Micatel
Generic Name
Telmisartan
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| micatel 80 mg tablet | ৳ 21.00 | ৳ 147.00 |
Description
Overview of the medicine
Micatel 80 mg Tablet contains Telmisartan, an angiotensin II receptor blocker (ARB) used to treat high blood pressure (hypertension) and reduce the risk of cardiovascular events in patients aged 55 years or older at high risk of developing major cardiovascular events.
Uses & Indications
Dosage
Adults
The usual recommended dose is 40 mg once daily. If necessary, the dose may be increased to 80 mg once daily. In some patients, a dose of 20 mg once daily may be sufficient.
Elderly
No dosage adjustment is necessary for elderly patients.
Renal_impairment
No dosage adjustment is necessary for patients with mild to moderate renal impairment. For patients with severe renal impairment, lower initial doses should be considered and careful monitoring is recommended.
How to Take
Micatel tablets should be taken orally once daily with or without food. It should be swallowed whole with water and not chewed or crushed.
Mechanism of Action
Telmisartan selectively blocks the binding of angiotensin II to the AT1 receptor, which is found in many tissues (e.g., vascular smooth muscle, adrenal gland). This blockade inhibits the vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to vasodilation, reduced aldosterone secretion, and consequently, decreased blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect usually evident within 3 hours. Maximum blood pressure reduction is achieved within 4-8 weeks.
Excretion
Almost entirely eliminated via feces (97%) primarily as unchanged drug and its acylglucuronide conjugate. Renal excretion is negligible (<1%).
Half life
Elimination half-life is approximately 20-24 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract. Absolute bioavailability varies with dose: approximately 42% for 40 mg and 58% for 160 mg. Peak plasma concentrations are reached within 0.5-1 hour. Food slightly decreases bioavailability.
Metabolism
Metabolized by conjugation to form an acylglucuronide, which is inactive. Not metabolized by cytochrome P450 enzymes.
Side Effects
Contraindications
- Hypersensitivity to telmisartan or any component of the tablet.
- Second and third trimesters of pregnancy.
- Biliary obstructive disorders.
- Severe hepatic impairment.
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m²).
Drug Interactions
Digoxin
Increased plasma digoxin concentrations. Monitor digoxin levels.
Lithium
Increased serum lithium concentrations and toxicity. Monitor lithium levels.
Diuretics (Thiazide or loop diuretics)
Concomitant use may result in excessive blood pressure reduction and/or acute renal failure.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect of telmisartan and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or other agents that increase potassium levels (e.g., heparin)
May lead to hyperkalemia. Monitor serum potassium.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Limited data are available concerning overdosage in humans. The most likely manifestations of overdosage would be hypotension and tachycardia; bradycardia might occur from parasympathetic (vagal) stimulation. Symptomatic and supportive treatment should be initiated. Telmisartan is not removed by hemodialysis.
Pregnancy & Lactation
Telmisartan is contraindicated in the second and third trimesters of pregnancy due to risks of fetal injury and death. It is not recommended during the first trimester. Due to the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Hypersensitivity to telmisartan or any component of the tablet.
- Second and third trimesters of pregnancy.
- Biliary obstructive disorders.
- Severe hepatic impairment.
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m²).
Drug Interactions
Digoxin
Increased plasma digoxin concentrations. Monitor digoxin levels.
Lithium
Increased serum lithium concentrations and toxicity. Monitor lithium levels.
Diuretics (Thiazide or loop diuretics)
Concomitant use may result in excessive blood pressure reduction and/or acute renal failure.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
May reduce the antihypertensive effect of telmisartan and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or other agents that increase potassium levels (e.g., heparin)
May lead to hyperkalemia. Monitor serum potassium.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Limited data are available concerning overdosage in humans. The most likely manifestations of overdosage would be hypotension and tachycardia; bradycardia might occur from parasympathetic (vagal) stimulation. Symptomatic and supportive treatment should be initiated. Telmisartan is not removed by hemodialysis.
Pregnancy & Lactation
Telmisartan is contraindicated in the second and third trimesters of pregnancy due to risks of fetal injury and death. It is not recommended during the first trimester. Due to the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific details on packaging.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Telmisartan has been extensively studied in various clinical trials, including the ONTARGET (Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomised Assessment Study in ACE intolerant subjects with cardiovascular disease) trials, demonstrating its efficacy in reducing cardiovascular events in high-risk populations.
Lab Monitoring
- Monitor serum potassium levels regularly, especially in patients with renal impairment or those taking potassium-sparing diuretics.
- Monitor renal function (creatinine, GFR) periodically.
Doctor Notes
- Regular monitoring of blood pressure, renal function (creatinine, GFR), and serum potassium levels is crucial for patients on telmisartan therapy.
- Caution should be exercised when co-administering telmisartan with NSAIDs, lithium, or potassium-sparing diuretics.
- Patients should be advised about the importance of adherence to therapy and lifestyle modifications.
- Strong contraindication in pregnancy, especially 2nd and 3rd trimesters; consider alternative antihypertensives for women of childbearing potential.
Patient Guidelines
- Take Micatel exactly as prescribed by your doctor.
- Do not stop taking Micatel without consulting your doctor, even if you feel well.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Report any symptoms of severe dizziness, fainting, or swelling of the face, lips, tongue, or throat immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Micatel may cause dizziness or lightheadedness, especially at the start of treatment or when changing dose. Patients should be cautioned about driving or operating machinery until they know how Micatel affects them.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid excessive alcohol consumption.
- Quit smoking to improve cardiovascular health.
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