Telmipres
Generic Name
Telmisartan
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| telmipres 40 mg tablet | ৳ 9.00 | ৳ 90.00 |
Description
Overview of the medicine
Telmipres 40 mg Tablet contains Telmisartan, an angiotensin II receptor blocker (ARB) used to treat high blood pressure and reduce the risk of cardiovascular events like heart attack and stroke in high-risk patients.
Uses & Indications
Dosage
Adults
The usual recommended dose is 40 mg once daily. Dosage may be increased to a maximum of 80 mg once daily if needed. May be taken with or without food.
Elderly
No dose adjustment is generally necessary for elderly patients.
Renal_impairment
No dose adjustment is necessary for patients with mild to moderate renal impairment. For severe renal impairment or hemodialysis patients, initial dose of 20 mg once daily may be considered. Close monitoring is recommended.
How to Take
Telmipres 40 mg Tablet should be swallowed whole with water, once daily, with or without food. It is recommended to take it at approximately the same time each day.
Mechanism of Action
Telmisartan selectively blocks the binding of angiotensin II to the AT1 receptor in various tissues, including vascular smooth muscle and the adrenal gland. This inhibits the vasoconstrictor and aldosterone-secreting effects of angiotensin II, leading to vasodilation, reduced sodium and water retention, and ultimately a decrease in blood pressure.
Pharmacokinetics
Onset
Antihypertensive effect begins within 3 hours; full effect within 4-8 weeks.
Excretion
Almost entirely excreted via bile into feces, mainly as unchanged drug. Less than 1% excreted in urine.
Half life
Approximately 20-24 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract. Absolute bioavailability is dose-dependent (approx. 42-58% for 40 mg). Peak plasma concentrations (Cmax) are reached within 0.5-1 hour.
Metabolism
Primarily metabolized by conjugation to form an inactive acylglucuronide. Not metabolized by cytochrome P450 enzymes.
Side Effects
Contraindications
- Hypersensitivity to Telmisartan or any excipients.
- 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.
Aliskiren
Concomitant use is contraindicated in patients with diabetes or renal impairment due to increased risk of hyperkalemia, hypotension, and renal impairment.
Diuretics and other antihypertensive agents
May increase the hypotensive effect.
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
May reduce the antihypertensive effect and increase the risk of renal function deterioration, including acute renal failure, especially in dehydrated or elderly patients. Monitor renal function.
Potassium-sparing diuretics, potassium supplements, or other agents that may increase potassium levels
May lead to hyperkalemia. Monitor serum potassium levels.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Limited data are available regarding overdose in humans. The most likely manifestations of overdose would be hypotension, dizziness, and tachycardia; bradycardia could occur from parasympathetic stimulation. Treatment is symptomatic and supportive. Telmisartan is not removed by hemodialysis.
Pregnancy & Lactation
Telmisartan is contraindicated during the second and third trimesters of pregnancy due to risks of fetal injury and death. It is not recommended during the first trimester. It is unknown whether Telmisartan is excreted in human milk, thus caution should be exercised when administered to a nursing mother. 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 excipients.
- 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.
Aliskiren
Concomitant use is contraindicated in patients with diabetes or renal impairment due to increased risk of hyperkalemia, hypotension, and renal impairment.
Diuretics and other antihypertensive agents
May increase the hypotensive effect.
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
May reduce the antihypertensive effect and increase the risk of renal function deterioration, including acute renal failure, especially in dehydrated or elderly patients. Monitor renal function.
Potassium-sparing diuretics, potassium supplements, or other agents that may increase potassium levels
May lead to hyperkalemia. Monitor serum potassium levels.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Limited data are available regarding overdose in humans. The most likely manifestations of overdose would be hypotension, dizziness, and tachycardia; bradycardia could occur from parasympathetic stimulation. Treatment is symptomatic and supportive. Telmisartan is not removed by hemodialysis.
Pregnancy & Lactation
Telmisartan is contraindicated during the second and third trimesters of pregnancy due to risks of fetal injury and death. It is not recommended during the first trimester. It is unknown whether Telmisartan is excreted in human milk, thus caution should be exercised when administered to a nursing mother. 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 24 to 36 months from the date of manufacture, specific to manufacturer.
Availability
Available in pharmacies nationwide
Approval Status
Approved (local and international regulatory bodies)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Telmisartan has been extensively studied in various clinical trials for its efficacy in hypertension and cardiovascular risk reduction, including trials like 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).
Lab Monitoring
- Serum potassium levels (especially in patients with renal impairment or those on potassium-sparing diuretics).
- Renal function (creatinine, GFR).
- Liver function tests (baseline and periodically if clinically indicated).
Doctor Notes
- Emphasize the importance of consistent daily dosing.
- Advise caution with concomitant use of NSAIDs.
- Monitor for signs of angioedema, particularly in patients with a history of such events.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking Telmipres without consulting your doctor, even if you feel well.
- Inform your doctor if you become pregnant or plan to become pregnant while taking this medication.
- Report any unusual side effects, especially swelling of the face, lips, tongue, or throat.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Telmisartan may cause dizziness or drowsiness, especially at the start of treatment or when the dose is increased. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Adopt a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking.
- Monitor blood pressure regularly at home.
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