Can Telmisartan (Angiotensin II Receptor Antagonist) cause weight gain?

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Last updated: May 28, 2025View editorial policy

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From the Guidelines

Telmisartan is not associated with weight gain and is considered a weight-neutral medication. According to the evidence from [@\1@], angiotensin II receptor blockers, such as telmisartan, are desirable options for the treatment of patients with obesity due to their favorable metabolic profile. They work by blocking the action of angiotensin II, a hormone that narrows blood vessels and can increase blood pressure, and may have additional properties that can improve insulin sensitivity and metabolic parameters, which could potentially help with weight management rather than causing weight gain.

Some key points to consider:

  • Telmisartan belongs to a class of medications called angiotensin II receptor blockers (ARBs) that are used to treat high blood pressure and protect kidney function in certain conditions.
  • Unlike some other blood pressure medications such as beta-blockers or certain calcium channel blockers that can cause weight gain as a side effect, telmisartan has a favorable metabolic profile [@\2@].
  • The European guidelines on cardiovascular disease prevention in clinical practice recommend ARBs, such as telmisartan, as a first-line treatment option for hypertension due to their ability to lower blood pressure and reduce the risk of cardiovascular morbidity and mortality [@\2@].
  • If you're taking telmisartan and experiencing weight changes, it's essential to consider other factors such as diet, physical activity, other medications, or underlying health conditions that might be contributing to weight fluctuations.

In terms of specific evidence, a study published in [@\1@] notes that antihypertensive medications that are considered weight-neutral include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers. Another study published in [@\2@] confirms that ARBs, such as telmisartan, can adequately lower blood pressure and significantly reduce the risk of cardiovascular morbidity and mortality.

From the FDA Drug Label

Call your doctor if you get: swelling in your feet, ankles, or hands unexplained weight gain

Weight gain is listed as a possible side effect of telmisartan tablets, specifically unexplained weight gain. If you experience this, you should call your doctor right away 1.

From the Research

Telmisartan and Weight Gain

  • There is no direct evidence in the provided studies that telmisartan causes weight gain 2, 3, 4, 5, 6.
  • The studies primarily focus on the effects of telmisartan on renal function, blood pressure, and diabetic nephropathy, with no mention of weight gain as a side effect.
  • One study examined the metabolic effects of telmisartan in subjects with abdominal obesity, but found no significant effect on body composition or weight 6.
  • Another study discussed the use of telmisartan in patients with diabetic nephropathy, but did not mention weight gain as a potential side effect 4, 5.
  • The available evidence suggests that telmisartan is generally well-tolerated, with few adverse events reported in the studies 2, 3, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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