Telmisartan Stella 40mg treatment for hypertension and preventing cardiovascular diseases (4 blisters x 7 tablets)

Dosage form Box of 4 blisters x 7 tablets
Specifications Telmisartan

Ingredient

Composition information	Content
Telmisartan	40mg

Uses

Indications

Telmisartan 40 mg is indicated in the following cases:

Hypertension: Treatment of primary hypertension in adults.

Pharmacokology

Telmisartan is a specific antagonist and oral impact on Angiotensin II receptor (TYP AT1).

Telmisartan takes up the seat of Angiotensin II for a strong affinity at the position of cohesion to the AT1 receptor, this receptor is responsible for all the known activities of Angiotensin II.

Telmisartan does not show any partial activity on the AT1 receptor.

Telmisartan is sustainable, long -term and selective on the AT1 receptor. Telmisartan has no affinity for other receptors, including AT2 and other less characteristic AT receptors.

It is unknown the function of these receptors as well as the effects of their excessive stimulation because angiotensin II when telmisartan increases angiotensin II concentration.

Telmisartan reduces aldosteron levels in plasma. Telmisartan does not inhibit renin in human plasma or ionic channels.

Telmisartan does not inhibit the enzyme transferring angiotensin (Kinase II), this enzyme also has the effect of degenerative Bradykinin. Therefore, there is no unwanted effect caused by indirect Bradykinin.

pharmacokinetic

absorption

Telmisartan is rapidly absorbed through the gastrointestinal tract. Absolute oral bioavailability depends on the dose and reaches about 42% after the dose of 40mg and 58% after the dose of 160mg.

Distribution

Telmisartan is connected to plasma proteins more than 99%.

Elimination

The drug is eliminated almost entirely in the biliary tract into the feces, mainly in the form of unchanged. Telmisartan's final waste time is about 24 hours.

Before taking Telmisartan Stella 40mg treatment for hypertension and preventing cardiovascular diseases (4 blisters x 7 tablets)

How to use

Use oral and do not belong to meals. Should take the medicine immediately after removing the pill from the blister.

Dosage

Adults

Treatment of hypertension

Usually effective dose is 40 mg/time/day. Some patients may work at a dose of 20 mg/time/day. In the absence of target blood pressure, Telmisartan may increase to maximum of 80 mg/time/day.

Telmisartan can be used in combination with thiazid diuretics such as hydrochlorothiazid. When considering increasing the dose, it should be noted that the maximum hypotension effect is usually achieved after starting 4 - 8 weeks of treatment.

Cardiovascular Prevention

The recommended dose is 80 mg/time/day. It is not known whether the Telmisartan dose is less than 80 mg, which is effective in reducing cardiovascular mortality. At the beginning of Telmisartan treatment to reduce cardiovascular mortality, recommend careful monitoring of blood pressure and if needed to adjust the dose to achieve lower blood pressure.

Patients with renal failure

Data on patients with severe kidney failure or dialysis is limited, the starting dose should be 20 mg/1 time/day. No need to adjust mild and medium dose patients.

Patients with liver failure

If mild or medium liver failure, daily dose must not exceed 40mg x 1 time/day single therapy and also in combination with hydrochlorothiazid. Contraindicated format in combination with thiazid diuretics in patients with severe liver failure.

Elderly

No dose adjustment.

Children under 18 years old

The safety and effectiveness of Telmisartan has not been determined. Recommended use of appropriate cell format when using Telmisartan dose of 20 mg.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Symptoms

The most typical manifestations of Telmisartan overdose are hypotension and tachycardia; Slow heart rate, dizziness, increased serum creatinine, and acute renal failure have also been reported.

Handling

Telmisartan is not eliminated by hemorrhage.

Patients should be closely monitored and treated and supported.

The treatment depends on the time after taken and the severity of the symptoms. Proposal measures include vomiting and/or gastric lavage. Activated carbon can be helpful in treating overdose.

Need to regularly monitor electrolytes in serum and creatinin. If hypotension occurs, patients need to be placed in a lying position, quickly compensate for salt and water.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Telmisartan 40 mg, you may experience unwanted effects (ADR).

Uncommon, 1/1000

Infection and parasitic infection: Upper respiratory infections include sore throat, sinusitis, urinary tract infections including cystitis. face.

heart: Slow heart rate. Conclusion: muscle pain, back pain (such as sciatica), muscle spasms.

Infection and parasitic infection: Blood infection (death). Sleep.

Eye: visual disorders tendon). ADR management

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Telmisartan 40 mg is contraindicated in the following cases:

Hypersensitivity to any component in the formula. ml/minute/1.73 m2).

Precautions when using

pregnancy

The drug should not be started during pregnancy. Unless the continuation of the drug is considered to be necessary, patients who have a plan to become pregnant should turn to replacement hypotension therapy that has been shown to be safe when used during pregnancy.

When diagnosed with pregnancy, it is advisable to stop treating with Angiotensin II receptor antagonists immediately, and if appropriate, the replacement therapy should start.

Hepatic failure

Because Telmisartan is excreted mainly through bile, does not use Telmisartan for patients with cholestasis, bile congestion disorders or severe liver failure. These patients can reduce the clearing of Telmisartan in the liver. Telmisartan should be used for patients with mild to moderate liver failure.

Hypertension caused by kidney disease

Increased risk of severe hypotension and renal failure when patients with narrowed kidney stenosis on both sides or one side are treated with drugs that influence the renin-angiotensin-aldosteron system.

kidney failure and kidney transplant

When using Telmisartan for patients with renal function, periodic monitoring of potassium and serum creatinine should be monitored. No experience using Telmisartan for new kidney transplant patients.

Reducing internal blood capacity

Symptomatic hypotension may occur, especially after the first dose in patients with reduced intravascular volume and/or sodium reduction due to strong diuretic treatment, salt, diarrhea or vomiting. This condition should be treated before using telmisartan.

It is not recommended to simultaneously use ACE inhibitors, Angiotensin II or Aliskiren receptor blockers. If double clutches are considered necessary, only use simultaneously under the supervision of the doctor and regularly monitor the kidney, electrolyte and blood pressure. ACE inhibitors and Angiotensin II receptor blockers should not be used simultaneously in patients with diabetic kidney disease.

Other diseases stimulate the renin-angiotensin-aldosteron system

In patients with vascular tone and renal function depends mainly on the activity of the renin-angiotensin-aldosteron system (such as patients with severe congestive heart failure or kidney disease including kidney stenosis), treatment with other drugs that affect the renin-anidensin-aldosteron system will cause acute blood pressure, hyperkemia, ureter or rarity.

Increasing primary aldosteron

Patients with primary hygiene increase often do not respond to antihypertensive drugs effectively acting through inhibition of the renin-angiotensin system. Therefore, it is not recommended to use Telmisartan for these patients.

Security of mitral valve and aortic valve, hypertrophic heart muscle disease

Similar to other vasodilators, special attention should be paid to patients with patients with aortic stenosis or mitral stenosis or obstructive heart muscle.

Patients with diabetes are treated with insulin or anti -diabetes drugs

Patients with hypoglycemia when treated with Telmisartan. Therefore, in these patients, considering monitoring appropriate blood glucose; Need to adjust insulin dose or anti -diabetes drugs when used simultaneously.

Telmisartan can cause porphyrin metabolism disorders, so they only use when there are no other safer drugs to replace and be cautious in severe hypertension patients.

Hyperbonia

The use of drugs affects the renin -anidensin - aldosteron system that can cause hyperboly.

On the elderly, patients with renal insufficiency, patients with diabetes, patients are treated simultaneously with other drugs that may increase the concentration of potassium and/or other patients with other diseases, increased potassium can cause death.

Before using simultaneously, the drugs affect the renin-ankiotensin-aldosteron system, should evaluate the ratio between treatment benefits and harmful risks.

Main risk factors for hyperkalemia:

Diabetes, kidney failure, age (> 70 years old).

Combined with one or more other medicinal preparations that affect the renin-angiotensin-aldosteron system and/or potassium supplements. Medicinal preparations or medication groups that can cause hyperkalemia are salt-containing substances containing potassium, potassium diuretics, ACE inhibitors, Angiotensin II receptor antagonists, nonsteroidal anti-inflammatory drugs (NSAIDs, including selective inhibitors of COX-2), Heparin, immunosuppressants (cyclosporin or tacrolimus), and and tacrolimus) trimethoprim.

Diseases, especially dehydration, acute cardiac loss, metabolic acidosis, deteriorating kidney function, suddenly worsening the kidney condition (such as infections), cellular cell league (acute ischemic anemia, muscle pilot, prolonged injury). Advice to strict monitoring serum potassium in patients at risk.

Sorbitol: Telmisartan Stella contains sorbitol. This drug should not be used for patients with rare genetic disorders.

Sodium ion: The maximum daily dose of this drug (80mg) contains 3,864 mg of sodium ions (in the form of NaOH). This amount is equivalent to about 0.2% of the maximum amount of sodium ion daily for adults.

Gastric ulcer, duodenum can be active or other stomach disease (increased the risk of stomach - intestinal bleeding).

Mild and medium renal function.

Other caution:

Observations of enzyme inhibitors, Telmisartan and other Angiotensin II receptor antagonists show that the effect of lowering blood pressure seems less effective in black skin patients compared to other skin -colored people, maybe due to the body of black skin hypertension with lower renin levels.

Like any hypertension, excessive decrease in blood pressure in patients with ischemia can lead to myocardial infarction or stroke.

The ability to drive and operate machinery

The drug can cause dizziness or dizziness due to the hypotension effect of Telmisartan, thus being used caution when driving and operating machinery.

Pregnancy

Take the medication in the middle 3 months and the last 3 months of pregnancy can cause damage and even the developing fetus. When detecting pregnancy, Telmisartan must be stopped as soon as possible.

Breastfeeding period

It is unclear whether Telmisartan is excreted in human milk or should not decide to stop breastfeeding or stop taking the drug, need to consider the importance of the drug for the mother.

Medicinal interaction

Digoxin: When Telmisartan is used simultaneously with Digoxinm, the concentration of Digoxin peaks in plasma increases. Digoxin concentration should be monitored to maintain concentration in the therapeutic range at the beginning of treatment, adjust the dose, and stop using Telmisartan.

Medicines that act on the Renin-Anotensin-Ordosteron system are used with Telmisartan that can cause hyperboly hyperply. Some drugs such as salt-containing salt substitutes, potassium diuretics, ACE inhibitors, Angiotensin II receptor antagonists, nonsteroidal anti-inflammatory drugs (NSAIDs, including selective Cox-2 inhibitors), heparin, immunosuppressive drugs (cyclosporin or tacrolimus), and trimethoprim).

There is no recommendation to simultaneously

Potassium diuretic (Spironolacton, Eplerenon, Triamteren or Amilorid) or potassium supplements can lead to significant increase in serum potassium levels. If indicated simultaneously due to hypokalemia, caution should be used carefully and regularly monitor serum potassium concentration.

Lithi: Increasing lithium toxicity with ACE inhibitors and Angiotensin II receptor antagonists, including telmisartan. If you need to use simultaneously, recommend careful monitoring of serum lithium concentration.

Precautions when using simultaneously

Non-steroid anti-inflammatory drugs: NSAID drugs (such as acetylsalicylic acid in the anti-inflammatory regimen, selective inhibitors of COX-2 and non-selective NSAID drugs) can reduce the effect of lowering the blood pressure of Angiotensin II receptor antagonists. In some patients with renal function damage (such as dehydrated patients or elderly patients with renal function damage), simultaneous use of Angiotensin II receptor antagonists and cyclo-olyenase inhibitors can lead to worse renal function impairment, including acute renal failure, but often recover. Therefore, cautious when used simultaneously, especially in the elderly. Patients should be fully rehydrated and should consider monitoring kidney function after starting treatment simultaneously and periodically later.

Diuretics (thiazid diuretics or diuretics): Previous treatment with high -dose dosage drugs such as Furosemid (strap diuretics) and hydrochlorothiazid (thiazid diuretics) can lead to dehydration and increase the risk of excessive blood pressure when starting treatment with Telmisartan.

Note when using simultaneously

Other hypotension drugs: Telmisartan's hypotension increases when used simultaneously with other anti -hypertension drugs. Drugs like Baclofen, Amifostin may increase the hypotension of hypotension drugs including Telmisartan. Moreover, hypotension can be worse due to alcohol, sedative, addictive sleeping pills or antidepressants.

corticosteroid (systemic effect): Reducing hypotension effect.

Storage

In closed packaging. The temperature does not exceed 30 ° C.

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.