Telmisartan
Pronunciation: pronunciation varies by local usage.
- Generic name
- telmisartan
- Brand names
- Micardis
- Drug class
- Angiotensin II receptor blocker (ARB)
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only medicine
Availability and supply rules vary by country
Trade names by country: Canada
Australia: · Full directory
What telmisartan is and how it works
Telmisartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure (hypertension) and to reduce the risk of heart attack, stroke, or death from heart disease in certain high-risk adults who cannot take ACE inhibitors. (1)
Telmisartan is taken by mouth once daily. The dose depends on your condition and response to treatment. It must not be used during pregnancy.
Mechanism of action: how telmisartan works
Telmisartan is an angiotensin II receptor blocker (ARB). It blocks the angiotensin II type 1 receptor, leading to vasodilation and reduced aldosterone secretion. (1)
What telmisartan is used for
Hypertension
Telmisartan is used to treat high blood pressure (hypertension). Lowering blood pressure reduces the risk of cardiovascular events. (1)
Cardiovascular risk reduction
In patients 55 years or older at high cardiovascular risk who are unable to take ACE inhibitors, telmisartan reduces the risk of myocardial infarction, stroke, or death from cardiovascular causes. (1)
Before taking telmisartan
Do not take / not appropriate for
- Do not take telmisartan if you are allergic to telmisartan or any of its ingredients. (all products) (1)
- Do not take telmisartan with aliskiren if you have diabetes. (all indications) (1)
- Do not take telmisartan if you are pregnant. Telmisartan can cause injury or death to the unborn baby. If you become pregnant, your prescriber will stop the medicine as soon as possible. (pregnancy) (1)
Tell your clinician about
- If you have low blood volume or salt depletion (for example, from vomiting, diarrhea, or taking water pills).
- If you have kidney problems or narrowing of the arteries that supply the kidneys (renal artery stenosis).
- If you have liver problems or a blockage of the bile ducts.
- If you have diabetes and are taking aliskiren.
- If you are pregnant, planning pregnancy, or breastfeeding.
- If you take other medicines, especially potassium supplements, diuretics, NSAIDs, lithium, or digoxin.
How to take telmisartan
- Take telmisartan by mouth once daily, exactly as prescribed.
- Your dose will depend on your condition. For high blood pressure, the usual starting dose is 40 mg once daily, with a range of 20–80 mg. For heart risk reduction, the dose is 80 mg once daily.
- Do not change your dose or stop taking telmisartan without talking to your prescriber.
- If you miss a dose, contact your prescriber for instructions. Do not take an extra dose to make up for a missed one.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
Contact your prescriber for instructions if you miss a dose. Do not take an extra dose.
Overdose
If you suspect an overdose, contact your local poison control center or seek emergency medical attention. Provide the medicine details. Overdose information is not detailed in the research notes; supportive care with close blood pressure monitoring is generally recommended. (1)
Side effects
Side effects can vary. The following have been reported in clinical trials.
Sinusitis
What to notice: Nasal congestion, facial pain or pressure, headache.
What to do: Tell your prescriber if symptoms are bothersome or persistent. (1)
Back pain
What to notice: Pain in the back, muscle stiffness.
What to do: Tell your prescriber if severe or persistent. (1)
Diarrhea
What to notice: Loose or watery stools.
What to do: Tell your prescriber if severe or persistent. (1)
Intermittent claudication
What to notice: Leg pain when walking, often relieved by rest.
What to do: Report new or worsening leg pain to your prescriber. (1)
Skin ulcer
What to notice: Open sore on the skin, often on the lower legs or feet.
What to do: Report any new skin ulcer to your prescriber promptly. (1)
Low blood pressure (hypotension)
What to notice: Dizziness, lightheadedness, fainting, especially when standing up quickly.
What to do: Contact your prescriber if you experience these symptoms. Do not stop taking telmisartan without advice. (1)
High potassium (hyperkalemia)
What to notice: Muscle weakness, slow or irregular heartbeat, tingling, nausea.
What to do: Contact your prescriber for evaluation; blood tests may be needed. (1)
Kidney problems
What to notice: Swelling of the legs or feet, changes in the amount of urine passed, confusion.
What to do: Contact your prescriber. Your kidney function may need checking. (1)
Serious warnings
Fetal toxicity — serious
Symptoms: Not applicable; harm occurs to the unborn baby if the mother takes telmisartan during pregnancy.
Action: If pregnancy is detected, tell your prescriber immediately. Do not stop the medicine on your own unless instructed. Your prescriber will stop telmisartan as soon as possible. (1)
Symptomatic hypotension — warning
Symptoms: If you feel dizzy, lightheaded, or faint, especially after starting or increasing the dose.
Action: Sit or lie down if you feel lightheaded. Contact your prescriber if symptoms occur. Do not stop taking telmisartan without medical advice. (1)
Hyperkalemia — serious
Symptoms: Contact your prescriber if you experience unusual muscle weakness, slow heart rate, or tingling. Your prescriber will monitor your potassium levels regularly.
Action: Seek medical assessment promptly; the clinician advises on whether any change to treatment is needed. (1)
Changes in kidney function — serious
Symptoms: Swelling of the legs/feet, changes in urine output, or confusion. Your prescriber will check your kidney function before and during treatment.
Action: Report any such symptoms to your prescriber. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| NSAIDs (e.g., ibuprofen, naproxen) | Increased risk of kidney impairment and reduced blood pressure lowering effect of telmisartan. | Tell your prescriber if you need to use NSAIDs regularly, especially if you have kidney problems. (1) |
| Lithium | Telmisartan can increase lithium levels in the blood, leading to toxicity. | Your prescriber will monitor your lithium blood levels closely. (1) |
| Digoxin | Telmisartan increases digoxin peak concentration by about 49% and trough concentration by about 20%. | Your prescriber will monitor your digoxin levels if you take both medicines. (1) |
| Other medicines that raise potassium (e.g., potassium supplements, potassium-sparing diuretics) | Increased risk of high potassium levels. | Do not take potassium supplements or salt substitutes containing potassium without checking with your prescriber. (1) |
| Aliskiren (in patients with diabetes or reduced kidney function) | Combination with aliskiren is contraindicated in patients with diabetes and should be avoided if kidney function is below 60 mL/min. | Do not take aliskiren with telmisartan if you have diabetes. Talk to your prescriber if you have kidney problems. (1) |
| Ramipril or other ACE inhibitors | Dual blockade of the renin-angiotensin system (e.g., with ramipril) increased the risk of kidney dysfunction compared with either drug alone. | Your prescriber will generally avoid combining telmisartan with an ACE inhibitor; if prescribed, close monitoring is needed. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Telmisartan can cause injury or death to the unborn baby. It is contraindicated during pregnancy. If you become pregnant, your prescriber will stop the medicine as soon as possible and switch to an alternative. Do not stop on your own without medical advice. (1)
Breastfeeding
Do not breastfeed while taking telmisartan, as it may pass into breast milk. Discuss alternatives with your prescriber. (1)
Hepatic impairment
If you have liver problems or a blockage of the bile ducts, your prescriber will start you on a low dose and increase it slowly under close supervision. Blood levels of telmisartan may be higher. (1)
Renal impairment
No dosage adjustment is required based on kidney function alone. Telmisartan is not removed by dialysis. Your prescriber will monitor your kidney function and potassium levels. (1)
Monitoring
Before starting
- Correct any salt or volume depletion before starting telmisartan.
- Check kidney function and potassium levels before starting treatment.
- Confirm that you are not pregnant; do not start telmisartan if pregnant.
- Discuss all other medicines you take, especially diuretics, potassium supplements, NSAIDs, lithium, or digoxin.
During treatment
- Monitor your blood pressure regularly, especially during the first few weeks or after dose changes.
- Your prescriber will periodically check your kidney function and potassium levels.
- If you are taking digoxin or lithium, your prescriber will monitor your blood levels.
- Report symptoms of low blood pressure (dizziness, fainting), high potassium (muscle weakness, slow pulse), or kidney problems (swelling, change in urine) to your prescriber promptly.
Storage
Store telmisartan tablets at 20–25°C (68–77°F). Keep the tablets in their original blister package until immediately before use, as they are sensitive to moisture.
Study the drug class: Angiotensin receptor blockers
Professional information
Clinician-facing context only. Refer to the full prescribing information for detailed dosing, monitoring, and safety data.
United States
Indication: Hypertension
Dose summary: Start 40 mg once daily; usual range 20–80 mg once daily. The majority of the antihypertensive effect is seen within 2 weeks, with maximal effect at 4 weeks.
Renal context: No dosage adjustment required for renal impairment; not removed by dialysis. (1)
United States
Indication: Cardiovascular risk reduction
Dose summary: 80 mg once daily. The benefit of lower doses has not been established.
Renal context: No dosage adjustment required; however, monitor renal function and potassium. (1)
Hepatic guidance
In patients with hepatic impairment or biliary obstructive disorders, initiate therapy at low doses and titrate slowly under close medical supervision.
Overdose note
In case of overdose, expect hypotension, dizziness, and tachycardia. Provide supportive care, including blood pressure monitoring and fluid resuscitation. Telmisartan is not removed by hemodialysis. (1)
Frequently asked questions
Can I take telmisartan during pregnancy?
No. Telmisartan can cause harm or death to the unborn baby. If you become pregnant, your prescriber will stop the medicine and switch you to a safer alternative. (1)
What should I do if I miss a dose?
Contact your prescriber for instructions. Do not take an extra dose to make up for a missed one. (1)
Can I take telmisartan with ibuprofen or other NSAIDs?
Taking NSAIDs with telmisartan may increase the risk of kidney problems and reduce the blood pressure-lowering effect of telmisartan. Tell your prescriber if you need to use NSAIDs regularly. (1)
What is the mechanism of action of telmisartan?
Telmisartan is an angiotensin II receptor blocker (ARB). It blocks the angiotensin II type 1 receptor, leading to vasodilation and reduced aldosterone secretion. (1)
What is the generic name of Telmisartan?
The generic name is telmisartan. It is sold under brand names including Micardis. (1)
What class of drug is telmisartan?
Telmisartan is classed as: Angiotensin II receptor blocker (ARB). (1)
References
- MICARDIS (telmisartan) tablets — prescribing informationU.S. Food and Drug Administration · United States · dated 2022-12 · accessed 2026-08-08 · source 1
- TELMISARTAN TABLET [REMEDYREPACK INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
- Telmisartan — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- telmisartan — FDA approval record (Drugs@FDA ANDA205150)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- telmisartan — RxNorm normalized drug concept (RXCUI 73494)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient telmisartan names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
Canada
- MICARDIS