Telmisartan Tablet – Uses, Side Effects, Composition and Price

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.

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)

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.

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.

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.

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.

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.

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.  

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.

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%) 

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

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.

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

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.

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.

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.

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.

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.