What should we pay attention to when using the antihypertensive drug telmisartan and who should not take it?

A friend told Huazi that he had just been diagnosed with high blood pressure and the doctor prescribed him telmisartan. He found that other friends with high blood pressure were also taking telmisartan. Why is this drug so popular?

Huazi said that telmisartan is a commonly used antihypertensive drug, and Huazi has recommended it to friends with high blood pressure. Because among sartan drugs, telmisartan has a stronger effect in lowering blood pressure, a longer-lasting effect, and a higher safety. While lowering blood pressure, it can also protect the heart and kidneys, but it is not recommended for people with poor liver function.

1. Sartan drugs for protecting the heart and kidneys

Sartans are commonly used first-line antihypertensive drugs that can block the binding of angiotensin 2 to the corresponding receptors on blood vessels and inhibit the **"renin-angiotensin-aldosterone" system (RAAS)**.

In the human body, RAAS has a significant impact on blood pressure. Angiotensin 2 not only increases blood pressure, but also promotes myocardial hypertrophy, fibroblast proliferation, ventricular remodeling, and induces or aggravates heart failure. Sartan drugs inhibit RAAS and can reverse this process.

When RAAS is activated, it will reduce the blood flow to the kidneys and cause kidney damage. Sartan drugs inhibit RAAS and can also protect renal blood vessels and kidney function.

2. Telmisartan, a powerful antihypertensive

Among sartan drugs, telmisartan and irbesartan have higher antihypertensive strength and longer duration of action, and are commonly used sartan drugs. However, irbesartan is affected by the "carcinogenic rumor", so telmisartan is more easily accepted by patients .

Last year, several batches of sartan drugs had excessive levels of carcinogenic impurities. Sartan drugs contain tetrazole rings in their structures, which are prone to the introduction of carcinogenic azido impurities during the chemical synthesis process. These drugs include irbesartan, losartan, valsartan and many other sartan drugs.

Telmisartan is a bisbenzimidazole, which is not affected by the "carcinogenic rumor". In fact, only a few batches of sartan were affected and recalled. The drugs produced later all meet the safety standards, so there is no need to worry.

3. What should I pay attention to when taking telmisartan?

1. Medication time : The normal pattern of human blood pressure is that it rises during the day and falls at night, so telmisartan is usually taken in the early morning , when the peak of blood drug concentration coincides with the peak of blood pressure, which can exert the best antihypertensive effect. However, if you have high blood pressure at night, you can also take it before going to bed.

2. Dosage : The initial dose of telmisartan is 40 mg once a day, and then according to the blood pressure, you can choose a maintenance dose of 20 mg to 80 mg once a day. After taking telmisartan, it takes 4 to 8 weeks to achieve the best antihypertensive effect , so don't rush to adjust the dose, and adjust it every 7 to 14 days.

3. Combination medication : If the effect of single medication is not good, or the initial blood pressure exceeds 160/100 mmHg, it can be combined with other antihypertensive drugs. Telmisartan can reduce lower limb edema caused by diazepam and counteract hypokalemia caused by diuretics . Therefore, it is a commonly used combination medication scheme to have synergistic antihypertensive effects and complementary adverse reactions when used in combination with diazepam and diuretics .

4. Adverse reactions : In clinical trials, the incidence of adverse reactions in the telmisartan and placebo groups was similar, and the safety was very good. Telmisartan can increase blood potassium, so pay attention to check blood potassium levels during medication.

5. Who should not use it : Those who are allergic to the drug are prohibited from using it; pregnant and lactating women are prohibited from using it; the drug is mainly metabolized by the liver and excreted in the bile, so it is prohibited for those with biliary obstruction and severe liver dysfunction; those with mild to moderate renal impairment can take it, as it has a kidney-protecting effect , but it is prohibited for those with severe renal impairment (creatinine clearance <30ml/min).

In summary, telmisartan is a commonly used first-line antihypertensive drug with strong effects, long-lasting efficacy and high safety. While lowering blood pressure, it also protects the heart and kidneys, so it is commonly used in clinical practice. The drug must be used under the guidance of a doctor. If you have any questions about the use of the drug, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.