Telmisartan — NZ Medication Guide

What is Telmisartan?

Telmisartan is an angiotensin II receptor blocker (ARB) used for the treatment of hypertension and cardiovascular risk reduction. This medication is commonly prescribed in New Zealand and is funded by Pharmac for hypertension.

What is Telmisartan Used For?

Telmisartan is used for hypertension (high blood pressure) and to reduce cardiovascular events (heart attack and stroke) in patients at high cardiovascular risk who are intolerant of ACE inhibitors.

How Does Telmisartan Work?

Telmisartan selectively blocks the angiotensin II type 1 (AT1) receptor, preventing angiotensin II from causing vasoconstriction, sodium retention, and aldosterone release. This results in vasodilation and reduced blood pressure. Unlike ACE inhibitors, it does not inhibit bradykinin breakdown, so it does not cause a cough.

How to Take Telmisartan

Taken once daily, with or without food. Standard doses are 40–80 mg daily. Blood pressure and renal function should be monitored when starting or adjusting therapy. Telmisartan has one of the longest half-lives of all ARBs, providing sustained 24-hour blood pressure control.

Common Side Effects of Telmisartan

  • Dizziness
  • Headache
  • Back pain
  • Upper respiratory tract infections
  • Fatigue
  • Elevated potassium (hyperkalaemia)

Serious Side Effects — Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

  • Angioedema (less common than with ACE inhibitors but can occur — seek emergency care)
  • Severe hyperkalaemia
  • Acute kidney injury
  • Severe hypotension (especially in volume-depleted patients)

Drug Interactions

Telmisartan may interact with other medicines. Always inform your doctor and pharmacist of all medications, supplements, and herbal products you are taking. Key interactions include:

  • Potassium-sparing diuretics and potassium supplements (hyperkalaemia risk)
  • NSAIDs (reduced antihypertensive effect and renal risk)
  • Lithium (increased lithium levels)
  • Digoxin (telmisartan may increase digoxin levels)
  • ACE inhibitors (avoid combination)

New Zealand Prescribing Information

Telmisartan is funded by Pharmac and available in New Zealand as 40 mg and 80 mg tablets. It is often preferred over ACE inhibitors in patients who develop an ACE inhibitor-associated cough. It is also available in combination with hydrochlorothiazide (Micardis Plus®) for patients requiring dual therapy.

Frequently Asked Questions

Is telmisartan safe in kidney disease?

Telmisartan can be used in mild to moderate chronic kidney disease (CKD) and may be renoprotective — particularly in diabetic nephropathy. However, it is contraindicated in severe renal impairment and in patients with bilateral renal artery stenosis. Regular monitoring of kidney function and potassium is essential.

Can I take telmisartan with ibuprofen?

NSAIDs like ibuprofen should be avoided with telmisartan where possible, as they reduce its blood pressure-lowering effect and may impair kidney function. Use paracetamol for pain relief instead, and consult your pharmacist or doctor if you regularly need anti-inflammatory medicines.

Reviewed by a Registered Pharmacist NZ

References & Further Information

The following New Zealand and international resources were used to inform this page:

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