telmisartan
Telmisartan (Micardis) is an angiotensin II receptor blocker (ARB). It's a prescription medication used to treat high blood pressure in adults. Telmisartan (Micardis) is also used to lower the risk of death or heart attack in certain people with heart problems. This medication is taken by mouth, typically once a day. Side effects aren't common, but people taking telmisartan (Micardis) have reported ones like upper respiratory infection and back pain.
What is Telmisartan (Micardis)?
What is Telmisartan (Micardis) used for?
- High blood pressure
- Lowering the risk of death, stroke, or heart attack in certain adults 55 years or older with a history of heart problems (e.g., coronary artery disease)
How Telmisartan (Micardis) works
Telmisartan (Micardis) is an angiotensin II receptor blocker (ARB). It works by blocking a hormone called angiotensin II. The main role of angiotensin II is to narrow your blood vessels. This then raises your blood pressure and causes your heart to work harder to pump out blood to the rest of your body. So by blocking this hormone, telmisartan (Micardis) relaxes your blood vessels, which lowers your blood pressure and eases the stress on your heart.
Drug facts
Side effects of Telmisartan (Micardis)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Upper respiratory tract infection (cough, sore throat; 7%)
- Pain in the legs while walking (up to 7%)
- Skin ulcers (up to 3%)
- Back pain (3%)
- Sinus infection (stuffy nose; 3%)
- Diarrhea (3%)
Less Common Side Effects
- Sore throat
- Flu-like symptoms
- Indigestion
- Muscle pain
- Urinary tract infection
- Belly pain
- Headache
- Dizziness
- Pain
- Feeling tired
- Cough
- Chest pain
- Nausea
- Swelling in the arms and legs
Telmisartan (Micardis) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious kidney problems: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
- High blood potassium levels: nausea, tiredness, chest pain, muscle weakness, tingling or numbness, pounding heart
- Severely low blood pressure: lightheadedness, dizziness, feeling faint, tiredness, confusion
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The following Telmisartan (Micardis) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Changes in vision
dizziness, lightheadedness, or fainting
fast heartbeat
large hives
painful urination or changes in urinary frequency
swelling in the hands, lower legs, and feet
Incidence not known
Blurred vision
chest pain or discomfort
confusion
dark-colored urine
decreased urine output
dilated neck veins
extreme fatigue
flushing
hives or welts
hoarseness
irregular breathing
irritation
joint pain, stiffness, or swelling
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
muscle cramps or stiffness
numbness or tingling in the hands, feet, or lips
pain or discomfort in the arms, jaw, back, or neck
pounding in the ears
rash
redness of the skin
slow, fast, or irregular heartbeat
sweating
swelling of the eyelids, face, or lips
tightness in the chest
trouble breathing or swallowing
trouble with speaking or walking
trouble with thinking
unusual tiredness or weakness
unusually warm skin
weakness or heaviness of the legs
weakness, numbness, or tingling in the arms or legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Abdominal or stomach pain
back pain
changes in appetite
ear pain or hearing problems
general tiredness or weakness
headache
increased sweating
muscle pain or spasm
nervousness
runny or stuffy nose
Incidence not known
Acid or sour stomach
belching
decreased interest in sexual intercourse
difficulty with moving
inability to have or keep an erection
indigestion
joint pain
lack or loss of strength
leg cramps
loss in sexual ability, desire, drive, or performance
muscle aching
stomach discomfort or upset
swelling
weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Telmisartan (Micardis)
Pros
- Available as a lower-cost generic medication
- Typically taken once a day
- Lowers the risk of heart attack or death due to heart problems in people with CAD
- Less likely to cause dry cough compared to ACE inhibitors
Cons
- Can’t take while pregnant
- Might require regular blood work and lab tests to make sure your kidneys are functioning normally
- Not safe for use in children
- Can take up to 4 weeks to see the full effect on high blood pressure
Pharmacist tips for Telmisartan (Micardis)
- You can keep track of how well telmisartan (Micardis) is working to control your blood pressure by checking your blood pressure regularly at home. Write down your blood pressure readings, and bring them to your appointments with your primary care provider so you can discuss how well telmisartan (Micardis) is working for you.
- Telmisartan (Micardis) works to lower your blood pressure, but this can cause dizziness and lightheadedness. You're more likely to feel dizzy or lightheaded during the first few days and if you're suddenly standing up from a sitting or lying down position. Make sure to get up slowly. Tell your primary care provider if you experience fainting or dizziness while taking this medication.
- Mark your calendar with your appointments to see your primary care provider and to get any blood work done when you take telmisartan (Micardis). Your primary care provider might order tests to check your potassium levels and kidney health during treatment. Based on your lab results and your blood pressure readings, they might change your dose to make sure the medication is safe and working well for you.
- Remember to drink enough water to stay hydrated while you're taking telmisartan (Micardis), especially on hot days or after exercising. Dehydration can put you at risk for very low blood pressure, dizziness, and falls. In addition, not having enough fluids in your body might raise your risk of kidney damage during treatment with this medication.
- Don't take telmisartan (Micardis) if you're pregnant or nursing since it can cause harm to your baby. If you're pregnant or thinking of getting pregnant during treatment, contact your primary care provider right away. Your primary care provider might prescribe you a different medication that's safer during pregnancy or suggest lifestyle changes.
- Telmisartan (Micardis) can interact with many medications. Let your care team know what medications you're taking, including over-the-counter products and supplements, before you start telmisartan (Micardis). Talk with your care team if you have any questions about interactions with this medication.
- Avoid taking telmisartan (Micardis) with angiotensin-converting enzyme (ACE) inhibitors, such as ramipril. Both of these medications work similarly, so taking them together can worsen your kidney problems or cause dangerously low blood pressure.
Common questions about Telmisartan (Micardis)
No, telmisartan (Micardis) isn't a beta blocker. But rather, it's an angiotensin II receptor blocker (ARB). Both beta blockers and ARBs are medications that can help lower blood pressure, but beta blockers do so by slowing down heart rate, whereas ARBs do so by relaxing the blood vessels. Ask your PCP if you've more questions about the differences between beta blockers and ARBs.
Take telmisartan (Micardis) as directed by your primary care provider (PCP). Your PCP might ask you to take telmisartan (Micardis) at a time when your blood pressure is the highest. Or, they might ask you to take this medication at the same time every day, regardless of timing. Either way, the important thing is to take telmisartan (Micardis) regularly. Doing so can help better control your blood pressure, which lowers your risk of heart diseases, such as heart attack and stroke. If you have trouble remembering to take your medications, consider using a pill box to organize your medications.
Telmisartan (Micardis) can start to lower blood pressure about 3 hours after a dose. But most people don't see a more noticeable drop in their blood pressure until after 2 weeks of treatment. And you might need to take this medication regularly for a month before you can experience the maximum benefit. Keep in mind that when you first start telmisartan (Micardis), your primary care provider might need to adjust your dose before finding what works best for you. You can keep track of how well telmisartan (Micardis) is working by checking your blood pressure regularly at home.
Weight gain isn't a side effect typically reported by people who take telmisartan (Micardis) after a dose. But if you find yourself gaining weight while taking telmisartan (Micardis), talk with your primary care provider. Unexplained weight gain, especially if you also have swelling in the feet or ankles, might be a symptom of kidney problem. And kidney problems is a rare, but serious, side effect of telmisartan (Micardis) that needs more medical attention.
Telmisartan (Micardis) isn't known to cause hair loss. If you're experiencing hair loss during treatment, let your care team know. They can examine you and discuss with you about possible other causes of your hair loss, such as other medications or medical conditions.
Some people who took telmisartan (Micardis) have reported erectile dysfunction, but these cases are very rare. And telmisartan (Micardis) is less likely to cause sexual side effects compared to some other blood pressure medications. Talk to your primary care provider if you're concerned about this side effect.
It can take around 5 days for most of telmisartan (Micardis) to leave your body. Keep in mind that this timeframe is estimated based on the half-life of telmisartan (Micardis). It can also depend on what health conditions you might have (e.g., kidney and liver health) and genetics. Talk with your primary care provider if you've more questions about how long telmisartan (Micardis) stays in your system.
Maybe. Telmisartan (Micardis) doesn't tend to cause too many side effects, but some of the more commonly reported ones include upper respiratory infections, back pain, and diarrhea. It's not clear whether all of these side effects will get better over time, but there are different ways to manage them. For example, you can try to protect yourself from infections by wearing a mask in crowded places or distancing yourself from someone who might have a cold. If appropriate, you might be able to take loperamide (Imodium A-D) to help with diarrhea or acetaminophen (Tylenol) to help with back pain. Talk to your care team if you have more questions about how to manage any specific side effect.
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Risks and warnings for Telmisartan (Micardis)
Telmisartan (Micardis) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to unborn baby
Taking telmisartan (Micardis) during the second and third trimesters of pregnancy might raise the risk for birth defects, such as kidney problems. Sometimes, this can be fatal to the unborn baby. Because of this potential risk, if you find out that you're pregnant while you're taking telmisartan (Micardis), stop and let your primary care provider know right away. If you're pregnant or are planning to become pregnant, discuss safer treatment options with your care team.
Low blood pressure
- Risk factors: Low fluids in the body (e.g., dehydration) | Low salt levels in your body | People on dialysis | Taking diuretics
Sometimes, taking telmisartan (Micardis) can cause your blood pressure to drop too much. This can cause you to feel dizzy, tired, or lightheaded. Low blood pressure is more common in the first 2 weeks of starting telmisartan (Micardis) and when your dose goes up. Make sure to stay well-hydrated during treatment. Don't get up suddenly from a sitting or lying down position, since this can cause your blood pressure to drop quickly. If you frequently feel dizzy, lightheaded, faint, tired, or confused while taking telmisartan (Micardis), let your primary care provider know.
Kidney problems
- Risk factors: Severe heart failure | Kidney problems | Taking diuretics
Telmisartan (Micardis) can usually improve blood flow to the kidneys, which is good for people with high blood pressure and chronic kidney disease (CKD). But in some cases, telmisartan (Micardis) can make kidney problems worse. The risk is higher for people who have certain medical conditions, such as blockage of the kidney artery or severe heart failure. As a result, your primary care provider might order lab tests during treatment to make sure your kidneys are healthy and working properly. Let your primary care provider know if you're urinating less often than usual, feeling tired, nauseous, or have chills. These can be symptoms of kidney damage.
High levels of potassium
- Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium
Very rarely, telmisartan (Micardis) can raise the amount of potassium in your body, which can be dangerous. Your risk of developing high potassium is greater if you have diabetes, kidney problems, or are taking other medications that also raise potassium levels. For this reason, make sure your primary care provider knows your full medical history and what medications you're taking before starting telmisartan (Micardis). If you experience signs of high potassium, such as nausea, muscle weakness, or abnormal heartbeat, tell your provider right away.
Liver problems
- Risk factor: History of liver problems
In some rare cases, people with a history of liver problems (e.g., blocked bile duct) can end up with a higher amount of telmisartan (Micardis) in their body. This can lead to higher risk of side effects, such as low blood pressure and kidney problems. Make sure to let your care team know if you've a history of liver problems. Your primary care provider can start you at a lower dose of the medication to make sure it's safe for you.
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Telmisartan (Micardis) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg | 30 tablets | $12.82 | $0.43 |
| 40mg | 90 tablets | $25.90 | $0.29 |
| 80mg | 90 tablets | $25.18 | $0.28 |
Typical dosage for Telmisartan (Micardis)
- High blood pressure: The typical starting dose is 40 mg by mouth once a day. Your prescriber will adjust your dose according to your blood pressure. The usual dosage range is 20 mg to 80 mg once a day.
- Lowering the risk of heart attack and stroke: The typical dose is 80 mg by mouth once daily.
More on Telmisartan (Micardis) dosage
Interactions between Telmisartan (Micardis) and other drugs
More on Telmisartan (Micardis) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Benazepril
- Captopril
- Digoxin
- Enalapril
- Enalaprilat
- Fosinopril
- Lisinopril
- Lithium
- Moexipril
- Mycophenolate Mofetil
- Perindopril
- Potassium Phosphate
- Quinapril
- Ramipril
- Trandolapril
- Trimethoprim
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bromfenac
- Bufexamac
- Celecoxib
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Valdecoxib
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Telmisartan (Micardis) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Telmisartan (Micardis) will not be safe for you to take.
- Taking aliskiren (Tekturna) and you also have diabetes
What are alternatives to Telmisartan (Micardis)?
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