What Are the Side Effects of Telmisartan?

Telmisartan is an oral tablet sold under the brand name "Micardis," available as both the brand name and generic name. Telmisartan side effects include fatigue, nausea, headache, and others.

Telmisartan is an oral tablet sold under the brand name “Micardis,” available as both the brand name and generic name. It comes in three strengths, 20 mg, 40 mg, and 80 mg. The tablets lower your high blood pressure and reduce the risks of heart attacks, strokes, and even death from cardiac conditions.

Telmisartan belongs to a drug family called angiotensin receptor blockers (ARBs). It restricts the ability of angiotensin, a chemical that causes blood vessels to become more narrow, to work. This restriction results in blood vessels relaxing. The tablet also helps your kidneys remove excess water and salt to lower your blood pressure.

People who are 55 years or above can take telmisartan as an alternative for angiotensin-converting enzyme (ACE) inhibitors to prevent significant risks of heart diseases. 

Telmisartan is safe to use in moderate dosage. However, it can cause specific side effects in some people. 

Mild side effects

The most commonly-occurring side effects of telmisartan include:

• Fatigue
• Nausea
• Headache
• Dizziness
• Stomach issues like diarrhea
• Sore throat
• Flu-like symptoms like fever and body aches
• Back pain
• Muscle pains
• Sinus pain and congestion

These telmisartan side effects are usually mild and may take a couple of days or weeks to go away. However, if these symptoms persist, consult your doctor as soon as possible to diagnose any underlying health condition.

Severe side effects

Some people may observe more severe side effects that don’t go away in weeks. These can be life-threatening if you don’t seek medical attention. Some serious telmisartan side effects include:

• Low Blood Pressure: Faintness and dizziness
• Kidney Disease: Swelling of feet, ankles, or hands and sudden weight gain
• Allergic Reaction: Swelling of face, tongue, or throat, trouble breathing, and skin rash

It’s important to note that every drug affects each person differently. So, the above side effects are just general or commonly-occurring ones. If you’re about to take telmisartan, always discuss the possible side effects with your doctor beforehand. 

Telmisartan has a higher chance of interacting with other medications, vitamin supplements, or herbs you’re already taking for any health condition. Drug interactions alter how a drug works to treat or relieve a medical issue. 

A healthcare professional usually manages your medications and prescribes only those that don’t interact with each other. Some drugs that may interact with telmisartan include:

Blood pressure regulating drugs

Your body has a renin-angiotensin-aldosterone system to maintain blood pressure in the normal range. The kidneys, an enzyme known as the angiotensin-converting enzyme, and angiotensin receptors all play a role in the system. Telmisartan affects the renin-angiotensin-aldosterone system of your body to lower blood pressure when it is too high. 

Therefore, you should avoid taking this drug with other blood pressure regulating medications, such as the following:

• Aliskiren: People with kidney diseases or diabetes should avoid taking aliskiren and telmisartan together. 
• Angiotensin Receptor Blockers (ARBs): These include candesartan, eprosartan, irbesartan, losartan, olmesartan, valsartan, and azilsartan.
• Angiotensin-converting Enzyme (ACE) Inhibitors: These include benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril.

Pain relief medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, effectively relieve pain and inflammation caused by several health problems. Telmisartan may interact with these drugs and increase risks for kidney problems, particularly in seniors. 

If you already have kidney issues or take diuretics (water pills), you should consult your doctor before taking telmisartan.

Digoxin

Digoxin is a medication with the brand name “Lanoxin.” It treats several heart conditions, including atrial flutter, atrial fibrillation, and heart failure. If you take digoxin with telmisartan, the digoxin levels in your blood may significantly increase. Your healthcare provider will evaluate your blood levels throughout your telmisartan course. 

Lithium

Lithium medications treat psychiatric conditions like bipolar disorder or depressive symptoms, which don’t go away with antidepressants. Taking telmisartan with lithium increases the lithium levels in your body. 

Note that these are some frequent drug interactions with telmisartan. Therefore, talk to your doctor to know more about the drugs that may interact with telmisartan.

Telmisartan has several warnings for people with allergies, specific health conditions, and certain groups. 

Allergic reactions

Telmisartan may cause several allergic symptoms, such as:

• Difficulty in breathing
• Swelling of the face, tongue, or throat
• Hives (raised, itchy rash)

Stop consuming the drug again if you observe these allergic reactions after the telmisartan intake.

People with health conditions

A clinical trial experiment evaluated the safety of telmisartan in 3700+ patients with different health conditions. Several patients experienced mild side effects, resulting in the drug being discontinued. 

A MICARDIS (20 to 160 mg) monotherapy involving 1041 patients in placebo-controlled trials treated the participants for 12 weeks. The overall occurrence of the adverse events were like that in patients treated with placebo. 

Some of these side effects include influenza-like symptoms, myalgia, urinary tract infection, dyspepsia, dizziness, nausea, abdominal pain, fatigue, hypertension, headache, pain, coughing, chest pain, and peripheral edema. 

In 0.3% of 3500 patients treated with telmisartan monotherapy, side effects included:

• Autonomic Nervous System: Increased sweating, flushing, and impotence
• Overall Body: Allergy, leg pain, and fever
• Cardiovascular Health: Palpitation, angina pectoris, dependent edema, leg edema, tachycardia, and abnormal ECG
• CNS: Insomnia, hypoesthesia, migraine, paresthesia, somnolence, vertigo, and involuntary muscle contractions
• Gastrointestinal Health: Constipation, gastritis, dry mouth, toothache, vomiting, hemorrhoids, enteritis, gastroenteritis, gastroesophageal reflux, and non-specific gastrointestinal disorders
• Metabolic System: Gout, diabetes mellitus, and hypercholesterolemia
• Musculoskeletal Health: Arthritis, leg cramps, arthralgia
• Psychiatric Issues: Anxiety, nervousness, and depression
• Resistance Mechanism: Infection, otitis media, and fungal infection
• Respiratory System: Asthma, rhinitis, bronchitis, epistaxis, and dyspnea
• Skin Issues: Dermatitis, eczema, rash, and pruritus
• Urinary: Micturition frequency and cystitis
• Vascular: Cerebrovascular disorder
• Special Senses: Abnormal vision, tinnitus, conjunctivitis, and earache

Pregnant women

A study found that medications that interact with the angiotensin-converting enzyme system can cause severe fetal and neonatal toxicity in pregnant women. These telmisartan side effects mainly occur when women are in the second and third trimesters. Even if you take telmisartan 40 mg during this period, it may end your pregnancy.

It’s essential to tell your doctor if you’re trying to get pregnant or are already pregnant. The doctor may recommend telmisartan 40 mg only if there are higher chances that you’ll get more benefits than harm.

Breastfeeding women

No medical evidence proves that telmisartan can pass into breast milk. But if it does, your breastfeeding child may get affected by the telmisartan side effects. Your doctor can make a better decision about whether you should take this drug while breastfeeding or not.

Seniors

Seniors usually metabolize drugs slowly. So, it’s better to start with a lower dose to avoid possible side effects of telmisartan. 

Children

There are no studies of telmisartan side effects in children. Thus, it’s better not to give this drug to children under 18.

There is no standard telmisartan dosage. However, a safe telmisartan dosage for adults (18 years and above) is typical as follows:

• Starting Dose: Telmisartan 40 mg, if consumed through the mouth once daily.
• Maintenance Dose: Telmisartan 20–80 mg, if taken through mouth daily.

Your doctor will suggest you start with a lower dose and increase it gradually according to the requirements. The correct telmisartan dose, form, and frequency usually depend on several factors, such as:

• Age
• Your health condition
• The severity of your condition 
• Any underlying medical conditions
• Your body’s reaction to the first dose

Always start your telmisartan dosage with proper consultation with your doctor. They will diagnose your health condition and suggest a dose accordingly. If you observe any telmisartan side effects, contact your doctor immediately.