Mibetel 40mg Hasan tablets treat hypertension (3 blisters x 10 tablets)

Caution when using

Caution when using medication for patients with mild and medium -sized liver failure, no drugs for patients with severe liver failure. Contraindicated in patients with biliary obstruction due to drugs excreted through bile, causing reduction in liver clearance.

narrowing of the kidney artery on one or both sides because of the increased risk of hypotension and severe kidney failure.

Kidney failure and kidney implant: regularly monitor the concentration of potassium and creatinine in serum. No experience using Telmisartan for new patients with kidney implants.

Dehydration (decreased volume and sodium caused by vomiting, diarrhea, prolonged diuretics, separation, salt restriction diet) increases the risk of excessive hypotension, especially after the first dose. This disorder must be adjusted before taking Telmisartan or reducing the dose and closely monitoring before treatment.

Combining drugs with the same effect on the Renin - Angiotensin - Aldosterone (RAAS) system: simultaneously use ACE ACE and Angiotensin II or Aliskiren inhibitors that increase the risk of hypotension, hyperkalemia and reduced kidney function (including acute renal failure). There is no simultaneous use of these drugs.

In some cases when the combination of drugs with the same impact on the RAAS system is absolutely necessary, it is necessary to conduct under the close supervision of health experts for kidney, electrolyte and blood pressure. Ace ACE and Angiotensin II should not be used at the same time in patients with diabetes with kidney complications.

Patients with arterial function and renal function depend mainly on the activity of the Renin - Angiotensin - Aldosterone system (severe congestive heart failure or potential kidney disease, including kidney artery stenosis), when treated with drugs that affect this system such as Telmisartan can lead to excessive hypotension, blood nitrogen, low urine or acute renal insufficiency.

Patients with primary Aldosterone intense not responding to antihypertensive drugs acting by inhibiting the Renin - Angiotensin system. Telmisartan should not be used for this group of patients.

Precautions in patients with aortic stenosis or mitral valve, hypertrophic cardiomyopathy.

Be cautious when using Telmisartan for diabetes patients treated with insulin or other anti -diabetes drugs because of the increased risk of hypoglycemia. Need closely monitoring blood sugar in these patients. Can consider adjusting insulin dose or diabetic medications.

Medicines that affect the Renin - Angiotensin - Aldosterone system such as Telmisartan can cause hyperburgemia, especially in the elderly, patients with renal impairment, diabetes or being treated with other drugs that increase potassium potassium (potassium -saving dterior drugs, ACE inhibitors, non -steroid anti -inflammatory drugs ...). Need to monitor blood potassium concentration in high -risk patients.

Like the enzyme inhibitors Angiotensin, Telmisartan and other Angiotensin receptor antagonists have a significant lowering effect on black people compared to other skin -colored people. Maybe because in the body of black people with high blood pressure has lower re -amount.

Like other medications for hypertension, excessive hypotension in patients with cardiovascular disease due to ischemia can lead to myocardial infarction or stroke.

The ability to drive and operate machinery

When driving or operating machinery, it is necessary to pay attention to dizziness or drowsiness can sometimes occur when using hypertension medication such as Telmisartan.

Pregnancy

There is no adequate document about using Telmisartan for pregnant women. Animal studies show that there is no clear evidence of teratogenic effects, but the toxicity for the fetus has been recorded. So be careful, it is best not to use Telmisartan in the first 3 months of pregnancy. If you intend to get pregnant, other drugs should be replaced before pregnancy.

Contraindicated Telmisartan from the 3rd month of pregnancy because the drug is directly acting on the Renin - Angiotensin system that can harm the fetus. When detecting pregnancy, it is necessary to stop using Telmisartan as soon as possible. If pregnant women have taken Angiotensin II receptor receptor drugs from the 3rd month of pregnancy, the fetal kidney and cortex test is recommended.

Babies with mothers have used Angiotensin II receptor receptor drugs from pregnancy should be closely checked to prevent the risk of hypotension.

breastfeeding period

Contraindications to use Telmisartan during breastfeeding because it is unclear whether Telmisartan is excreted through breast milk or not. To ensure the safety of breastfeeding, it is necessary to decide to stop breastfeeding or stop the drug, depending on the importance of the drug for the mother.

Drug interaction

Digoxin: Concomitance with Telmisartan increases the concentration of digoxin in plasma (average peak concentration increases 49% and base concentration increases by 20%). At the beginning of treatment, adjusting and stopping Telmisartan, and monitoring the concentration of Digoxin in the blood maintenance in the therapy range.

Potassium -saving diocesia (Spironolactone, Eplerenone, Triamterene, Amiloride) or potassium supplements: may increase the effect of hyperboly of Telmisartan.

Lithium: Increased lithium concentration in serum and toxicity has been recorded when used with ACE inhibitors, Angiotensin II receptor antagonists, including Telmisartan. Therefore, the lithium concentration should be monitored when using two medications simultaneously.

Non -steroid anti -inflammatory drugs (NSAIDs): may reduce the effect of treating hypertension of Angiotensin II receptor antagonist drugs. In some patients with impaired renal function (patients dehydrated, elderly), simultaneous use of Angiotensin II receptor antagonists and cycloxygenase inhibitors (NSAIDs) can lead to kidney damage, including acute renal failure, often reversed. Therefore, it is advisable to be careful, especially in the elderly. Need to monitor the kidney function at the beginning of treatment and then periodically.

Diuretics (Thiazide or diuretics): The initial treatment of high -dose diuretic such as Furosemide (diuretics) and hydrochlorothiazide (thiazide diuretics) can reduce fluid volume and cause excessive hypotension when starting treatment with Telmisartan.

Other medications for hypertension: Telmisartan's hypotension effect may increase when uncomfortable with other hypertension medications. In addition, hypotension can occur more seriously when used with alcohol, barbiturate, sedation that causes sleep or antidepressants.

Corticosteroid drugs: reduce the effectiveness of Telmisartan treatment.

Cavalry of the drug: Due to no studies on the correspondence of the drug, not mixing this drug with other drugs.