Micardis: Effective Blood Pressure Control for Cardiovascular Health
Micardis
| Product dosage: 20mg | |||
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| Product dosage: 40mg | |||
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Synonyms | |||
Micardis (telmisartan) is an angiotensin II receptor blocker (ARB) indicated for the treatment of hypertension in adults. It may be used alone or in combination with other antihypertensive agents. By selectively blocking the binding of angiotensin II to the AT1 receptor, Micardis inhibits the vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to vasodilation and reduced blood pressure. This mechanism offers a well-tolerated therapeutic option for patients requiring long-term management of high blood pressure, with a once-daily dosing regimen that supports adherence and consistent 24-hour efficacy.
Features
- Active ingredient: Telmisartan
- Available in 20 mg, 40 mg, and 80 mg tablet strengths
- Once-daily oral administration
- Bioavailability approximately 42%
- Half-life of approximately 24 hours
- Excreted predominantly unchanged via feces
- Not significantly metabolized by cytochrome P450 system
Benefits
- Provides effective and sustained 24-hour blood pressure reduction with a single daily dose
- Lowers the risk of cardiovascular events in patients unable to take ACE inhibitors
- Demonstrates a favorable side effect profile with a low incidence of cough compared to ACE inhibitors
- Offers renal protective effects in hypertensive patients with type 2 diabetes and established renal disease
- May improve endothelial function and insulin sensitivity in certain patient populations
- Supports long-term adherence due to simple dosing and generally good tolerability
Common use
Micardis is primarily prescribed for the management of essential hypertension. It is suitable for first-line monotherapy or as part of a combination regimen with other antihypertensive drugs such as thiazide diuretics or calcium channel blockers. In specific clinical scenarios, it may also be used for cardiovascular risk reduction in patients intolerant to ACE inhibitors. Off-label uses may include proteinuria reduction in diabetic nephropathy, though such applications require careful individual assessment and specialist oversight.
Dosage and direction
The recommended initial dose of Micardis is 40 mg once daily. Dosage may be titrated to 80 mg once daily based on blood pressure response. In volume-depleted patients (e.g., those on high-dose diuretics), initiation with 20 mg is advised to minimize potential hypotensive effects. Tablets should be taken with or without food, at approximately the same time each day to maintain consistent plasma concentrations. Blood pressure monitoring should continue during dose adjustment periods, with full therapeutic effect typically observed within 4-8 weeks of initiation.
Precautions
Use with caution in patients with renal impairment, particularly those with renal artery stenosis, as changes in renal function may occur. Hepatic impairment requires careful dosage consideration due to primarily biliary excretion. Monitor serum potassium levels, especially in patients with renal insufficiency, diabetes, or those concomitantly using potassium-sparing diuretics or potassium supplements. Not recommended during pregnancy due to potential fetal harm. Avoid use in patients with primary hyperaldosteronism. Orthostatic hypotension may occur, particularly in volume-depleted patients or those with heart failure.
Contraindications
Hypersensitivity to telmisartan or any component of the formulation. Concomitant use with aliskiren in patients with diabetes. Severe hepatic impairment (Child-Pugh class C). Second and third trimester of pregnancy. Bilateral renal artery stenosis or stenosis to a solitary kidney.
Possible side effects
Common adverse reactions (≥1%): upper respiratory tract infection, back pain, sinusitis, diarrhea, pharyngitis. Serious but less frequent effects: symptomatic hypotension, hyperkalemia, renal impairment, angioedema (rare). Laboratory abnormalities may include elevated serum creatinine, BUN, and potassium. Discontinuation rate due to adverse effects is generally low (<2%). Postmarketing reports include hepatic function abnormalities, thrombocytopenia, and rhabdomyolysis.
Drug interaction
Increased risk of hyperkalemia with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium. NSAIDs may reduce antihypertensive effect and increase risk of renal impairment. Lithium levels may increase with concomitant use. Dual blockade of the renin-angiotensin system with ACE inhibitors or aliskiren increases risks of hypotension, hyperkalemia, and renal impairment. Telmisartan may increase digoxin peak plasma concentration.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If the next day’s dose is approaching, skip the missed dose and resume the regular schedule. Do not double the dose to make up for a missed administration. Consistent daily dosing is important for maintaining stable blood pressure control.
Overdose
Symptoms may include hypotension, tachycardia, bradycardia, dizziness, and renal failure. Management involves supportive care with volume expansion with normal saline. Hemodialysis is not effective due to high protein binding. Symptomatic treatment should be provided based on clinical presentation. Close monitoring of vital signs, electrolyte balance, and renal function is essential.
Storage
Store at room temperature (20-25°C/68-77°F) in the original container. Protect from moisture and light. Keep tightly closed and out of reach of children. Do not use after the expiration date printed on the packaging. Do not transfer tablets to other containers that may not provide adequate protection from light or moisture.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made by qualified healthcare professionals based on individual patient characteristics. Always follow the prescribing information provided with the medication and consult appropriate clinical guidelines. Dosage adjustments may be necessary based on renal or hepatic function, concomitant medications, and therapeutic response.
Reviews
Clinical trials demonstrate Micardis provides effective blood pressure reduction with mean decreases of 10-15 mmHg systolic and 6-10 mmHg diastolic at 80 mg daily. The ONTARGET trial showed telmisartan was not inferior to ramipril in high-risk vascular patients with a better tolerability profile. Real-world evidence supports maintained efficacy over long-term use with persistence rates superior to some other antihypertensive classes. Patient satisfaction surveys indicate appreciation for once-daily dosing and low incidence of bothersome side effects compared to other antihypertensive agents.