High level summary

Micardis is a brand name for telmisartan, an angiotensin II receptor blocker that lowers blood pressure by relaxing blood vessels and reducing vascular resistance. The active ingredient is telmisartan, commonly available in tablet strengths such as 20 mg, 40 mg and 80 mg on the Australian mainland.

Main utilities include treatment of hypertension and, for selected older patients at elevated cardiovascular risk, reduction of some major cardiovascular events. Details for dosing can be found in the patient information sheet. How to use properly Micardis. To view other treatment options and cost considerations see Replacement choices and benchmarking comparisons and Prices charged in Australia.

Who is Micardis for

Telmisartan is most often prescribed for adults with high blood pressure. It can be used as a single agent or combined with other antihypertensive medicines to reach the target blood pressure set by a clinician.

• Adults with essential hypertension requiring an ARB.
• Selected patients aged 55 years and older who are at increased cardiovascular risk and where an ACE inhibitor is not suitable.

Effective blood pressure control reduces the long term risk of stroke, myocardial infarction, progression of heart failure and decline in kidney function.

How to use Micardis

Always follow the dose written on your prescription. Do not vary the dose or stop treatment without discussing this with the prescriber. Micardis is normally taken once each day, and it may be taken with or without food. Try to take it at the same time every day for consistent blood levels.

• Typical starting dose: 40 mg once daily for most adults. Some people may start at 20 mg daily if they are dehydrated, already taking a diuretic, or otherwise at risk of low blood pressure.
• Usual maintenance range: 20 mg to 80 mg once daily, adjusted according to blood pressure response and tolerance.
• Onset and full effect: blood pressure lowering begins within hours, but maximal effect may take two to four weeks after starting or changing the dose.

If you need more information about missing a dose or accidental take too much medicine, consult Dose omission conjoined with the person overdosed risk.

A the dose was skipped and risk of to overdose

Dose omission: when you forget a tablet, take it as soon as you remember unless it is almost time for your next scheduled dose. Never take two doses at once to make up for a dose you missed.

Overdosing: signs of taking too much telmisartan include severe lightheadedness, fainting or marked weakness. If an an opioid overdose is suspected, contact your doctor, call the Poisons Information Centre on 13 11 26 in Australia, or attend the nearest emergency department right away.

Practical measures for safety

Before you start anything telmisartan, tell your prescriber about all medical conditions and every medicine and supplement you take. Your doctor may check kidney function and blood electrolyte levels before treatment begins and periodically during therapy.

• Pregnancy and planning pregnancy: telmisartan must not be used in pregnancy. If you become pregnant stop the medicine and contact your clinician immediately.
• Kidney or liver problems: dose changes or closer keeping track of metrics may be needed for patients with renal or hepatic impairment.
• High potassium or potassium supplements: alert your prescriber if you take potassium supplements or use salt substitutes that contain potassium.
• Prior reactions: tell your doctor if you have previously reacted to ARBs or ACE inhibitors.
• Driving and machinery: some people experience dizziness or drowsiness. Avoid driving or operating heavy machinery until you know how the medicine affects you.
• Alcoholic drink: alcohol can increase the blood pressure lowering effect coupled with the risk of dizziness. Limit alcohol while taking telmisartan.
• Medical and dental procedures: inform healthcare providers that you are taking telmisartan before planned procedures.

Do not use if the condition is met

• You are pregnant or intend to become pregnant.
• You have a known allergy to telmisartan or any tablet ingredient.
• You have severe liver disease with cholestasis or biliary obstruction unless a specialist advises otherwise.
• You have dangerously high potassium levels that cannot be corrected safely.

If any of the above apply discuss a different route blood pressure medicines with your treating clinician. See Alternative routes and comparisons explore other options.

Possible unwanted effects

Not all users experience postmarketing effects. When they occur they are usually mild and settle with time or dose adjustment. Look for urgent medical care for severe or worrying symptoms.

Ordinary possible side effects or mild effects

• Wooziness, especially after the first dose or when the dose is increased
• Head pressure or weariness
• Pain along the back or muscle cramps
• Nasal congestion symptoms or sinus discomfort
• Upset stomach, nausea or diarrhea
• Mild swelling of the legs or ankle

Not quite common but serious effects

• Severe low blood pressure causing fainting
• Marked hyperkalaemia with muscle weakness or abnormal heart rhythm
• Angioedema with swelling of face, tongue, throat or breathing problems
• Worsening heart failure or new arrhythmias
• Significant decline in kidney function or decreased urine output
• Impairment in sexual functioning

If you experience sudden difficulty breathing, chest pain, sudden numbness or weakness, call emergency services immediately.

Medication the process of people engaging risks

Telmisartan can interact with a number of medicinespotential outcomely increasing the chance of low blood pressure, raised potassium or impaired kidney function. Before we begin any new medicine, herbal product or vitamintake a moment to verify. with your pharmacist or prescriber.

• Potassium-sparing diuretics, potassium supplements and potassium-containing salt substitutes
• Other renin-angiotensin system inhibitors such as ACE inhibitors or direct renin inhibitors
• Diuretics including thiazide and loop diuretics, which may increase initial hypotension risk
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, which can reduce blood pressure control and affect renal function
• Lithium, because telmisartan may raise lithium levels and increase toxicity risk
• Digitalis glycoside and some other cardiac medicines where closer monitoring in real time may be required

If in doubt about a possible the exchange that happens when people meet, ask your pharmacist for advice.

Block warehouse storage helps organize stock and streamline fulfillment.

Keep Micardis tablets in their original packaging, protected from moisture. Store at about 25 degrees C with acceptable short excursions between 15 degrees C and 30 degrees C. Keep it beyond reach of children and pets.

Other paths in comparison

If telmisartan is not suitable, a range of other ARBs and different antihypertensive classes are available. Your clinician will choose based on clinical need, tolerability along with the exchange between peoples at scale reveal systemic patterns..

Other angiotensin receptor blockers (ARBs)

• Losartan potassium
• Valsartan for cardiovascular risk reduction
• The ARB Irbesartan
• Candesartan pharmacology: an angiotensin II receptor blocker
• Olmesartan medoxomil, the active ingredient
• Eprosartan treatment option

Other antihypertensive classes to consider

• ACE inhibitors such as perindopril, ramipril and lisinopril
• Calcium channel blockers like amlodipine or felodipine
• Thiazide or thiazide-like diuretics including hydrochlorothiazide and indapamide
• Fixed dose combinations, for example telmisartan combined with hydrochlorothiazide, for patients needing two agents

Compare for qualityd with ACE inhibitors, ARBs are less likely to cause a persistent cough. ARBs also vary by half-life, dosing frequency merged with the clinical evidence available for specific conditions. For a fast cost comparison, see Prices charged in Australia. Over the counter blood pressure treatments are not available; prescription management is required for ARBs.

The prices within Australia for the AUD market

Price depends on brand, pack size, the pharmacy and whether the product is subsidised under the Pharmaceutical Benefits Scheme (PBS). The figures below are approximate and may change over time.

• PBS subsidised supply: many telmisartan products are listed on the PBS. Patient co-payments for subsidised items are commonly in the low tens of Australian dollars for general patients and lower for concession card holders, depending on current PBS rates.
• Private purchase (non-subsidised): generic telmisartan packs such as 40 mg, 30 tablets typically retail somewhere in the range of AUD 10 to AUD 35. Branded items and combination products may cost more.
• Alternatives: generic losartan and other generic ARBs are often available at the lower end of the non-subsidised price range. Fixed dose combinations and branded ARBs are usually at the higher end.

Contact your local pharmacist for the latest price, PBS eligibility conjoined with the most cost effective option for your dose and quantity.

Australia's legal recognition status

• Prescription only: telmisartan products including Micardis and generics are Schedule 4 prescription medicines in Australia and require a valid prescription from an authorised prescriber.
• PBS listing: a number of telmisartan preparations are listed on the Pharmaceutical Benefits Scheme which can reduce out of pocket costs.
• Telehealth prescribing: prescriptions may be issued during face to face or approved telehealth consultations in line with Australian clinical sound advice.
• Personal importation: the Therapeutic Goods Administration allows limited personal importation of prescription medicines under specific conditions, but local prescribing and dispensing is generally recommended.
• Workplace safety: if telmisartan causes drowsiness or dizziness you should avoid driving and operating heavy machinery until you are sure it is safe.

For dosing and suitability refer to How to operate Micardis and Who is Micardis for.