Micardis: Effective Hypertension Control with Telmisartan
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| Product dosage: 40mg | |||
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Synonyms | |||
Micardis (telmisartan) is an angiotensin II receptor blocker (ARB) indicated for the treatment of hypertension in adults. It may be used alone or in combination with other antihypertensive agents. By selectively blocking the binding of angiotensin II to the AT1 receptor, Micardis inhibits the vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to blood pressure reduction. This medication offers 24-hour efficacy with a single daily dose, supporting consistent hemodynamic control. It is also indicated to reduce cardiovascular morbidity in patients with manifest atherothrombotic cardiovascular disease or diabetes mellitus with documented target organ damage.
Features
- Active ingredient: Telmisartan
- Available in tablet strengths: 20 mg, 40 mg, 80 mg
- Once-daily oral administration
- Angiotensin II receptor blocker (ARB) class
- Bioavailability approximately 42%
- Half-life of approximately 24 hours
- Not significantly metabolized by cytochrome P450 system
- Excreted predominantly via feces
Benefits
- Provides effective 24-hour blood pressure control with single daily dosing
- Reduces the risk of cardiovascular events in high-risk hypertensive patients
- Demonstrates excellent tolerability profile with low incidence of side effects
- Shows neutral metabolic effects with no adverse impact on glucose or lipid metabolism
- May be used as monotherapy or in combination with other antihypertensive agents
- Offers flexible dosing options to achieve individual blood pressure targets
Common use
Micardis is primarily prescribed for the management of essential hypertension in adult patients. It is suitable for first-line treatment and may be used as part of combination therapy when monotherapy provides insufficient blood pressure control. The medication is particularly valuable for patients who require consistent 24-hour blood pressure coverage due to its prolonged half-life. Additionally, Micardis is indicated for cardiovascular risk reduction in patients with established atherosclerotic cardiovascular disease or type 2 diabetes mellitus with documented target organ damage.
Dosage and direction
The recommended starting dose of Micardis is 40 mg once daily. Dosage may be increased to 80 mg once daily if blood pressure control is not achieved. For patients with possible depletion of intravascular volume, consider initiating therapy with 20 mg once daily. The tablets may be taken with or without food, preferably at the same time each day to maintain consistent plasma concentrations. Blood pressure response is dose-related over the range of 20-80 mg. Maximum blood pressure reduction is generally attained within 4-8 weeks of treatment initiation.
Precautions
Monitor renal function and electrolytes periodically, particularly in patients with renal impairment, heart failure, or those receiving concomitant diuretics. Use with caution in patients with hepatic impairment as telmisartan is predominantly eliminated via biliary excretion. Avoid use in pregnancy due to potential fetal harm; discontinue immediately if pregnancy is detected. Exercise caution in patients with bilateral renal artery stenosis or solitary kidney. Monitor for symptomatic hypotension, especially in volume-depleted patients or those receiving concurrent diuretic therapy.
Contraindications
Hypersensitivity to telmisartan or any component of the formulation. Concomitant use with aliskiren in patients with diabetes. Second and third trimester of pregnancy. Severe hepatic impairment (Child-Pugh class C). Bilateral renal artery stenosis or stenosis to a solitary kidney.
Possible side effects
Common adverse reactions (≥1%): Upper respiratory tract infection, back pain, sinusitis, diarrhea, pharyngitis. Serious side effects: Angioedema, hypotension, renal impairment, hyperkalemia, elevated liver enzymes. Rare events: Anaphylactic reactions, rhabdomyolysis, thrombocytopenia. Most adverse reactions are mild and transient, with discontinuation rates comparable to placebo.
Drug interaction
Increased risk of hyperkalemia with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium. Enhanced hypotensive effect with other antihypertensive agents. NSAIDs may reduce antihypertensive effect and increase risk of renal impairment. Lithium levels may increase when co-administered with telmisartan. Digoxin peak concentrations may be increased by approximately 20%. No clinically significant interactions with warfarin, hydrochlorothiazide, or amlodipine.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time of the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent dosing intervals to ensure optimal blood pressure control.
Overdose
Symptoms may include hypotension, tachycardia, bradycardia, dizziness, and renal failure. Management involves supportive care with volume expansion using normal saline. Hemodialysis is not effective due to high protein binding. Monitor vital signs, electrolyte balance, and renal function closely. Vasopressors may be required for severe hypotension unresponsive to volume expansion.
Storage
Store at room temperature (20-25°C/68-77°F) in the original container. Protect from moisture and light. Keep tightly closed. Do not remove desiccant from the bottle. Keep out of reach of children. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual patient responses may vary, and treatment decisions should be based on comprehensive medical evaluation. The prescribing physician should be aware of the complete medical history and concurrent medications.
Reviews
Clinical studies demonstrate Micardis provides effective 24-hour blood pressure control with excellent tolerability. The ONTARGET trial showed telmisartan was non-inferior to ramipril in reducing cardiovascular events in high-risk patients. PRISMA studies confirmed the efficacy and safety profile in diverse patient populations. Real-world evidence supports sustained blood pressure reduction and good adherence rates due to once-daily dosing and favorable side effect profile.