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Adults: Micardis: Treatment of essential hypertension: The recommended dose is 40 mg once daily. In cases where the target blood pressure is not achieved, telmisartan dose can be increased to a maximum of 80 mg once daily.
When considering raising the dose, it must be borne in mind that the maximum antihypertensive effect is generally attained four to eight weeks after the start of treatment.
Alternatively, telmisartan may be used in combination with thiazide-type diuretics such as hydrochlorothiazide or calcium channel-blockers such as amlodipine, which have been shown to have an additive blood pressure lowering effect with telmisartan.
In patients with severe hypertension treatment with telmisartan at doses up to 160 mg alone and in combination with hydrochlorothiazide 12.5-25 mg daily was well tolerated and effective.
Prevention of cardiovascular morbidity and mortality: The recommended dose is 80 mg once daily. It is not known whether doses lower than 80 mg of telmisartan are effective in preventing cardiovascular morbidity and mortality.
When initiating telmisartan therapy for the prevention of cardiovascular morbidity and mortality, monitoring of blood pressure is recommended, and if appropriate adjustment of medications that lower blood pressure may be necessary.
Micardis Plus: MICARDIS PLUS should be taken once daily. The dose of telmisartan could be up-titrated before switching to MICARDIS PLUS. Direct change from monotherapy to the fixed combinations may be considered.
MICARDIS PLUS 40/12.5 mg may be administered in patients whose blood pressure is not adequately controlled by MICARDIS 40 mg or hydrochlorothiazide.
MICARDIS PLUS 80/12.5 mg may be administered in patients whose blood pressure is not adequately controlled by MICARDIS 80 mg or by MICARDIS PLUS 40/12.5 mg.
Sodium or volume depletion should be corrected before treatment commencement with MICARDIS PLUS.
The maximum antihypertensive effect is generally attained with MICARDIS PLUS 4-8 weeks after the start of treatment.
When necessary, MICARDIS PLUS may be administered with another antihypertensive drug.
In patients with severe hypertension treatment with telmisartan at doses up to 160 mg alone and in combination with hydrochlorothiazide 12.5-25 mg daily was well tolerated and effective.
Special populations: Renal impairment: Telmisartan is not removed from blood by hemofiltration and is not dialyzable.
Micardis: No posology adjustment is required for patients with renal impairment, including those on haemodialysis.
Micardis Plus: Due to the hydrochlorothiazide component, MICARDIS PLUS must not be used in patients with severe renal dysfunction (creatinine clearance <30 mL/min). Loop diuretics are preferred to thiazides in this population. Experience in patients with mild to moderate renal impairment is modest but has not suggested adverse renal effects and dose adjustment is not considered necessary. Periodic monitoring of renal function is advised.
Elderly: No dosing adjustment is necessary (see Contraindications).
Hepatic impairment: In patients with mild to moderate hepatic impairment, MICARDIS/MICARDIS PLUS should be administered with caution. For telmisartan, the posology should not exceed 40 mg once daily (see Contraindications).
Thiazides should be used with caution in patients with impaired hepatic function.
Elderly: No dosing adjustment is necessary.
Micardis Plus: With advanced age (≥65 years), one should be aware of possible renal impairment.
Children and adolescents: Micardis: The safety and efficacy of MICARDIS for use in children below 18 years have not been established.
Micardis Plus: Safety and efficacy of MICARDIS PLUS have not been established in patients aged below 18 years. Use of MICARDIS PLUS is not recommended in children and adolescents.
Method of Administration: MICARDIS/MICARDIS PLUS tablets are for once-daily oral administration and should be swallowed whole with liquid. MICARDIS/MICARDIS PLUS can be taken with or without food.
