Telmirin 40/Telmirin 80

HTN as monotherapy or in combination w/ other antihypertensives.

Initially 40 mg once daily, may be increased to max of 80 mg once daily.

May be taken with or without food.

Hypersensitivity. Biliary obstructive disorders. Concomitant use w/ aliskiren in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²). Severe hepatic impairment. Pregnancy (2nd & 3rd trimesters).

Not to be given to patients w/ cholestasis, biliary obstructive disorders or severe hepatic impairment. Not to be used concomitantly w/ ACE inhibitors in patients w/ diabetic nephropathy. Not recommended in patients w/ primary aldosteronism. Dual blockade of renin-angiotensin-aldosterone system (RAAS) through combination w/ ACE inhibitors or aliskiren is not recommended. Increased risk of severe hypotension & renal insufficiency in patients w/ bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney. Acute hypotension, hyperazotaemia, oliguria, or rarely acute renal failure in patients whose vascular tone & renal function depend predominantly on the activity of the RAAS eg, patients w/ severe CHF or underlying renal disease, including renal artery stenosis. Hypoglycaemia may occur in patients w/ diabetic patients treated w/ insulin or antidiabetics. Excessive BP reduction in patients w/ ischaemic cardiopathy or CV disease could result in MI or stroke. Caution in patients suffering from aortic or mitral stenosis, or obstructive hypertrophic cardiomyopathy. Less effective in lowering BP in black patients. Periodic monitoring of K & creatinine serum levels is recommended in patients w/ renal impairment. Correct vol- &/or Na-depletion (eg, in patients w/ vigorous diuretic therapy, dietary salt restriction, diarrhoea or vomiting) prior to administration. Close monitoring of serum K in patients at risk of hyperkalaemia is recommended. Not to be taken by patients w/ galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Caution in patients w/ mild to moderate hepatic impairment. No experience in patients w/ recent kidney transplantation. Not recommended during 1st trimester of pregnancy & should not be initiated during pregnancy. Not recommended during breastfeeding.

Increased peak plasma & trough conc of digoxin. May increase serum K w/ K sparing diuretics (eg, spironolactone, eplerenone, triamterene, or amiloride), K supplements, or K-containing salt substitutes. Reversible increases in serum lithium conc & toxicity. Antihypertensive effect may be reduced w/ NSAIDs (ie, ASA at inflammatory dose regimens, COX-2 inhibitors & non-selective NSAIDs). May result in further deterioration of renal function, including possible acute renal failure, w/ COX inhibitors in some patients w/ compromised renal function (eg, dehydrated patients or elderly). Increased AUC_0-24 & C_max of ramipril & ramiprilat. May result in vol depletion w/ prior treatment w/ high-dose diuretics eg, furosemide (loop diuretic) & hydrochlorothiazide (thiazide diuretic) & in risk of hypotension when initiating therapy. BP-lowering effect can be increased w/ other antihypertensive medicinal products. Higher frequency of adverse effects (eg, hypotension, hyperkalaemia & decreased renal function including acute renal failure) associated w/ dual blockade of the RAAS through combination w/ ACE inhibitors or aliskiren. Hypotensive effects may be potentiated w/ baclofen, amifostine. Orthostatic hypotension may be aggravated w/ alcohol, barbiturates, narcotics, or antidepressants. Reduced antihypertensive effect of corticosteroids (systemic use).

Angiotensin II Antagonists

C09CA07 - telmisartan ; Belongs to the class of angiotensin II receptor blockers (ARBs). Used in the treatment of cardiovascular disease.

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