Telma 80

Product Overview: Telma 80mg (Telmisartan 80mg)

What it is: Telma 80mg contains Telmisartan, which belongs to the class of drugs known as Angiotensin II Receptor Blockers (ARBs). It works by blocking the action of a natural substance in the body called angiotensin II, which normally causes blood vessels to narrow. By blocking this action, Telmisartan allows blood vessels to relax and widen, leading to lower blood pressure and improved blood flow.

Therapeutic Class: Angiotensin II Receptor Blocker (ARB), Antihypertensive.

Mechanism of Action: Telmisartan selectively blocks the AT1 receptors, which are the main receptors responsible for the harmful effects of angiotensin II, such as vasoconstriction and stimulation of aldosterone release. By preventing angiotensin II from binding to these receptors, Telmisartan achieves:

• Vasodilation: It causes relaxation and widening of blood vessels, reducing peripheral vascular resistance and lowering blood pressure.
• Reduced Aldosterone Secretion: It indirectly reduces the release of aldosterone, a hormone that promotes sodium and water retention, contributing to fluid excretion and blood pressure reduction.
• Organ Protection: Telmisartan has demonstrated significant benefits beyond just blood pressure control, particularly in protecting the kidneys in diabetic patients and reducing the risk of cardiovascular events like stroke and heart attack in high-risk individuals.

Indications (Uses): Telma 80mg is commonly prescribed for:

• Hypertension (High Blood Pressure): It is widely used to treat essential hypertension in adults, either alone or in combination with other antihypertensive agents. Effective blood pressure control is crucial to prevent complications such as heart attack, stroke, and kidney damage.
• Cardiovascular Prevention: Telma 80mg is also indicated for the reduction of cardiovascular morbidity (e.g., heart attack, stroke, and cardiovascular death) in adults with:
  • Atherothrombotic cardiovascular disease (history of coronary heart disease, stroke, or peripheral arterial disease).
  • Type 2 Diabetes Mellitus with documented target organ damage (e.g., kidney problems).
• Heart Failure: It can be used in the management of heart failure, especially in patients who cannot tolerate ACE inhibitors, to improve symptoms and outcomes by reducing the workload on the heart.
• Diabetic Nephropathy: It helps in preserving kidney function in patients with diabetes by reducing proteinuria and slowing the progression of kidney disease.

Dosage and Administration: The dosage of Telma 80mg will be individualized by your doctor based on your specific condition, blood pressure response, and any underlying medical conditions.

• For Hypertension (Adults): The usual starting dose is 40 mg once daily. However, depending on blood pressure response and individual needs, the dose can be adjusted. For some patients, 80 mg once daily might be the required dose. For patients with intravascular volume depletion (e.g., those on high-dose diuretics) or severe liver impairment, a lower initial dose is typically recommended.
• For Cardiovascular Prevention/Diabetic Nephropathy (Adults): The usual recommended dose is 80 mg once daily.
• Administration: Telma 80mg can be taken with or without food. It is generally advised to take it at the same time each day to maintain consistent drug levels and ensure optimal blood pressure control.
• Crucial: Always follow your doctor’s instructions precisely regarding dosage and duration. Do not stop taking Telma 80mg suddenly without consulting your doctor, as this can lead to a rapid increase in blood pressure or worsening of your condition. It does not cure high blood pressure but controls it, so long-term use is often necessary.

Side Effects:

While generally well-tolerated, Telma 80mg can cause side effects.

Common Side Effects (often mild and may decrease over time):

• Dizziness or Lightheadedness: Especially when standing up quickly (orthostatic hypotension), due to the blood pressure-lowering effect. This is more likely when starting the medication or after a dose increase.
• Headache.
• Fatigue or Weakness (Asthenia).
• Diarrhea.
• Back pain.
• Sinusitis / Upper Respiratory Tract Infections (e.g., stuffy nose, sore throat, cold/flu symptoms).
• Hyperkalemia (High Potassium Levels): ARBs can cause potassium retention. Symptoms can include muscle weakness, irregular heartbeat, or numbness/tingling. Regular blood tests are important to monitor potassium levels.
• Nausea.
• Peripheral Edema (swelling in the legs and arms – though less common with Telmisartan alone compared to Amlodipine combinations).

Serious or Less Common Side Effects (seek immediate medical attention if you experience any of these):

• Angioedema: A rare but serious allergic reaction characterized by rapid swelling of the face, lips, tongue, or throat, which can cause difficulty breathing or swallowing. This is a medical emergency.
• Severe Hypotension: An extreme and persistent drop in blood pressure leading to fainting, severe dizziness, or confusion.
• Kidney Failure or Significant Worsening of Kidney Function: Especially in individuals with pre-existing kidney problems or bilateral renal artery stenosis. Symptoms might include decreased urine output, swelling of the feet/ankles, or unusual tiredness.
• Liver Problems (Hepatitis): Very rare, but symptoms like yellowing of the skin or eyes (jaundice), dark urine, or persistent nausea/vomiting may indicate liver issues.
• Sepsis (Blood Poisoning): Very rare, but serious.
• Severe Electrolyte Disturbances: (beyond mild hyperkalemia), leading to severe muscle weakness, irregular heartbeat, or seizures.

Precautions:

Before taking Telma 80mg, provide your doctor with your complete medical history and a list of all medications you are currently taking.

• Allergies: Do not take Telma 80mg if you have a known allergy to Telmisartan or any other component of the drug. A history of angioedema related to ACE inhibitor therapy is also generally a contraindication for ARBs.
• Pregnancy: Telma 80mg (and other ARBs) is contraindicated during pregnancy, especially in the second and third trimesters, as it can cause serious harm or death to the developing fetus. If pregnancy is detected, Telma should be discontinued as soon as possible.
• Breastfeeding: Telmisartan is excreted in breast milk. It is generally not recommended during breastfeeding. Discuss the risks and benefits with your doctor.
• Kidney Impairment: Use with caution. The dosage may need to be adjusted. It is not recommended for severe kidney problems. Close monitoring of kidney function (creatinine, GFR) and potassium levels is essential.
• Liver Impairment: Use with caution. It is contraindicated in severe liver impairment (e.g., cholestasis or biliary obstruction).
• Diabetes: Close monitoring of blood glucose levels is necessary. Concomitant use with aliskiren (another blood pressure medication) is contraindicated in diabetic patients with renal impairment (GFR < 60 mL/min).
• Volume Depletion: Patients who are volume-depleted (e.g., due to high-dose diuretics, excessive vomiting, or diarrhea) are at a higher risk of experiencing significant low blood pressure (hypotension) with the first dose. This condition should be corrected before starting Telma, or a lower initial dose should be considered.
• Bilateral Renal Artery Stenosis: Use with caution, as ARBs can potentially worsen kidney function in these patients.
• Electrolyte Monitoring: Regular blood tests are crucial to monitor potassium, sodium, and other electrolyte levels, especially when initiating treatment or changing doses.
• Driving and Operating Machinery: Telma 80mg may cause dizziness, drowsiness, or blurred vision. Avoid driving or operating heavy machinery until you know how the medication affects you.
• Alcohol Consumption: Avoid or significantly limit alcohol intake while taking Telma 80mg, as it can dangerously enhance the blood pressure-lowering effect and increase drowsiness and dizziness.
• Dietary Potassium: Avoid potassium supplements, potassium-containing salt substitutes, or excessive intake of potassium-rich foods unless specifically advised by your doctor, due to the risk of hyperkalemia.
• Other Medications: Inform your doctor about all prescription, over-the-counter drugs, herbal remedies, and supplements you are taking. Significant interactions can occur with:
  • Aliskiren: Dangerously increased risk of severe hypotension, hyperkalemia, and renal impairment, especially in diabetes or kidney problems.
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs – e.g., ibuprofen, naproxen, aspirin): Can reduce the blood pressure-lowering effect of Telmisartan and increase the risk of kidney problems and hyperkalemia.
  • Potassium-Sparing Diuretics (e.g., spironolactone, amiloride, triamterene), Potassium Supplements, or Potassium-Containing Salt Substitutes: Greatly increased risk of severe hyperkalemia.
  • Lithium: May increase serum lithium levels and toxicity. Lithium levels must be closely monitored.
  • Digoxin: May increase digoxin levels.
  • Other Antihypertensives: Can lead to an additive blood pressure-lowering effect, increasing the risk of severe hypotension.
• Surgery: Inform your surgeon or anesthesiologist that you are taking Telma 80mg before any surgical procedures.

Prescriptions:

Telma 80mg is a prescription-only medication. It can only be obtained with a valid prescription from a licensed healthcare professional. In Nepal, it is widely available and manufactured by Glenmark Pharmaceuticals Ltd.

When prescribing Telma 80mg, your doctor will:

• Conduct a thorough assessment of your blood pressure and overall cardiovascular health.
• Review your complete medical history, including any pre-existing conditions like kidney or liver problems, diabetes, or allergies.
• Consider all other medications you are currently taking to identify potential drug interactions.
• Determine the appropriate starting dose and may adjust it based on your blood pressure response and tolerance.
• Provide clear instructions on how to take the medication, including any dietary considerations.
• Schedule regular follow-up appointments to monitor your blood pressure, kidney function, and electrolyte levels (especially potassium), as these are crucial for safe and effective treatment.

It is essential for you as a patient to:

• Take the medication exactly as prescribed. Do not alter the dose or stop taking it suddenly without consulting your doctor.
• Attend all scheduled follow-up appointments and blood tests.
• Report any new or worsening symptoms or side effects to your doctor promptly.
• Adhere to any lifestyle modifications (e.g., a low-sodium diet, regular exercise, weight management, smoking cessation) advised by your doctor, as these are integral to managing high blood pressure and cardiovascular risk effectively.

Always consult your healthcare provider for personalized medical advice regarding Telma 80mg or any other medication.