Telmisartan

About Telmisartan

Telmisartan stops angiotensin II from acting on its receptor, which relaxes blood vessels. It is taken once a day, with or without food, and its full effect on blood pressure appears after about four weeks. At 80 mg a day it is also approved to reduce the risk of heart attack, stroke or cardiovascular death in people aged 55 and over at high risk, such as those with artery disease, a past stroke or diabetes with organ damage, who cannot take an ACE inhibitor.

Back pain, sinusitis and diarrhea were the most common side effects in blood pressure trials. Its boxed warning concerns pregnancy: it can injure or kill a developing baby, so it is stopped as soon as pregnancy is found, and breastfeeding is not advised. Potassium can rise, especially with kidney disease or potassium supplements, and kidney function can worsen, so blood tests are checked. Because it is cleared through the bile, people with liver disease start on a low dose.

It must not be combined with aliskiren in people with diabetes, and adding an ACE inhibitor brings more risk without benefit for most people. It raises digoxin levels. Combinations exist with hydrochlorothiazide (Micardis HCT and generics), with amlodipine (generics only) and in a low-dose three-drug tablet, Widaplik.

Taking Telmisartan

How to take it

Once a day at about the same time, with or without food. Keep each tablet in its blister or bottle until just before you take it, as the tablets must be protected from moisture.

If you miss a dose

Take it as soon as you remember, unless it is nearly time for your next dose; in that case skip the missed dose and carry on as usual. Never take two doses at once to make up.

Storage

At room temperature in the original pack, protected from moisture, out of reach of children.

Interactions to know about

Potassium supplements, potassium salt substitutes and potassium-sparing diuretics can push potassium too high. Anti-inflammatories can weaken it and harm the kidneys. It raises digoxin and lithium levels, which are checked. Vomiting, diarrhea or dehydration can drop blood pressure too far. It must not be taken in pregnancy.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Telmisartan differs from pharmacy to pharmacy

Telmisartan has many generic makers, but it is prescribed far less often than losartan and is missing from some flat-price generic lists, so pharmacies stock less of it and price it less consistently, which leaves room for mark-up and wider differences between quotes.

The hydrochlorothiazide combination is still sold as a brand alongside generics, the amlodipine combination has few generic makers, and Widaplik is brand-only, so combination prices depend on the product written and what the pharmacy stocks.

Ways to pay less for Telmisartan without insurance

• Ask whether telmisartan is on the pharmacy’s flat-price generic list.
• For a combination tablet, ask for a quote on the separate generics too.
• If quotes are high, ask the prescriber whether another generic ARB such as losartan would suit you.
• Ask for a ninety-day prescription once your dose is stable.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Telmisartan

1. 1.Should I avoid potassium supplements or salt substitutes?
2. 2.When will my potassium and kidney function be checked?
3. 3.Is it safe with my digoxin, lithium or anti-inflammatory painkillers?
4. 4.What should I do if I become pregnant?
5. 5.Should the tablets stay in the blister until I take them?

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