From the Research
Telmisartan is the angiotensin receptor blocker (ARB) with the longest half-life, approximately 24 hours, making it suitable for once-daily dosing. The typical dosage range is 20-80 mg once daily, with 40 mg being the standard starting dose for hypertension 1. This long half-life provides consistent 24-hour blood pressure control and may improve medication adherence compared to ARBs requiring multiple daily doses. Telmisartan's extended duration of action results from its high lipophilicity and strong binding affinity to the angiotensin II type 1 (AT1) receptor.
Some key benefits of telmisartan include:
- Consistent 24-hour blood pressure control
- Improved medication adherence due to once-daily dosing
- Unique property of activating peroxisome proliferator-activated receptor gamma (PPAR-γ), which may provide metabolic benefits beyond blood pressure control
- Reduced cardiovascular morbidity and mortality, as demonstrated in the ONTARGET trial 2
When initiating telmisartan, monitor blood pressure regularly and be aware that full therapeutic effects may take several weeks to develop. Telmisartan can be taken with or without food, and dose adjustments may be necessary for patients with hepatic impairment, though no adjustment is typically needed for renal impairment. Overall, telmisartan is a preferred option for patients with hypertension due to its powerful and sustained blood pressure control, cardiovascular protection, and tolerability 3.