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Angiotensin II receptor blocker (ARB)

Telmisartan

Brand names: Micardis

Telmisartan is a long-acting angiotensin-II receptor blocker (ARB) used for hypertension and to reduce cardiovascular risk in selected patients. It is a useful alternative when an ACE-inhibitor cough is troublesome.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

May be administered with or without food ( 2.1 ) When used for cardiovascular risk reduction, monitoring of blood pressure is recommended, and if appropriate, adjustment of medications that lower blood pressure may be necessary ( 2.2 ) Indication Starting Dose Dose Range Hypertension ( 2.1 ) 40 mg once daily 40 to 80 mg once daily Cardiovascular Risk Reduction ( 2.2 ) 80 mg once daily 80 mg once daily 2.1 Hypertension Dosage must be individualized. The usual starting dose of telmisartan tablets is 40 mg once a day. Blood pressure response is dose-related over the range of 20 to 80 mg [see Clinical Studies (14.1) ]. Most of the antihypertensive effect is apparent within 2 weeks and maximal …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-06-05. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It selectively blocks the angiotensin II type 1 (AT1) receptor, preventing angiotensin II-mediated vasoconstriction and aldosterone release, thereby lowering blood pressure.

Prescribing in practice

  • Avoid in pregnancy — ARBs are associated with fetal toxicity; women planning pregnancy should be switched to an alternative.
  • Hyperkalaemia and deterioration in renal function can occur, particularly with renal impairment, in renal artery stenosis, or alongside potassium-sparing diuretics, potassium supplements or NSAIDs.
  • Do not combine an ARB with an ACE inhibitor; symptomatic hypotension may occur, especially in volume-depleted patients (e.g. those on high-dose diuretics).

Monitoring

Check renal function, electrolytes (including potassium) and blood pressure before starting and after initiation or dose changes. Monitor blood pressure for treatment response and watch renal function closely in those at higher risk of deterioration.

Counselling the patient

  • Tell us at once if you become pregnant or are planning pregnancy, as this medicine must be stopped.
  • Avoid potassium-based salt substitutes and do not start potassium supplements unless advised.
  • Dizziness can occur, particularly with the first doses; rise slowly from sitting or lying.

Evidence & guidelines

ARBs are a guideline-recommended option for hypertension (NICE NG136).

Reference: NICE NG136; ESC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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