Reviewed by Ashley Robinson, PharmD, Pharmacy Manager for TelyRx
Telmisartan is a prescription medication used to treat high blood pressure (hypertension). It’s also used to reduce the risk of heart attack, stroke, or death in patients 55 years of age or older who have a history of heart problems and are unable to take ACE inhibitors.
Telmisartan belongs to a class of drugs known as angiotensin II receptor blockers (ARBs). It is taken by mouth once daily. Common side effects include back or leg pain, stuffy nose, diarrhea, and skin ulcers.
Telmisartan is an angiotensin II receptor blocker (ARB). It works by blocking the receptors in the body that normally bind to a substance called angiotensin II.
Angiotensin II is a hormone that causes the blood vessels to narrow or constrict. When this hormone binds to its receptors, blood pressure rises, forcing the heart to work harder to pump blood throughout the body.
By blocking these receptors, telmisartan prevents angiotensin II from constricting the vessels. This allows the blood vessels to relax and widen, facilitating smoother blood flow, lowering blood pressure, and making it easier for the heart to pump.
| Common Brands | Micardis |
| Drug Class | Angiotensin II receptor blocker (ARB) |
| Generic Status | Generic for Micardis |
| Availability | Prescription only |
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs.
Telmisartan is an oral tablet available in dosage strengths of 20 mg, 40 mg, and 80 mg. It is typically taken by mouth once daily. The recommended dose depends on what you’re taking telmisartan for.
Always follow your healthcare provider’s instructions for exact dosing.
Telmisartan is FDA-approved for:
You may see telmisartan prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
Telmisartan may be prescribed off-label to slow the worsening of kidney problems in people with type 2 diabetes and high blood pressure.
Like all medications, telmisartan can cause side effects. Some common side effects may improve over time as your body adjusts to the medication. Other side effects may be serious and require medical attention.
Serious side effects are rare, but it’s important to know what to look for if they do occur. Stop using telmisartan and call your doctor immediately if you experience:
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Telmisartan can interact with other medications, potentially altering their effectiveness or increasing the risk of side effects. For example:
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
Why is telmisartan considered better than losartan for 24-hour blood pressure control?
Both losartan and telmisartan are ARBs, but telmisartan’s longer half-life can provide more consistent blood pressure management over a 24-hour period.
Is it better to take telmisartan in the morning or at night?
You should take telmisartan as directed by your doctor. Some providers may suggest a specific time based on when your blood pressure is highest, while others may simply recommend taking it at the same time every day to establish a routine.
Does telmisartan cause erectile dysfunction?
Reports of erectile dysfunction (ED) are very rare among people taking telmisartan. Talk to your healthcare provider if you experience ED while taking telmisartan.
Can I drink alcohol while taking telmisartan?
It is unknown if alcohol interacts with telmisartan itself, but drinking alcohol may increase the risk of dizziness and low blood pressure — both possible side effects of telmisartan.
Does telmisartan cause hair loss?
Telmisartan is not known to cause hair loss. If you experience hair loss while taking telmisartan, it is recommended to consult your healthcare provider to investigate other potential causes.
Does telmisartan interact with ibuprofen or other NSAIDs?
Yes. NSAIDs, such as ibuprofen, aspirin, and naproxen, can interact with telmisartan. Taking them together may reduce the blood pressure-lowering effect or increase the risk of kidney problems.
How long does it take for telmisartan to start working?
The medication can begin to lower blood pressure approximately 3 hours after a dose. However, it often takes up to 2 weeks to see a noticeable drop, and up to 4 weeks (one month) to experience maximum benefits.
Why does telmisartan sometimes come in a blister pack instead of a bottle?
Telmisartan tablets are sensitive to environmental factors. It’s recommended not to remove the tablets from the blister packs until you are ready to take them, which helps protect the medication from moisture.
What happens if I miss a dose of telmisartan?
If you miss a dose of telmisartan, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed one and continue with your regular schedule. Do not double up or take extra doses to make up for the missed one.
Can telmisartan cause anxiety or insomnia?
Anxiety and insomnia are not listed as common side effects of telmisartan. However, nervousness can be a less common side effect. If you experience mood changes, consult your provider.
Is telmisartan a beta-blocker or a diuretic?
Telmisartan is neither a beta-blocker nor a diuretic. It is an angiotensin II receptor blocker (ARB). While beta-blockers slow the heart rate and diuretics help remove fluid, ARBs work by relaxing blood vessels.
What is the difference between Telmisartan and Losartan?
Both telmisartan and losartan are ARBs used for high blood pressure. However, telmisartan is additionally approved for reducing cardiovascular risk in patients aged 55+ with heart problems, while losartan is also approved to lower stroke risk in patients with a thickened heart (left ventricular hypertrophy) and to protect kidneys in people with type 2 diabetes.
There are several medications that your doctor can prescribe in place of telmisartan. Here are a few possible alternatives below.
Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with board-certified licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions.
