Telmisartan is an angiotensin II receptor blocker (sometimes called an ARB) that is used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Telmisartan is also used to reduce the risk of stroke, heart attack, or death from heart problems in people who are at least 55 years old with risk factors for serious heart disorders.

Telmisartan may also be used for purposes not listed in this medication guide.

Do not use if you are pregnant. Stop using telmisartan and tell your doctor right away if you become pregnant.

If you have diabetes, do not take telmisartan with any medicine that contains aliskiren (a blood pressure medicine).

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take telmisartan at the same time each day, with or without food.

Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking telmisartan.

It may take 2 to 4 weeks before your blood pressure is under control. Keep using this medicine even if you feel well. High blood pressure often has no symptoms.

You may need to use blood pressure medicine for the rest of your life. Treatment may also include diet, exercise, lowering cholesterol, not smoking, and controlling diabetes.

Your blood pressure will need to be checked often. Your liver or kidney function may also need to be checked.

Store at room temperature away from moisture and heat. Keep the tablets in their original package or container, along with any packet or canister of moisture-absorbing preservative.

Keep this medicine in its original packaging until you're ready to take a tablet. Tear or cut one tablet blister from the package, peel back the paper liner, and push the tablet through the foil.

Usual Adult Dose for Hypertension:

Initial dose: 40 mg orally once a day

Maintenance dose: 40 to 80 mg orally once a day

Comments: Most of the antihypertensive effect is present within 2 weeks; maximum blood pressure reduction at a given dose is generally observed within 4 weeks of starting that dose.

Usual Adult Dose for Cardiovascular Risk Reduction:

80 mg orally once a day

Comments:
-It is unknown whether doses lower than 80 mg are effective in reducing the risk of cardiovascular morbidity and mortality.
-When initiating this drug for cardiovascular risk reduction, monitoring of blood pressure is recommended, and if appropriate, adjustment of other medications that lower blood pressure.

Use: Reduction of risk of myocardial infarction, stroke, or death from cardiovascular causes in patients 55 years or older at high risk of developing major cardiovascular events who are unable to take angiotensin-converting enzyme (ACE) inhibitors. High risk for cardiovascular events can be evidenced by a history of coronary artery disease, peripheral arterial disease, stroke, transient ischemic attack, or high-risk diabetes (insulin-dependent or non-insulin dependent) with evidence of end-organ damage.

You should not use telmisartan if you are allergic to it.

If you have diabetes, do not take telmisartan with any medicine that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking telmisartan with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• a heart condition other than one being treated with telmisartan;

• liver disease;

• kidney disease (or if you are on dialysis); or

• if you are on a low-salt diet.

Do not use if you are pregnant. Stop using the medicine and tell your doctor right away if you become pregnant. Telmisartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

If you plan to get pregnant, ask your doctor for a safer medicine to use before and during pregnancy. Having high blood pressure during pregnancy may cause complications in the mother and the baby.

You should not breastfeed while using telmisartan.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the blister pack it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Do not use salt substitutes containing potassium without talking to your doctor. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Also call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• little or no urination;

• swelling in your feet or ankles, rapid weight gain;

• unusual pain or tightness in your lower body;

• a skin ulcer; or

• high blood potassium--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common side effects of telmisartan may include:

• stuffy nose, sinus pain;

• back pain; or

• diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• digoxin;

• lithium;

• a diuretic or "water pill" or other blood pressure medicine; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

This list is not complete. Other drugs may affect telmisartan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to telmisartan.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Twynsta® (containing Amlodipine, Telmisartan)