What is the recommended dosage and use of Telmisartan (Angiotensin II Receptor Blocker) for treating hypertension?

From the Guidelines

Telmisartan is recommended to be initiated at a dose of 40 mg once daily for the treatment of hypertension, with a goal dose of 40-80 mg daily as needed for blood pressure control. According to the study by 1, the starting dose and goal dose for Telmisartan are clearly outlined, providing a guideline for clinicians to follow. The study suggests that goal doses should be at the higher end of the dose range when possible, which is consistent with the goal of achieving optimal blood pressure control.

Some key points to consider when prescribing Telmisartan include:

• The medication should be taken at the same time each day, with or without food
• Blood pressure should be monitored regularly, especially during the initial 1-2 weeks of treatment
• Telmisartan has a long half-life of about 24 hours, allowing for once-daily dosing
• Common side effects may include dizziness, back pain, and upper respiratory infections
• The medication should not be discontinued suddenly without consulting a healthcare provider, as this could lead to a rebound increase in blood pressure
• Telmisartan should not be used during pregnancy, particularly in the second and third trimesters, as it can cause injury or death to the developing fetus.

It's also important to note that higher levels of blood pressure are associated with more rapid progression of kidney disease, and that ACE inhibitors and ARBs, such as Telmisartan, are effective in slowing the progression of kidney disease characterized by microalbuminuria in hypertensive patients with type 1 or type 2 diabetes, as stated in the study by 1.

From the FDA Drug Label

Dosage must be individualized. The usual starting dose of telmisartan tablets is 40 mg once a day. Blood pressure response is dose-related over the range of 20 to 80 mg [see Clinical Studies (14. 1)]. Most of the antihypertensive effect is apparent within 2 weeks and maximal reduction is generally attained after 4 weeks. No initial dosage adjustment is necessary for elderly patients or patients with renal impairment, including those on hemodialysis. Patients on dialysis may develop orthostatic hypotension; their blood pressure should be closely monitored Telmisartan tablets may be administered with other antihypertensive agents. Telmisartan tablets may be administered with or without food.

The recommended dosage of Telmisartan for treating hypertension is:

• Starting dose: 40 mg once a day
• Dose range: 20 to 80 mg once a day
• Administration: With or without food
• Monitoring: Blood pressure should be closely monitored, especially in patients on dialysis The use of Telmisartan for treating hypertension is as an angiotensin II receptor blocker to lower blood pressure, and it may be used alone or in combination with other antihypertensive agents 2.

From the Research

Recommended Dosage of Telmisartan

• The recommended dosage of Telmisartan for treating hypertension is 20 to 160 mg once daily, with maximum blood pressure reduction occurring at a dosage of 40 to 80 mg/day 3.
• Telmisartan 40 to 120 mg/day was found to be as effective as amlodipine 5 to 10 mg/day or atenolol 50 to 100 mg/day in dose-titration studies 3.
• Telmisartan 80 mg/day was more effective than submaximal dosages of losartan (50 mg/day) or valsartan (80 mg/day) and was as effective as a fixed-dose combination of losartan 50 mg plus hydrochlorothiazide 12.5 mg 3.

Use of Telmisartan in Hypertension

• Telmisartan is an effective antihypertensive agent with a tolerability profile similar to that of placebo 3, 4.
• Telmisartan is a useful therapeutic option in the management of patients with hypertension, including those with coexisting type 2 diabetes mellitus, metabolic syndrome, and/or renal impairment 4.
• The addition of hydrochlorothiazide to telmisartan was more effective than each agent alone at lowering blood pressure in patients with hypertension 3, 5.
• Telmisartan effectively and safely reduced blood pressure and brought about regression of proteinuria in diabetic and nondiabetic, hypertensive, proteinuric patients with chronic kidney disease 6.

Efficacy and Safety of Telmisartan

• Telmisartan had a tolerability profile similar to that of placebo in clinical studies 3, 7.
• Telmisartan was significantly less likely to cause persistent, dry cough than lisinopril 3.
• Telmisartan was well tolerated in patients with mild to moderate hypertension, with a low incidence of adverse events 3, 4.