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Telmisartan Capsules

Function and Efficacy

Pharmacological properties Telmisartan is an orally effective, specific angiotensin II receptor (AT1 type) antagonist. Telmisartan replaces angiotensin II receptors and binds with high affinity to the AT1 receptor subtype (known angiotensin II action site). Telmisartan does not have any partial agonist effect at the AT1 receptor site. Telmisartan selectively binds to the AT1 receptor, and the binding effect is long-lasting. Telmisartan has no affinity for other receptors (including AT2 and other AT receptors with fewer characteristics). The functions of the above other receptors are not yet known, and the receptor overstimulation effect that may be caused by the increase in angiotensin II levels caused by telmisartan is also unknown. Telmisartan can cause a decrease in blood aldosterone levels. Telmisartan does not inhibit human plasma renin or block ion channels. Telmisartan does not inhibit angiotensin converting enzyme (kinase II), which can also degrade bradykinin, so there will be no adverse reactions caused by the enhancement of bradykinin action. Administration of 80 mg of telmisartan to humans almost completely inhibits the increase in blood pressure caused by angiotensin II. The inhibitory effect lasts for 24 hours and can still be measured at 48 hours. The antihypertensive effect gradually becomes apparent within 3 hours after the first dose of telmisartan. The maximum antihypertensive effect can be obtained four weeks after the start of treatment and can be maintained in long-term treatment. The dynamic blood pressure monitor shows that the antihypertensive effect lasts for more than 24 hours after taking the medicine, including the 4 hours before the next dose. This result was confirmed in a placebo-controlled clinical trial study: the ratio of trough to peak after taking 40 mg and 80 mg of telmisartan continued to be above 80%. There is a clear dose-time dependence in the return to baseline SBP. The data on DBP in this regard are inconsistent. For hypertensive patients, telmisartan can reduce systolic and diastolic blood pressure without affecting the pulse. The antihypertensive effect of telmisartan is comparable to other types of representative antihypertensive drugs. (Clinical studies have compared telmisartan with amlodipine, atenolol, enalapril, hydrochlorothiazide, losartan, and lisinopril.) If telmisartan treatment is abruptly discontinued, blood pressure gradually returns to pre-treatment levels after a few days without rebound hypertension. In clinical trials directly comparing two antihypertensive drugs, the incidence of dry cough in patients treated with telmisartan was significantly lower than that in patients treated with angiotensin-converting enzyme inhibitors. The effect of telmisartan on improving mortality and cardiovascular disease morbidity is currently unknown. Toxicology The doses used in preclinical safety studies, which are equivalent to clinical treatment doses, can cause decreases in red blood cell indices (erythrocytes, hemoglobin, hematocrit) and changes in renal hemodynamics (increased blood urea nitrogen and creatinine) and increased serum potassium in normotensive animals. Renal tubular dilatation and atrophy can be seen in dogs. Digestive mucosal damage (erosion, ulceration, inflammation) can also be seen in rats and dogs. These pharmacological adverse reactions are known from preclinical studies to be common reactions of angiotensin-converting enzyme inhibitors and angiotensin II antagonists, and can be prevented by oral salt supplementation. Increased plasma renin activity and hypertrophy/proliferation of juxtaglomerular cells can be seen in both species. The above changes are also common reactions of angiotensin-converting enzyme inhibitors and other angiotensin II antagonists and are not clinically specific. Animal experiments have shown that telmisartan has some potential adverse effects on the postnatal development of newborns, including weight loss, delayed eye opening, and increased mortality. No mutagenicity and related mutagenic activity were found in in vitro experiments, and no carcinogenicity was found in mouse and rat experiments.

Ingredients

4'-[(2-n-propyl-4-methyl-6-(1-methylbenzimidazol-2-yl)-benzimidazol-1-yl)methyl]diphenyl-2-carboxylic acid = Telmisartan

Name Description Content CAS NO. Manufacturer
TelmisartanIngredients

Telmisartan is an orally effective, specific angiotensin II receptor (AT1 type) antagonist. Telmisartan replaces angiotensin II receptors and binds to AT1 receptor subtypes with high affinity. It has no partial agonist effect at the AT1 receptor site, selectively binds to AT1 receptors and the binding effect is long-lasting. Telmisartan can cause a decrease in blood aldosterone levels, does not inhibit human plasma renin or ion channels, and does not inhibit angiotensin converting enzyme (kinase II), so there will be no adverse reactions caused by enhanced bradykinin action. Telmisartan can reduce systolic and diastolic blood pressure without affecting the pulse, and its antihypertensive effect is comparable to other types of representative antihypertensive drugs.

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144701-48-4 109

Appearance

This product is a hard capsule, and the contents are white or slightly yellow granules or powder.

Indication

Used for the treatment of essential hypertension.

Usage and Dosage

1. Adults: Individualized medication should be used. The usual initial dose is one tablet (40 mg) once a day. Within the dose range of 20-80 mg, the antihypertensive effect of telmisartan is related to the dose. If the ideal blood pressure is not achieved after medication, the dose can be increased, and the maximum dose is 80 mg (two tablets) once a day. This product can be used in combination with thiazide diuretics such as hydrochlorothiazide, which have a synergistic antihypertensive effect with this product. Because telmisartan can only exert its maximum efficacy four to eight weeks after the start of the treatment, if you want to increase the drug dose, this should be considered. 2. Patients with renal insufficiency, patients with mild or moderate renal dysfunction, do not need to adjust the dose of this product. Telmisartan cannot be eliminated by hemodialysis. 3. Patients with hepatic insufficiency, patients with mild or moderate hepatic insufficiency, the daily dosage of this product should not exceed 40 mg. 4. Elderly: No dose adjustment is required for taking this product. 5. Children: The safety and efficacy data of this product have not been established for children and adolescents under 18 years of age.

Adverse Reactions

Diarrhea is a possible adverse reaction after taking this product, which is similar to other angiotensin II antagonists. Angioedema, itching, rash, and urticaria have been reported in very rare cases.

Precautions

1. Those who are allergic to the active ingredients and any of the excipients of this product. 2. Those in the second or third trimester of pregnancy and breastfeeding. 3. Patients with biliary obstructive diseases. 4. Patients with severe liver dysfunction. 5. Patients with severe renal dysfunction (creatinine clearance 30ml/min).

Special Population Medication

Precautions for children: For children and adolescents under 18 years old, the safety and efficacy data of this product have not been established. Precautions for pregnancy and lactation: 1. Use during pregnancy: There is not enough data to show whether this product can be used in pregnant women. Animal experiments did not show teratogenicity, but showed embryotoxicity. Therefore, for the sake of caution, do not use telmisartan in the first two months of pregnancy. Before planning pregnancy, appropriate alternative therapies should be taken. In the middle and late stages of pregnancy (during the second and third trimesters), drugs that directly act on the renin-angiotensin system can cause damage to the fetus or even death, so telmisartan is contraindicated in the middle and late stages of pregnancy. Once pregnancy is confirmed, this product should be discontinued as soon as possible. 2. Use during lactation: Since it is unknown whether this product is excreted through breast milk, this product is contraindicated during lactation. Precautions for the elderly: No dosage adjustment is required when taking this product.

Drug Interactions

1. Lithium punishment: The combination of lithium and angiotensin converting enzyme inhibitors can cause reversible increases in blood lithium levels and toxic reactions. There are also individual cases caused by the combination of lithium and angiotensin II receptor antagonists. Therefore, lithium and this product should be used with caution. If combined use is necessary, blood lithium levels should be monitored during the combined use. 2. Some drugs can affect blood potassium levels or cause hyperkalemia (such as ACE inhibitors, potassium-sparing diuretics, potassium ion supplements, potassium-containing salt substitutes, cyclosporine A or other drugs such as heparin sodium); if this product needs to be used in combination with these drugs, it is recommended to test blood potassium levels. Based on the experience of using other drugs that affect the renin-angiotensin system, this product combined with the above drugs can cause an increase in blood potassium levels (see Precautions). 3. Pharmacokinetic studies have studied the interaction of this product with digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, amlodipine and other drugs. It can increase the average trough blood concentration of digoxin by 20% (in some cases by 39%), so the digoxin plasma concentration must be clinically measured. 4. This product can enhance the antihypertensive effect of other antihypertensive drugs. Other clinically significant interactions have not yet been confirmed. 5. Based on their pharmacological properties, the following drugs can enhance the antihypertensive effect of antihypertensive drugs including telmisartan: baclofen, amifostine. In addition, alcohol, barbiturates, sedatives, hypnotics or antidepressants can enhance the orthostatic hypotension effect. 6. When used in combination with telmisartan, the Cmax of simvastatin metabolites (simvastatin acid) is slightly increased (1.34 times) and the elimination is accelerated.

Storage

Store at room temperature in a dry place.

Packaging Specification

40mg

Validity Period

24 months

Manufacturer

Changzhou Pharmaceutical Factory Co., Ltd.

  • Founded in:

    2001-12-14
  • Address:

    No. 518, Laodong East Road, Changzhou
  • Tax NO.:

    91320400137158490L
  • Registered Funds:

    108 million yuan
  • Website:

  • Email:

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