Telmisartan

1. TELMISARTAN
BY:
Mohammed A.Alnabi
M.B.CH.B

2. Telmisartan
Angiotensin II receptor antagonists
Used for the treatment of hypertension, to lower blood pressure.
• Effective dose is 40 mg/daily. Some patients may benefit a20 mg/daily and can be
increased to a maximum of 80 mg once daily.
• May in combination with diuretics such hydrochlorothiazide or with amlodipine .
Decrees the risk of fatal and nonfatal cardiovascular events.
• The recommended dose is 80 mg once daily.
Patients with renal impairment
• A lower starting dose of 20 mg is recommended in these patients.
Patients with hepatic impairment
• Telmisartan is contraindicated in patients with severe hepatic impairment

5. ARBs VS ACEI

6. Pharmacokinetic properties of the angiotensin Il receptor blockers

7. Why Telmisartan?
Pharmacologic superiority!!
• Have strongest affinity to AT1.
• May have long lasting BP lowering effects.
• Lower renal excretion.
• Superior cardioprotective properties.
• Partial agonist of peroxisome proliferator-
activated receptor-Ƴ(PPAR-Ƴ).
PPAR- Y activity influences
• Improve insulin resistance in diabetic patients.
• Antinflammatory, anti-oxidative and anti-
proliferative effects on vascular wall cells.
• ↓↓the risks for atherosclerosis.
• Use in both diabetes and CVD in hypertensive
patients.

8. Side effects
Doesn't cause drowsiness.
More common side effects
• sinus pain and congestion
• back pain
• diarrhea
• sore throat
• flu-like symptoms
• upset stomach
• muscle pain
• headache
• dizziness
• nausea
Drug interaction
• Combination with aliskiren in DM
and with renal impairment (GFR
<60 ml/min/1.73 m2)
• When coadministered with
digoxin, median increases in
digoxin peak plasma
concentration (49%) and in trough
concentration (20%) were
observed; monitor digoxin levels
when initiating, adjusting, and
discontinuing telmisartan

9. Contraindication
• Hypersensitivity to it or other
component
• Combination with aliskiren in
DM .
Caution
• Advanced renal impairment,
heart failure, on renal
replacement therapy, or on
potassium supplements.
• Biliary obstructive disorders or
hepatic insufficiency .
• Pregnancy (2nd and 3rd
trimesters).
• Dual blockade of the renin-
angiotensin system with (ARBs),
(ACE) inhibitors, or aliskiren is
associated with increased risk of
hypotension, hyperkalemia, and
altered renal function .

10. Telmisartan brands in Iraq
Telmisartan brands in Iraq

11. Telmisartan+Hydrochlorothiazide

12. Telmisartan+Amlodipine

13. THANK
YOU