from angiotensin II receptor blockers (ARB) are effective, well-tolerated, widely used BP-lowering drugs. The PRISMA I study from 2005 demonstrated the superiority of telmisartan over ramipril (Angiotensin-converting enzyme (ACE) inhibitors – another group of drugs reducing hypertension) during the normalization of hypertension.

Telmisartan was more effective than ramipril in reducing blood pressure throughout the 24-hour dosing interval and especially during the last 6 hour, when patients are at greatest risk of cerebrovascular events. Both drugs were well-tolerated, but ramipril caused more coughing.
Does telmisartan lower heart rate?
No, there is no evidence of telmisartan reducing heart rate. It does not affect heart rate like other hypertensive drugs such as amlodipine or nifedipine which can improve the cardiac drive. Nevertheless, there is clear clinical evidence of telmisartan enhancing renoprotection (kidney protection) as well as cardio protection. Telmisartan enhances cardiac protection by reducing:
- left ventricular hypertrophy (thickening of the wall of left ventricular in the heart resulting in the poor pumping of the blood),
- arterial arteriosclerosis (stiffness and thickening of arteries) and
- the recurrence of atrial fibrillation (irregular and rapid heart rhythm)
Is telmisartan a beta blocker?

No, telmisartan tablet is not a beta blocker. It belongs to the class of Angiotensin Receptor-Blockers (ARB).

Telmisartan can at times be prescribed with a beta blocker which also helps in the reduction of hypertension.

Beta blockers can help reduce hypertension by making the heart to beat more slowly and with less force, which lowers blood pressure.
Does telmisartan cause weight gain?

No. Telmisartan tablets cannot cause weight gain, they can cause the opposite effect.

A study in 2010 concluded that telmisartan prevents weight gain and adipogenesis by energy uncoupling in several tissues. Abdominal obesity, which increases cardiometabolic risks, is often associated with hypertension.
Which is best telmisartan or amlodipine?

While telmisartan and amlodipine are prescribed to reduce hypertension, the mechanisms of action of both the drugs vary greatly which is why they are indicated in different groups of patients.

Various factors such as associated comorbidities age of the patient and grade of hypertension etc can influence the prescribing pattern of the physician.

An Indian study nevertheless demonstrated that a combination of telmisartan and amlodipine at low doses provided a better therapeutic approach when compared with individually separated high-dose mono-therapy.
Can telmisartan and amlodipine be taken together?

Yes, physicians / nephrologists can prescribe a combination of telmisartan and amlodipine if necessary.

The synergy of both the drugs can rapidly help in controlling hyperthyroidism. An Indian study demonstrated that a combination of both telmisartan and amlodipine at low doses provided a better therapeutic approach when compared with individually separated high-dose mono-therapy.
When to take telmisartan?
The dosing frequency of telmisartan varies between patients. Doctors can instruct to take the drug on morning or night based on various factors such as:
- The presence of associated comorbidities with hypertension
- Avoidance of interactions in case of polypharmacy (taking many drugs at a time)
- A Spanish study in 2007 compared the bed time dosings of telmisartan with morning dosings. It was found that although both the dosings resulted in the significant reduction in blood pressure, the bedtime administration of telmisartan however was more effective than morning administration at lowering the mean nocturnal blood pressure thus enhancing the night-time blood pressure regulation.
Can I replace telmisartan with losartan?

No, telmisartan cannot be with losartan without the physician’s intervention despite being superior in the same category.

A meta-analysis from Netherlands in 2003 compared the ability of telmisartan 40/80mg per day and losartan 50/100mg per day to reduce mean diastolic blood pressure (DBP) during the last 6 hours of the 24-hours dosing interval. It was concluded that telmisartan is superior to losartan in controlling DBP as well as systolic blood pressure (SBP) during the last 6 hours of the 24-hours dosing interval.
Can telmisartan cause anxiety?

No. So far there haven’t been any studies which described telmisartan induced anxiety.
On the other hand, a German study in 2021 involving mice demonstrated that the administration of telmisartan prevented a diet-induced anxiety-like behaviour in the animals. I also could prevent obesity related cognitive deficits in Alzheimer’s disease.
Does telmisartan cause constipation?
No. So far, there haven’t been any studies which described the adverse effect of constipation when telmisartan was administered.

On the contrary, about 3% of the patients taking telmisartan could experience diarrhoea. The other gastrointestinal adverse effects include:
- Dyspepsia (indigestion) (1%)
- Nausea (1%)
- Abdominal pain (1%)
How much telmisartan is safe?
20-80 mg of telmisartan tablet per day can be considered safe. Anything above the aforementioned given per day could be considered an overdose. The most noticeable effects of overdose include:
- Hypotension
- Tachycardia
- Bradycardia
- Dizziness
- Increased serum creatinine, and
- Acute renal failure
How long should I take telmisartan?

Maximum blood pressure reduction occurs 4 to 8 weeks after treatment begins and is maintained over time. Antihypertensive activity from telmisartan begins within 3 hours of the first dose. Blood pressure measurements show the antihypertensive effect lasts 24 hours after dosing and 4 hours before the next dose.
Who should not take telmisartan?
Telmisartan should not be given to any hypertensive patient hypersensitive to the drug. The other contraindications include the following:
- Renal artery stenosis (the narrowing of one or more renal arteries)
- Renal impairment
- Hepatic impairment
- Volume depletion (also called extracellular fluid volume contraction, which occurs as a result of loss of total body sodium resulting in increased heart rate and orthostatic hypotension)
- Hyponatremia (low concentration of sodium in the blood)
- Severe congestive heart failure (heart muscle can’t pump blood as well as it should)
- Pregnancy
Does telmisartan affect sleep?

Yes. Telmisartan could positively affect the sleep of the hypertensive patient to whom it is prescribed.

A Spanish study in 2007 compared the bedtime dosings of telmisartan with morning dosings. It was found that telmisartan dosing on awakening and at bedtime similarly reduced blood pressure during the 24 hours. However, telmisartan at bedtime was especially efficient in reducing nocturnal blood pressure and increasing the sleep time–relative decline of blood pressure.
Is telmisartan a good blood pressure medication?

Yes, all the drugs from angiotensin II receptor blockers (in which telmisartan is also categorised) are effective, well-tolerated, and widely used for the treatment of hypertension. It must be understood that prescriptions for each hypertensive patient is tailormade taking into account of various factor – primarily the age and associated comorbidities. It would be futile attempt to expect telmisartan to be provided to each patient irrespective of the comorbidities.
Is telmisartan and olmesartan the same?

No. telmisartan and olmesartan are not the same. They are drugs belonging to the same category as angiotensin II receptor blockers.

A 2017 Indian study compared the efficacy and tolerability of telmisartan, and olmesartan. After 12 weeks of observation, it was understood that although Olmesartan is the most efficacious drug in reducing hypertension, it is telmisartan which demonstrated shows the most favourable effects on fasting blood glucose as well as a lipid profile.
Is telmisartan bad for kidneys?

No. Telmisartan is not bad for kidneys. On the contrary telmisartan demonstrated the most potent renoprotection among all the ARBs (losartan, candesartan or olmesartan) in patients with early-stage diabetic nephropathy (kidney complications due to diabetes).

The Indian study from 2016 concluded the effectiveness and tolerability of telmisartan in reducing proteinuria (protein in urine) in chronic kidney disease patients.
Can telmisartan be taken on empty stomach?

Yes, telmisartan is taken on with or without food. Nevertheless, it must be understood that the dosing frequency prescribed by the physician must be taken paramount. The main point of maintaining a dosing schedule is to ensure a constant supply of drugs in the blood, which is why it is important not to miss out on any doses.